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Even the smallest hospitals and private medical practices these days have electronic health records (EHRs), which are intended to improve healthcare by making it easier for providers to collect, store, and access patient records.
But EHRs also have been blamed for causing providers to spend too much time in front of a computer screen and less time interacting with patients. Poor design and usability issues with EHRs can even put patients in peril. A study published in the Journal of the American Medical Association (JAMA) in late March found evidence that EHR usability issues can contribute to possible patient harm.
One problem is that EHR vendors aren’t compelled to test their products in the development process for usability flaws.
“In general, federal regulations do not require EHR developers and users to conduct robust testing to detect usability flaws that can threaten patient safety,” writes Ben Moscovitch, who manages The Pew Charitable Trusts' health information technology initiative. “So there is a dearth of standards and comprehensive best practices that can be employed to mitigate the risk of harm.”
Pew, in conjunction with MedStar Health’s National Center for Human Factors in Healthcare and the American Medical Association (AMA), has issued a report exploring ways to improve EHR safety, including implementation of best practices and model test cases for guiding rigorous safety assessments of EHRs.
“EHR vendors mainly test these products before they are customized and used in specific health care facilities,” Moscovitch said. “And their assessments often do not thoroughly examine safety implications, including those that arise from particular procedures within facilities or through customizations. As a result, usability issues can go undetected until they cause patients harm.”
EHR vendors and healthcare providers should use the resources in the report to identify “usability-related risks to patients throughout the life cycle of these products, including the design, customization, implementation, and training stages.”
The report urges hospitals to test the safety of their customized EHRs, rather than assume it was tested by the vendor. It also suggests that a voluntary certification program could drive usability-related safety improvements.