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John Flemming is a high-ranking official with the Office of the National Coordinator for Health Information Technology (ONC) and a former Louisiana congressman. But back in the 1990s, Flemming was a practicing physician, and one of the first in the U.S. to fully implement electronic health records (EHRs).
“Whether it is from excessive documentation requirements, or the struggles to even navigate within the EHR, I remember when I was with my patients, I was spending more time with my eyes on the computer screen than I was with my eyes on them,” Flemming, ONC's deputy assistant secretary for health technology reform, wrote Monday in a blog post to kick off National Health IT Week.
Two decades later, and healthcare professionals still are struggling to use EHRs and other technologies in a way that doesn’t detract from the doctor-patient relationship. A new study by the University of Wisconsin and the American Medical Association (AMA) concludes that during a typical 11.4-hour workday, primary care physicians spent an average of 5.9 hours on data entry and other tasks with electronic health records (EHR) systems during and after clinical hours.
Flemming cites his own experiences and the results of a 2016 study by the American College of Physicians (ACP) to make the case that usability is the major factor in determining whether providers are happy with their EHRs.
As Flemming notes, the ACP study, titled “Survey on Physician Use of EHR System – Ease of Use Baseline Data,” found that “89 percent of respondents who indicated they were satisfied or very satisfied with their EHR also reported that their EHR was easy or very easy to use.” Conversely, 90 percent of respondents who said they were dissatisfied with their EHRs reported that these systems were difficult or very difficult to use.
Flemming argues that usability hurdles must be overcome in order to meet the needs of providers and patients.
“Those hurdles we are striving to push through may include improving health IT system implementation in the care environment, ensuring staff receives better training and helping providers pick the best health IT system for their care center, to name a few,” he says.
Flemming says ONC is working with the Centers for Medicare and Medicaid Services, Congress, and healthcare industry stakeholder groups to find “the perfect recipe” for health IT usability, as well as to develop sensible documentation and reporting requirements.
“As the deputy assistant secretary for health technology reform, I have made it one of my personal missions to improve the ease of use and usability of EHRs, and make it easier for the patient to get their information, but also for doctors to have a better working environment,” Flemming writes. “Improving usability is just one goal in that mission, but as we move through National Health IT Week, I am reminded it may be the most important one.”