Calls for design overhaul to boost usability

AMA presses for better EHRs

By Bernie Monegain
07:55 AM
AMA President-elect Steven J. Stack, MD

The American Medical Association, which represents more than 200,000 members, says its time to fix poorly designed EHRs so doctors can use them more effectively and better serve their patients.

The demand follows an AMA study with RAND Corp. confirming that physician frustration with EHRs is taking a significant toll not only on them, but also on their patients.

Calling the need for better EHR design "urgent," the AMA on Tuesday released a new framework outlining eight priorities for improving EHR usability to benefit caregivers and patients.

"Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work," AMA President-elect Steven J. Stack, MD, said in announcing the initiative. "This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients."

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Among physician concerns that the AMA highlighted is that EHRs are cumbersome, requiring too much time-consuming data entry, which leaves less time for patients.
 
Other studies support the findings, the AMA points out, including a recent survey by International Data Corporation that found 58 percent of ambulatory physicians were not satisfied with their EHR technology, "most office-based providers find themselves at lower productivity levels than before the implementation of their EHR" and that "workflow, usability, productivity, and vendor quality issues continue to drive dissatisfaction."

"Now is the time to recognize that requiring electronic health records to be all things to all people – regulators, payers, auditors and lawyers – diminishes the ability of the technology to perform the most critical function – helping physicians care for their patients,” Stack said in a press statement. "Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus."

The AMA framework outlines the following usability priorities along with related challenges:

  • Enhance physicians' ability to provide high-quality patient care
  • Support team-based care
  • Promote care coordination
  • Offer product modularity and configurability
  • Reduce cognitive workload
  • Promote data liquidity
  • Facilitate digital and mobile patient engagement
  • Expedite user input into product design and post-implementation feedback

The priorities were developed with the support of an external advisory committee composed of practicing physicians, as well as noted experts, researchers and executives in the field of health information technology, AMA stated.

[See also: 5 health IT insiders offer their takes on EHR usability.]

The AMA notes that despite numerous usability issues, physicians are mandated to use certified EHR technology to participate in the federal government’s EHR incentive programs.

"Unfortunately, the very incentives intended to drive widespread EHR adoption have exacerbated and, in some instances, directly caused usability issues," the organization states in a news release. "The AMA has called for the federal government to acknowledge the challenges physicians face and abandon the all-or-nothing approach for meeting meaningful use standards. Moreover, federal certification criteria for EHRs need to allow vendors to better focus on the clinical needs of their physician customers."