ONC has ideas for reducing clinician burden with health IT
Advancements in healthcare information technology have driven progress but also introduced new challenges for providers, say two officials in the Office of the National Coordinator for Health IT.
"As adoption of health IT has increased, we have seen firsthand how usability issues associated with the underlying software, implementation choices made by practices and institutions, and lack of effective training can diminish the desired impact of health IT use," wrote ONC Chief Clinical Officer Dr. Andrew Gettinger and Chief Scientist Teresa Zayas Cabán in a blog post this past week.
"Rectifying these issues requires coordinated attention to improved design of health IT systems, better system configuration decisions, and effective end-user training during implementation," they said.
WHY IT MATTERS
Health IT's role in clinician burnout has been a hot-button topic for years, with individuals often pointing to technology such as electronic health records as the culprit.
But as Gettinger and Zayas Cabán note in their blog – and in a corresponding Journal of the American Medical Informatics Association article published this past month – IT has the potential to be an asset rather than an obstacle.
"We need to continue to build on current efforts to improve user-centered design and use of human factors and ergonomics in design and implementation of health IT," wrote the officials in that article.
They cite a report published last year identifying four areas that need to be addressed in order to improve health IT usability:
- Better alignment of EHRs with clinical workflow
- Optimized user interface design
- Harmonized clinical content
- Promotion of implementation decisions for clinician efficacy, satisfaction and lower burden
They also note that ONC has "led the charge" in understanding usability issues: developing tools, implementing regulations and advancing the national conversation. In addition, they say, ONC funded research to examine efficacy of user-centered design policies and resource development to support practices and hospitals.
"In addition, ONC worked collaboratively with CMS to inform their efforts to reduce burden related to health IT-associated documentation requirements, which CMS is implementing under its Patients over Paperwork initiative," wrote Gettinger and Zayas Cabán.
Looking ahead, the ONC officials say improving user-centered design will become increasingly important as the Cures Act rules are implemented.
"Health IT developers should make design decisions based on a robust understanding of clinician’s cognitive and workflow needs, and providers should make configuration decisions with an understanding of their impact on usability and use of the systems," they said.
In the coming year, the agency will continue to address usability challenges and to collaborate with CMS and other federal partners in reducing health IT-related documentation requirements that add to clinician burden.
"We at ONC look forward to doing our part in advancing the field through policy and technical development and by continuing to engage the broad community of health IT stakeholders," the JAMIA article reads.
THE LARGER TREND
A recently published JAMIA study found that experts underestimated EHRs' impact on burnout after the passage of the HITECH Act, noting that the "magnitude of the current burnout crisis" was largely unseen a decade ago.
Patient workload, shifting information and general fear have all contributed to feelings of stress and anxiety.
ON THE RECORD
"The assessment that 'every system is perfectly designed to get the result observed' can be applied to health IT," wrote Gettinger and Zayas Cabán in the JAMIA article.
"We should work toward a future state where all clinicians feel that their health IT is so essential to their practice that they cannot provide care without it," they continued.