Reflections on EHRA, Past and Future

By Mark Segal, PhD, FHIMSS

Mark Segal Morocco

Mark Segal welcomed ‘retirement’ by exploring Morocco with his son.

Late in 2017, I left GE Healthcare via an early “retirement” opportunity. Retirement is in quotes but that is a story for another day; suffice it to say that I intend to remain active in the digital health policy world.

One of the biggest changes with my departure from GE is that I also left the EHRA Executive Committee, on which I had served in both elected and ex officio capacity for years. This was a double whammy of many fewer conference calls per day.

My involvement with EHRA, wearing many hats, has been one of the most important and satisfying aspects of my professional life. Read the full post »

Don’t Create a Certification Ceiling

By Sasha TerMaat


Certification blog quoteAt the end of November 2017, JAMIA published the article,
“Are all certified EHRs created equal? Assessing the relationship between EHR vendor and hospital meaningful use performance.” The authors, A Jay Holmgren, Julia Adler-Milstein, and Jeffrey McCullough, performed a statistical analysis of publicly available data sets on Meaningful Use EHR Incentive Program performance, stratifying based on the developer of the EHR product used by the Meaningful Use participant.

It’s wonderful to see the data sets published by CMS and ONC used for insightful research. I know from personal experience doing data analysis of CMS and ONC published data sets that a lot of effort goes into data normalization, and the authors took a thoughtful and careful approach.

However, I was surprised by the authors’ conclusions and policy recommendations at the close of the article. Having found EHR developer-correlated variability in performance on certain activities measured in the Meaningful Use incentive program, the authors state that is undesirable, and write recommendations to standardize. The authors say, “Our results suggest that policy-makers should pursue modifications to the EHR certification process to decrease such variation across EHR vendors and improve EHR systems.” Read the full post »

FDA Health IT Guidance Is A Good Start, But More Clarity Is Needed

By Shari Medina, MD

This month, the FDA issued long-awaited guidelines EHR tablet graphicon the agency’s implementation of the 21st Century Cures Act in regards to Clinical Decision Support and the FDA’s intent to exercise enforcement discretion for many types of patient-facing software, mobile applications, and software which have not obtained ONC certification.
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How Consistency in EHR Design Can Contribute to Patient Safety

By Emily Richmond and Tammy Coutts, Chair and Vice Chair, EHRA Clinician Experience Workgroup

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Anyone who switches frequently between a Mac and a PC knows the pain of inconsistency. The OK and Cancel buttons are in different places, the menus are in different locations, and there are even differences in the way you close a screen or program. These inconsistencies, while seemingly trivial, can contribute to a user’s “cognitive load,” which is the thing that makes you feel fuzzy and slow when you’re navigating a screen that doesn’t fit your mental model.

As system designers, electronic health record (EHR) developers operate in the same way as the designers of other systems–they work closely with users to understand their needs and the context of their use, and they strive to create designs that are straightforward, simple to understand, and a joy to use. However, despite this shared dedication to delivering a high quality product, EHR products from different companies don’t always present solutions to those problems in the same way. The result could be that systems that were designed in isolation to reduce cognitive load might end up contributing to it when a user must use multiple platforms to complete their daily tasks.

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Improving EHR Usability by Reducing Regulatory Burdens

it is our experience that clinicians_ frustrations with EHRs are often less about the technology, and more about using it not simply for patient care but to fulfill regulation-driven dIn a speech last month, CMS Administrator Seema Verma expressed her desire for CMS “to focus on patients first.” To do this, she said, “one of our top priorities is to ease regulatory burden that is destroying the doctor-patient relationship. We want doctors to be able to deliver the best quality care to their patients.”

We applaud Administrator Verma for leading this effort to reduce regulatory burdens on healthcare providers. As regulatory requirements for data collection from clinicians directly through the EHR have increased, it has become increasingly more challenging to maintain focus on the data essential to direct patient care. Read the full post »

Working Together to Address Patient Safety

By Shari Medina, MD, and Janet Campbell

 

ftr1017_coverEHRA was recently invited by For The Record magazine to write a column focused on EHRs and patient safety.  Our collaboration, “Patient Safety is a Shared Responsibility,” has been published in the October issue, and we wanted to share a few excerpts here on the EHRA blog.

Obviously patient safety is at the core of what all of us in healthcare do—providers, payers, IT professionals, and software developers. While EHRs contribute to patient safety, patient safety is a shared responsibility, with each stakeholder playing a key role.

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