Clinical Information Systems Usability Discussion Topics

Rasu B. Shrestha, MD MBA, Vice President of Medical Information Technology at University of Pittsburgh Medical Center

Rasu B. Shrestha, MD MBA, Vice President of Medical Information Technology at
University of Pittsburgh Medical Center

As a clinician, I find that usability around clinical information systems is challenging at best, and otherwise horribly inefficient and fraught with risks. It seems we as a healthcare IT community have learned to tolerate these usability challenges.

Often, clinicians find themselves playing more of a role of a detective than a clinician, as they hunt for information, navigate through a sea of applications, tabs and folders. We are seemingly functioning in an environment where we are data rich and information poor.

The basic clinical data management problem is that existing clinical information systems are still using antiquated user interfaces with variable reporting formats that display results as incomplete, hard to read, fragmented data. The challenges of usability have their roots in the lack of data interoperability and the challenges of data standards around medications, labs, problems, etc. Clinical information systems also lack adherence to basic design principles and seem to be clunky and antiquated.

The definition of usability as referenced in the 2009 HIMSS usability primer is as follows:

Usability is the effectiveness, efficiency and satisfaction with which specific users can achieve a specific set of tasks in a particular environment. In essence, a system with good usability is easy to use and effective. It is intuitive, forgiving of mistakes and allows one to perform necessary tasks quickly, efficiently, and with a minimum of mental effort. Tasks which can be performed by the software (such as data retrieval, organization, summary, cross‐checking, calculating, etc.) are done in the background, improving accuracy and freeing up the user’s cognitive resources for other tasks.

As the healthcare IT community continues to move from analog to digital, it is critical for us to focus on usability. It is not merely enough to replicate paper-based workflows with clinical information systems, it is critical for us to bring our patient’s stories to life in a visually rich, contextually relevant, highly usable format.

Better usability could mean efficient, safer, higher quality, better coordinated care, and should be a goal for every EMR vendor, developer, designer, programmer and clinical informatician.

Let’s discuss usability here in the comments and also during Friday’s #HITsm TweetChat.

  1. We are data rich and information poor. Are data interoperability, analytics and better system designs the answers?
  2. Can Meaningful Use actually help enable better clinical information system usability?
  3. Will EMRs continue to evolve and embrace newer technologies such as cloud and Web 2.0?
  4. Care coordination, collaboration and communication are key in clinical care. What’s missing? How do we refine this?
  5. Will we see better usability with embracing of mobility in healthcare? What are the challenges? Opportunities?

Rasu B. Shrestha, MD, MBA

Dr. Rasu B. Shrestha is vice president of medical information technology at University of Pittsburgh Medical Center.

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