Hate Your EHR? Here’s Why, Says JAMA

It’s not you; it’s them, say researchers in a recently published JAMA article.

Many clinicians complain that their EHR systems aren’t user-friendly, despite an HHS ONC requirement that certified EHR vendors (including ophthalmology EHR vendors) attest to user-centered design (UCD) and formal usability testing that directly involves the clinicians they serve. In order to be certified for Meaningful Use, EHR vendors are supposed to report to ONC the UCD process they used, as well as as the results of usability tests involving at least 15 end users.

But this publicly available information is missing or incomplete for many of the 50 EHR vendors that serve the highest number of hospitals and practices, the JAMA researchers say.

  • Of 50 certified vendor reports, only 82% were available for public review.
  • Of those 82%, 34% had not met the requirement to describe their UCD process and 63% had not met the requirement to test their systems with at least 15 clinician users.
  • A whopping 17 vendors among those with publicly available reports had not tested their EHR systems with any physicians at all.

Wow. Just Wow.

“Enforcement of existing standards, specific usability guidelines, and greater scrutiny of vendor UCD processes may be necessary to achieve the functional and safety goals for the next generation of EHRs,” the JAMA authors conclude.

The study sends a strong signal to the government to watch the vendors they’ve certified for Meaningful Use much more carefully. Last week, ONC removed certifications from two EHR companies, and experts predict more decertifications in the future.

Biggest takeaway: The JAMA study reminds vision care practices to look out for themselves when purchasing or upgrading ophthalmology EHR software. Here are some tips for conducting your own “usability studies” before you invest in ophthalmology EHR.

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