The design, development and implementation of EHRs must be improved, not only to strengthen usability for clinicians, but also to enhance patient safety, according to a recent study published in the Journal of the American Medical Informatics Association.
Researchers with Columbia, Md.-based MedStar Health's National Center for Human Factors in Healthcare and the American Medical Association, among other organizations, reviewed EHR use at four hospital sites — two on Epic and two on Cerner.
About 12 to 15 physicians at each location were asked to perform common EHR tasks — such as placing orders for medical imaging, lab tests and medications — for hypothetical patient cases. The researchers collected data on the time physicians spent and the number of clicks they made while completing each task, and then evaluated the physicians' accuracy.
The researchers found wide variation across the four sites. For example, it only took physicians at one site 25 seconds to place an imaging order, compared with more than a minute at another site. Physicians required an average of eight clicks to place an imaging order at one site, while the same task at a different site averaged 31 clicks. For a medication order, one site saw no errors, but another site reported a 30 percent error rate.
"Our results suggest that basic performance standards for all implemented EHRs should be considered in order to ensure usable and safe systems," the study authors concluded. "Both EHR vendors and providers should work together to ensure that usable and safe products are implemented and used."