Holistic Approaches to Tackling EHR Usability Challenges

Key Takeaways

• The SUS (System Usability Scale) tool is used to measure EHR usability. This tool consists of 10 questions with five response options for respondents, ranging from strongly agree to strongly disagree.
• Current EHRs create tension between structured and unstructured data that physicians believe degrades the quality of clinical care narrative. So, to enhance EHR usability developers focus on EHRs that provide context-sensitive, concise, and real-time data.
• Poor EHR usability interferes with face-to-face communication, needs more time documenting patient encounters, and is slow in accessing patient information.

EHR usability defines how easy and satisfactory a solution is for healthcare providers and patients. The HIMSS (Healthcare Information and Management Systems Society) defines EHR usability as the effectiveness, efficiency, and satisfaction with which users can accomplish tasks. Aspects such as patient safety, productivity, clinician burnout, clinician satisfaction, and profitability, all are impacted by EHR usability. It is a necessary aspect to improve EHR in all aspects and optimize it for better workflow.

Research stated that nurses who worked in hospitals with poor EHR usability had higher odds of burnout, intention to leave, and job dissatisfaction compared to nurses who worked in hospitals with better EHR usability. This article highlights tools, benefits, and challenges of EHR usability.

Tool to Measure EHR Usability

The SUS (System Usability Scale) tool is used to measure EHR usability. This tool consists of 10 questions with five response options for respondents, ranging from strongly agree to strongly disagree. The SUS tool was created by John Brooke in 1986, and can also be used to evaluate other services and products such as hardware, software, websites, and applications.

SUS is a reliable tool because it can be used for small sizes and get accurate results. Further, it can easily differentiate between usable and unusable EHR systems.

Considerations for using SUS include:

1. It has a complex scoring system.
2. The best way to interpret the scores is to normalize them and produce a percentile ranking.
3. It is not a diagnostic tool, rather is used to check the ease-of-use of EHR systems.

Usability.gov mentions certain questions that respondents are asked to answer and rate them from strongly agree to strongly disagree. These questions include:

1. I think that I would like to use this system frequently.
2. I found the system unnecessarily complex.
3. I thought the system was easy to use.
4. I think that I would need the support of a technical person to be able to use this system.
5. I found the various functions in this system were well integrated.
6. I thought there was too much inconsistency in this system.
7. I would imagine that most people would learn to use this system very quickly.
8. I found the system very cumbersome to use.
9. I felt very confident using the system.
10. I needed to learn a lot of things before I could get going with this system.

Once the questions are answered, they are interpreted. Every participant’s score is converted to a number, added together, and then multiplied by 2.5, to convert the original score of 0 to 40 to 0 to 100. The scores are not in percentage but should be considered only in their percentile rankings. As per a study, scores above 68 are considered above average. Further, the best way to interpret results is to normalize them and convert them into percentile ranking.

Top EHR Usability Challenges and their Solutions

1. Cognitive Workload

Today’s electronic health records focus on data collection and not on data synthesis at the patient level. Current data synthesis methods are neither patient nor context-specific. So, the lack of awareness of context can lead to frequent administrative and clinical reminders that may force physicians to make hard-stops even for non-urgent matters, thus physician workflow is interrupted.

Furthermore, current EHRs create tension between structured and unstructured data that physicians believe degrades the quality of the clinical care narrative. So, the tension compels healthcare providers to enter data without regard to value. The comprehensive workload of thinking, reading, writing, and navigating in the EHRs is not balanced.

The solution for cognitive workload is that developers can build EHRs that provide context-sensitive, concise, and real-time data that is uncluttered. EHR can be made to manage the information flow and adjust user preferences and context. Preferences can consist of how reminders are presented and whether an action is required on them. Moreover, workflow, data entry, and representation flexibility can also help with the cognitive workload issue.

2. Inability to Provide High-Quality Care

Current EHRs prevent physicians from ensuring high-quality care because they take significant time from physicians and prevent them from spending enough time with patients. Poor EHR usability interferes with face-to-face communication, needs more time documenting patient encounters, and is slow in accessing patient information. All of these aspects prevent physicians from offering high-quality care to patients.

The solution for this is that EHR development companies can focus on creating EHRs that seamlessly fit into the practice and not distract physicians from their work. Awareness about clinical operations, workflow considerations, documentation, and attention to team-based care can help to create an EHR with better usability and tackle the issue of high-quality care.

3. Care Coordination

Care coordination and transition has always been a major challenge for delivering efficient care. While technology is expected to improve care coordination, there is still a lack of usability and interoperability, including insufficient care transitions between teams.

The solution is to improve EHR usability to a standard that automatically tracks consultations and referrals actively and follow patients’ progress throughout the care routine. The same approach can be used for checking whether lab results have been conveyed to patients or not, and whether prescriptions are refilled or not. With enhanced EHR usability, providers can track patient care to avoid information chaos and overload.

EHR software is loaded with multiple features and functionalities that are not only user-friendly but also convenient for remote care. EHR software can be a game changer for clinics and hospitals as it builds seamless data exchange and ensures the security and privacy of patient data.

If you’re looking for an EHR system that offers you exceptional features, great usability, and compliance, then connect with Arkenea, a leading healthcare software development company that builds and delivers state-of-the-art healthcare software.