There's so much bad news about electronic health records, generally, that it's refreshing to read about some positive developments this week. For one, it looks like health information exchanges (HIEs) are finally coming into their own.
Just a few months ago, it looked like HIEs were on shaky ground. All we heard about were their financial problems, health IT challenges, lack of support from their state and providers and questions about their effectiveness.
But a new study of HIEs in six states found that they are not only performing well, but that they're stepping up their game. They've become more established, more visible and more accepted in their communities. The exchanges are no longer just capturing data and serving as a means to meet Meaningful Use requirements, but also are evolving and offering more sophisticated services as demand for their services increases. They're also playing more of a role in improving care delivery.
Yes, there are still challenges, including the cost of participating, lack of interoperability of EHR systems and shortage of tech-savvy staff. However, at least these recent trends are promising.
Another positive development centers on vendors' work on EHR usability and user-centered design (UCD). Two thirds of 41 vendors that were part of a recent study report they have a UCD process, as required by the Office of the National Coordinator for Health IT's certification requirements, FierceEMR recently reported.
That number can be seen as disappointing, since all vendors are supposed to have a UCD process; however, I expected the number to be lower.
Some vendors appear to have gotten the memo on usability. In a webinar, during which the study mentioned above was discussed, Ross Teague, Ph.D., senior manager of User Experience at Allscripts, spoke about the nuances of UCD applied to EHRs and the steps to take to make EHRs more usable.
Any company that appoints a Ph.D. as "senior manager of user experience" sounds like it wants its products to be usable.
In addition, Kris Engdahl, senior manager of user research for cloud vendor athenahealth, reported that the company has more than 80 people on the research and development staff, more than 40 of whom are related to clinical care, as well as a cross-functional patient safety team. All research and development employees are expected to visit a client site within the first 90 days of employment, and the company has conducted more than 150 research activities on their products in 2015, a process Engdahl called "robust."
I don't know if this translates to better usability, but it certainly is a step in the right direction.
The question, then, is what happens going forward--and at least some actions are apparent:
- ONC and its certifying bodies must pay close attention to whether vendors are meeting the usability requirements and take action against those who are non-compliant, since their products may not deserve certification
- HIEs that are working to meet the needs of providers deserve support
- Vendors who are really striving to make their EHRs better should get a shout out