“The AMA believes that it is imperative to step back and place the EHR in the proper role” in healthcare, Stack said. “Doctors find that these tools have great promise and potential, but they're very much not where they need to be.”
The AMA's approach is to work with EHR vendors, the government and fellow providers “to make them better,” he said.
EHRs should enhance physicians' ability to provide high quality of care by fitting seamlessly into their practice and not distract physicians from care of their patients, AMA contends.
Systems should also support team-based care and help physicians delegate work to care team members. They should support care coordination by automatically keeping track of referrals and consults so that a physician can track patients across the continuum of care. They should be modular and take advantage of a new push toward the use in healthcare of application programming interfaces, or APIs, to achieve greater interoperability between different EHR systems and mobile apps.
The systems also should reduce the cognitive workload of physicians by being more intuitive, like the best smartphones; facilitate the use of mobile devices and expedite user input into product design and improvements.
The Electronic Health Record Association, a trade group representing developers of EHRs affiliated with the Healthcare Information and Management Systems Society, said in a statement that it “commends” the AMA on its report, while association co-chairwoman Dr. Sarah Corley, CMO of NextGen Healthcare Information Systems, said the group “encourages its member companies to incorporate user-centered design” methods in creating their products.
“Like the AMA, the EHRA has expressed concern that the EHR incentive program certification criteria have been too prescriptive,” the association’s statement said, adding the regs “have impeded natural provider workflows, and continue to hamper EHR developers' ability to innovate to meet customers' needs.”
“We agree on a number of points, including that usability is a shared responsibility among multiple stakeholders, all of whom play an important role in creating, implementing, and using EHRs in a safe and effective way,” Corley said. “Our members look forward to ongoing discussions with these and other key stakeholder organizations, as well as our customers, as we continue to work together to improve the usability of EHRs.” she said.
The AMA's work on improving EHR usability is part of a broader campaign on improving professional satisfaction and practice sustainability.
A study by the RAND Corp. for the AMA and released last year identified uncooperative EHRs and the feds' rigid meaningful-use program as major sources of frustration for physicians.
Follow Joseph Conn on Twitter: @MHJConn