by adgrooms on November 5, 2019

A doctor recently posted on Twitter about attending a healthcare technology conference and seeing an engineer from an EHR company stand up in a forum and ask the room "What can we do better? We are listening." This short post brings up a mental image of a doctor determined and focused to get through rounds, stopping briefly between rooms to frantically type up notes on the last patient while an alert pops up requiring input into another patient's record. The alert is not urgent, so the doctor dismisses it and clicks through several pages of the next patient's record to find a test. It is not where they thought it is supposed to be. After a little more digging and another dismissed alert, the test is located. Off to the next....."Oh wait, I've have to finish up those notes that the alert took my mind off of. What page was that?"

What would the doctor tell the engineer? That their time interacting with the EHR system is stressful and time-wasting? That it is taking valuable bedside time away from patients? This brings to mind all of the ideas we have been thinking about and would like the opportunity to implement in EHR systems. In case you are listening, EHR engineers, here are some thoughts:

UX Improvement- EHR systems of 2019 look like they need an MS-DOS prompt to get started. Some doctors are too young to know what that even means. Software systems built today usually have several UX (User Experience) engineers working on the usability and function of a product. Good UX design should create an enjoyable, relevant, and meaningful experience that doesn't leave the user feeling like they are operating an outdated clunky system from 1990.

Alert Audit - Alerts are good to have on an EHR system until there are too many. Alerts popping up every few seconds can disrupt workflow and make entering notes or finding information difficult. They are an unnecessary addition to cognitive load and stress. An alert audit with input from providers could sort out what is needed and what is not.

Voice Command - Clicking around and typing in an EHR system is time-consuming. With the improving capabilities of voice recognition software, there are opportunities in EHRs to use this technology for dictation and voice command. One study found that speech recognition is 3 times faster and more accurate than typing. That is a lot of time considering the 2 to 1 ratio of administrative tasks to patient time. Voice commands could further return time to physicians by making it easier to go directly to the information they are looking for without having to click or type anything.

Workflow optimizations - Workflow in an EHR system needs to be efficient, with relevant information accessible when needed. Poor workflow can make an EHR system feel cumbersome and chaotic. The workflow should be intuitive, enhancing a clinician's interaction with patient information. Thoughtful, custom views and transitions based on roles will streamline work and improve the experience.

Open App Marketplace - EHR companies may not be in a hurry to improve working conditions for clinicians, but there is an opportunity if they have an open system where outside vendors can create apps to augment the base system. Smaller technology companies can develop these apps much faster than overhauling a whole EHR system. They provide more options for enhancement and customization and rapid improvement.

We want to make the EHR useful for clinicians whether that is by sharing ideas, building apps, or making customizations. If you are in a position to try any of these, please do and let us know your results.