Rethinking data input to fix EHRs

Chris Nerney
Chris Nerney, Contributing Writer |
Rethinking data input to fix EHRs

Electronic health records (EHRs) were supposed to improve healthcare by making it easier to access patient data and by making the process of collecting data more efficient.
Instead, doctors and other clinicians complain they are being bogged down by data entry activities, leading to burnout and less attention focused on patients.
Two healthcare experts say they have a solution to the EHR problem. Writing in the Harvard Business Review, Robert Wachter, MD, head of the Department of Medicine at the University of California, San Francisco, and Jeff Goldsmith, associate professor of public health sciences at the University of Virginia and national adviser to Navigant Consulting, make a case for modernized, streamlined EHR interfaces.
“The electronic systems hospitals have adopted at huge expense are fronted by user interfaces out of the mid-1990s: Windows 95-style screens and dropdown menus, data input by typing and navigation by point and click,” they write. “These antiquated user interfaces are astonishingly difficult to navigate. Clinical information vital for care decisions is sometimes entombed dozens of clicks beneath the user-facing pages of the patient’s chart.”
Calling for a “revolution in usability” to liberate clinicians from busywork, Wachter and Goldsmith argue that “typing and point and click must go.”
“Voice and gesture-based interfaces must replace the unsanitary and clunky keyboard and mouse as the method of building and interacting with the record,” they write. “Both documenting the clinical encounter and ordering should be done by voice command, confirmed by screen touch.”
The authors also recommend that EHRs make it easier to retrieve patient data.
“Interactive data visualization must replace the time-wasting click storm presently required to unearth patient data,” they write. “Results of voice searches of the patient’s record should be available for display in the nursing station and the physicians’ ready room. It should also be presentable to patients on interactive white boards in patient rooms.”
Wachter and Goldsmith also criticize the “primitive state” of artificial intelligence (AI) in EHRs, which they call “a major barrier to efficient care.”
“Clinical record systems must become a lot smarter if clinical care is to predominate, in particular by reducing needless and duplicative documentation requirements,” they say.
The authors conclude that the technology exists to fix the usability and efficiency problems which often bog down clinicians working with EHRs.
“We must use AI, vastly improved data visualization, and modern interface design to improve usability,” they write. “When this has been accomplished, we believe that clinicians will be converted from surly prisoners of poorly realized technology to advocates of the systems themselves and enthusiastic leaders of efforts to further improve them.”