Could better EHR and CDS design mean better outcomes?

'Thoughtful systems engineering approaches' could be key to quality
By Mike Miliard
10:53 AM
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A new report looking at EHR usability and clinical decision support draws upon AHRQ research to explore ways improved health IT interfaces -- websites, apps, dashboards -- can lead to better patient care.

It's "promising that electronic health records and clinical decision support tools are rapidly being implemented in hospitals and clinics nationwide," writes Thomas McGinn, MD, chair of medicine at Hofstra North Shore-LIJ School of Medicine, in the study's introduction.

Nevertheless, "implementing EHR and CDS tools into complex healthcare systems and clinical workflow continues to be challenging," he adds. Poor integration runs the risk of "substantially reducing adoption and use."

Thankfully, there have been some substantial recent pushes to think a bit more closely about the clinical users of these technologies.

"It is believed that thoughtful systems engineering approaches, including consideration of user experience and improvements in user interface, can greatly improve the ability of CDS tools to reach their potential to improve quality of care and patient outcomes," writes McGinn.

Access the report at eGEMs (it stands for Generating Evidence & Methods to improve patient outcomes), a peer-reviewed, open access journal of the EDM Forum, which launched in 2013 to accelerate research and quality improvement using electronic health data.

Exploring topics such as UX and system redesign, EHR-based visualization tools and integration patient-reported data, the multi-part study aims to spur some rethinking about the ways EHR decision support is presented to clinicians.

"All of the articles in this issue explore, in some fashion, CDS systems and how we can best bring providers and their work environment to the evidence," McGinn writes. "We are at the very early stages of the science of usability. Much more research and funding is needed in this area if we hope to improve the dissemination and implementation of evidence in practice."

See also:

Clinical decision support: No longer just a nice-to-have

When EHR design is a 'what not to do'

How one hospital tweaks its EHR to fight alert fatigue