CMS chief medical officer: We must develop new skills for EHR usability and human-centered design
The Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT offered a glimpse at behind-the-scenes work they are doing together to reduce the burden EHRs place on doctors, nurses and other technicians as well as working to eliminate physician burnout.
“One of the first things we said is ‘this cannot be PQRS 2.0 or meaningful use 2.0,’” CMS director and chief medical officer Kate Goodrich said Thursday during an ONC panel discussion.
That’s 2.0 as in the Web 2.0 vernacular, for the record, and not to be confused with meaningful use Stage 2.
Goodrich noted, for instance, that her team is working to achieve a more customer or user-centric design approach in the development of everything from the website on, including backend IT operations, policy development, communications and a new service center.
“We at CMS had to develop some new skills,” Goodrich said. “One of the skills that we have been developing over the past two years is human-centered design. We are trying very hard to spread those skills across the agency for everything we do from survey and certification to quality improvement, to value based purchasing.”
ONC Chief Medical Officer Thomas Mason, MD, works with Goodrich’s team exploring ways to decrease both administrative and regulatory burden caused by today’s crop of electronic health records.
As a part of the ONC certification program, health IT developers that certify to the 2015 edition EHRs are required to use a user-centered design process for the development and the testing of their software. Also, safety enhanced or user-centered design criteria were built into the certified health IT product list
The developer community is working to incorporate the human- centered design elements into the software development process, he said.
Mason pointed out that there are a number of design decisions that occur during the EHR implementation process that significantly impact both usability and safety. ONC conducted an environmental scan, literature review and gathered input from the clinical community on what are these issues and challenges around usability.
Mason pointed to AMAs STEPS Forward initiative as one example.
“We incorporated the AMA's STEPS Forward modules. These are practice transformation modules that are designed to help clinicians with strategies and steps to improve practice efficiency as well as help practices achieve the quadruple aim,” Mason said. “There is a wealth of resources and tools to help with workflow and techniques and strategies around a variety of care settings that are very helpful.”
CMS and ONC shared these insights at the ONC Annual Meeting, Nov. 30 to Dec. 1 in Washington DC.