I have posted previous notes on the usability of EMRs, particularly by physicians (see: "Usability Failures" of EMRs Frustate Physician Users; EMR Failures and a Recipe for Their Avoidance in the Future; Why Many Clinicians Dislike Their EMRs). It's a worthwhile area for inquiry and, apparently, the National Institute of Standards and Technology (NIST) will be looking into this matter (see: NIST to test EHR usability). Below is an excerpt from the article:
The National Institute of Standards and Technology has decided to tackle the problem of poor electronic health record usability, asking EHR vendors to share their products with the agency so it can research how they work, according to an iHealthBeat report. According to NIST's Federal Register notice, the agency plans to conduct research designed to develop a set of guidelines/ standards for usability of EHRs and develop a framework for assessing their "performance oriented" usability. NIST also may examine the EHR systems' relevant instructions, documentation and error messages. It will release its findings in a report. NIST estimates that it will take a year to conduct the research, and vendors can't make modifications to products being researched during that time. The agency does assure vendors that it will keep the EHRs protected, applying the same high security measures in place in its main headquarters in Gaithersburg, Md., even if testing is performed off-site. NIST will not accept personal health information for this project. It will report any usability problems to the vendor. This is not the first time that NIST, which has a keen interest in EHRs, has expressed concern about EHRs' usability. In a 108-page report released last fall, NIST noted that EHR usability was "critical" but that EHRs were harder to use than they should be. The report called for further studies to assess the problem and recommended that a usability protocol be developed for the products.
For me, a key aspect of current EMR usability is the fact that some hospitals are employing EMR scribes to enter clinical data dictated by physicians and nurses into workstations (see: The Emergence of EMR Scribes as a New Category of Hospital Employees). I can't help making the comparison between this situation and that of, say, engineers for whom their computers are key productivity tools. I would hazard a guess that there is no such thing as scribes working for engineering firms to input computer data for these engineers. Why this difference between the hospital and engineering environments? The difference is that many hospital physicians do not view the EMR as a useful productivity tool that helps them care for patients. Although EMR vendors now seem to be stressing system usability (see: EMR vendors stress usability to attract physicians), I am not sure that this factor, in and of itself, will be sufficient to gain the confidence of physician users.
Put me down as being pessimistic about whether a NIST report will have any effect on the design of the EMRs, either now or in the future. I am, in part, influenced by the last two sentences of the above article. The previous 108-page NIST report released last fall called for "further studies" and recommended that a "usability protocol" be developed. Nothing will happen until hospital executives start complaining about the quality of EMRs and demanding that they be changed in some way. Even then, these products are large and complex pieces of software. Anything but cosmetic changes will be difficult to implement.