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.

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Draft TEFCA Needs A Lot More Work

TEFCASince the release of the Draft Trusted Exchange Framework and Common Agreement (TEFCA) on January 5th, EHRA volunteers from the Standards and Interoperability, Privacy and Security, and Public Policy Leadership Workgroups have been reviewing and discussing the document. Together, they drafted EHRA’s comments, which were submitted this week to the Office of the National Coordinator for Health IT (ONC).

As EHR developers, we support the goal to provide nationwide interoperability using networks as important building blocks, and believe TEFCA has the potential to dramatically improve interoperability.

However, the draft TEFCA overreaches, neglects important details, and doesn’t consider the practicality or potential unintended consequences of the policy. We strongly recommend that ONC review stakeholder feedback and publish a revised proposed draft for another round of feedback, before finalizing the policy.

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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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