Virtual Conference session touts paper and pencils for EMR design

By Mike Miliard
01:39 PM

Earlier this month, the Agency for Healthcare Research and Quality (AHRQ) released a report about the usability of electronic medical records that emphasized the importance of appealing but utilitarian design in the quest to make EMRs that are easier – and thus safer – to use.

"By not identifying critical usability issues through a wide range of user testing during design and development," the report read, "vendors are opening the door to potential patient safety incidents and costly post-release fixes."

At Wednesday's online session, "Usability Methods to Improve EMRs," offered as part of the HIMSS Virtual Conference and Expo, Jeffery Belden, MD, a physician with the department of family and community medicine at the University of Missouri, and Janey Barnes, the human factors specialist at User-View Inc., presented a detailed and user-focused design process for organizations developing EMRs.

"Don't forget the buyer's side of usability," were Belden's marching orders, as he led attendees through the stages of efficacious EMR design and development, from initial note-taking and information gathering, through brainstorming and storyboarding, to beta testing, launching and beyond.

Understanding the end-user's tasks is critical, said Belden, recommending that EMR makers make one or more on-site visits to observe physicians and clinicians at work. Make special note of the "workflow and environment of the users," Belden said, "specify how users carry out their tasks in a specific process."

Perhaps ironically for an industry that seeks nothing less than the wholesale replacement of paper-based health records, Belden said designers should make generous use of paper, and that "pencil works just fine."

Because sketches, note cards and sticky notes are perfect vehicles for brainstorming screen design, he said – easily grouped and regrouped and clustered and rearranged again.

"Paper is cheap and quick," said Belden. And card sorting "aids information design," allowing the EMR developers a spontaneous way to work through the finding of "latent structures in an unsorted group of ideas."

Having surveyed physicians and surmised their workplace wants and needs, Belden says designers should then rank those necessary and/or desirable features and functions, and then use the fungibility of notecards and a bulletin board to move various components around, helping them discover "users' mental model" and hopefully arriving at an optimal design.

Because in the end, added Barnes later, visual design is "not just about pretty colors." It's about "communicating information organization and priority."

For electronic health records, that means making technology that's easy and appealing for doctors, nurses and clinicians to use – and, in turn, translates into better outcomes for patients.

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The new Tift Regional Medical Center expansion will open in the fall of 2021 in Tifton, Georgia. The 263,000-square-foot, four-story tower will include a new emergency center, inpatient units and new ICU. (Credit: Tift Regional Medical Center)

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