Final IPPS Rule Ignores EHR Developer Concerns–Includes Impossible Measures, Will Lead to Increased Clinician Burden

By Sasha TerMaat
EHRA Vice Chair

IPPS blogOn August 2, 2018, CMS published the 2600-page pre-publication version of the 2019 IPPS Final Rule. EHRA members have begun digging into the Promoting Interoperability/Meaningful Use program, hoping to see changes based on their public comments on the proposed rule released in May. While we’re glad to see the requirement for 2015 CEHRT in 2019 confirmed, overall we’re disappointed that CMS failed to respond to many of EHRA’s comments as well as other stakeholder feedback.

In releasing the final rule less than six weeks after the public comment period closed (during which it received 1,058 comments), CMS appears to have rushed what should have been a thoughtful process. Several measures will be infeasible to program. Other measures will result in additional burden on clinicians, solely for the purpose of measurement rather than improved patient care. (more…)

Introducing the EHRA Persona Library

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

Developing a deep understanding of users and their surrounding environment is an important first step in the process of designing usable, safe and effective products. Documenting the who, why and how of individual users and the scenarios they face as part of normal (and abnormal) workflows can take the form of a persona, representing a real user based on qualitative and quantitative research and first-person experience. Personas enable clear understanding of the different users of a product and their goals, problems and backgrounds, cultivating empathy within a development team for who their users really are.

EHRA is pleased to introduce the EHRA Persona Library, created by the EHRA Clinician Experience Workgroup using the input of last year’s Usability Summit participants as a starting point. The library launched with 11 persona templates—ranging from Hospitalist to Family Caregiver to Medical Assistant—with plans to add additional personas in the future. (more…)

HIMSS18: Listening, Learning, Leading

IMG_6591EHRA member companies were out in force at HIMSS18 in Las Vegas, and not just in booths on the exhibit floor.

In a small conference room on the 4th floor of the Sands Convention Center, EHRA volunteer executives were meeting with stakeholder groups to discuss how EHRs can be optimized to improve usability, interoperability, and patient safety. We listened, we asked questions, and we shared our perspectives on the challenges and what the next steps could be.

(more…)

How Consistency in EHR Design Can Contribute to Patient Safety

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

pexels-photo-65543

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.

(more…)

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. (more…)

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.

(more…)