Providers and vendors team up for user-friendly EHRs
Skip to main content
Sister Publication Links
  • Modern Healthcare Metrics
MDHC_Logotype_white
Subscribe
  • Subscribe
  • Register
  • Login
  • News
    • This Week's News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • House GOP leaders introduce drug-pricing bill to counter Pelosi plan
      IHI releases principles to improving patient safety measures
      Plan members unlikely to benefit from Supreme Court risk corridor battle
      Connecticut tentatively resolves hospital spat over taxes
    • Not-for-profit hospitals stabilized by Medicare pay raise, DSH cut delays
      November was healthcare's second strongest hiring month of 2019
      Primary-care provider ChenMed to enter five new markets
      Lacking specialist access drives health disparities
    • Plan members unlikely to benefit from Supreme Court risk corridor battle
      Joan Budden
      Q&A: Priority Health CEO eager to share best practices with Total Health Care
      Silver-loading, CSR elimination lowered premiums for some rural enrollees
      Centene to sell Illinois plan to CVS Health
    • Capitol Building with pills
      Week Ahead: House to vote on drug bill; SCOTUS hears risk-corridor case
      MedPAC thinks hospice payments are too high
      MedPAC says ambulatory surgical centers don't need a pay raise
      States focus on healthcare costs to address coverage problems
    • Analysts to CommonSpirit Health: Show us the savings
      Smallest hospitals saw biggest earnings gains last month
      Sutter Health postpones financial filing
      doctor helping patient stock image Sandoz
      Sponsored Content Provided By Sandoz
      As hospital executives look to reduce costs, biosimilars offer a compelling option
    • astronaut
      Astronauts developed bloodstream issues in space
      Sponsored Content Provided By ABM Healthcare
      Protecting and Maintaining Medical Devices
      human hand robotic hand stock image
      Sponsored Content Provided By Deloitte
      The Health System of the Future: How Digital Health Technology is Transforming Care
      EHR
      EHR vendors most in-use throughout Medicare incentive program
    • IHI releases principles to improving patient safety measures
      MRIs of dense breasts find more cancer but also false alarms
      Flu season takes off quickly in Deep South states
      Uber driver says South Carolina hospital dumped patient on him
    • Trinity Health appoints new COO: Ben Carter
      Jim Allison playing the harmonica
      Documentary tells tale of Nobel winning researcher
      Seema Verma
      Seema Verma's bold initiatives land her in No. 1 Most Influential spot
      New CEO takes the helm at Lurie Children's Hospital of Chicago
    • Midwest
    • Northeast
    • South
    • West
  • Special Features
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • Chest x-ray from a patient with a vaping-related lung injury
      Vaping-related cases lead to care guidelines from Intermountain
      Arkansas Children’s was a founding partner in Solutions for Patient Safety.
      Children's hospitals collaborate rather than compete on patient safety
      Peer recovery specialists at St. Barnabas Medical Center work with nurse Brenna Zarra.
      Peer recovery helping patients with addiction seek treatment
      UNC Health Care trains staff to treat dementia patients
    • Linda Kenney
      Patient advocate recalls two medical errors that nearly killed her
      Dr. Mark Chassin
      One-size-fits-all approach to patient safety improvement won’t get us to the ultimate goal—zero harm
      Betsy Lehman
      Recent safety scandals suggest healthcare leaders haven't learned lessons
      Doctors and nurse with patient
      20 years after 'To Err is Human,' hospital care quality measures are still of little use
    • Advanced ICU Care
      Telemedicine helps rural hospitals meet intensivist shortage
      Randy Oostra, CEO of ProMedica
      HCR ManorCare deal laid foundation for ProMedica’s growth
      Paging Dr. Robot: Artificial intelligence moves into care
      A child being screened for vision problems using a smartphone.
      App screens kids for eye problems before they can talk
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • ProMedica doubles down on social needs data analysis
      Amazon taps first pharmacy for Alexa Rx management
      Trump administration unveils new price transparency rules
      A child being screened for vision problems using a smartphone.
      App screens kids for eye problems before they can talk
    • VA dives into artificial intelligence R&D
      Home health to pare down therapy services, up telehealth offerings
      Amazon launches medical transcription service
      Hospitals' uncompensated care continues to rise
    • Chest x-ray from a patient with a vaping-related lung injury
      Vaping-related cases lead to care guidelines from Intermountain
      Advanced ICU Care
      Telemedicine helps rural hospitals meet intensivist shortage
      Peer recovery specialists at St. Barnabas Medical Center work with nurse Brenna Zarra.
      Peer recovery helping patients with addiction seek treatment
      UNC Health Care trains staff to treat dementia patients
    • Value-based pay still struggles to improve costs, quality
      Hospitals sue HHS over negotiated price disclosure rule
      Bundled payments get a boost in two states with employee programs
      CMS wants primary-care docs to take on financial risk
  • Data/Lists
    • Rankings/Lists
    • Data Points
    • Modern Healthcare Metrics
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Randy Oostra, CEO of ProMedica
      HCR ManorCare deal laid foundation for ProMedica’s growth
      Steve Strongwater
      How Atrius Health stayed independent by not shying away from risk
      Why moving the VA to a new EHR was a pivotal decision
      Why AdventHealth's rebrand was more than a name change
    • Terry Shaw
      A diverse and inclusive culture should empower others
      Paving the path to diversity and inclusion
      The next step in healthcare evolution
      Breaking Bias: A road map to boost women and minorities into healthcare leadership
    • Dr. Richard Snyder
      Outdated privacy laws hinder coordinated care, especially in the fight against addiction
      David Dill and Keith Myers
      Healthcare partnerships are a proven path to better care, healthier communities
      Health systems need to devote more resources to caring for the caregivers
      Chip Kahn and Alan Morgan
      Rural healthcare needs innovation, policy changes to survive
    • Letters: Let’s keep humanity in discussions about patient safety
      Hospital with money
      Letters: Let providers set their prices,
 and then publish them all
      Letters: Ambulatory surgery centers aren't getting a break on regulation
      Letters: Rising Medicaid spending isn't a windfall for providers
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Nominate
    • Award Programs
    • Previous Award Programs
    • Other Award Programs
    • Nominations Open - Top 25 Minority Leaders
      Nominations Open - Health Care Hall of Fame
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • Kronos webinar logo lockup
      Sponsored Content Provided By Kronos
      Webinar: The Future of Work in Healthcare
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Critical Connections: Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Health Care Hall of Fame Gala
    • Top 25 Women Leaders Gala
    • Best Places to Work Awards Gala
    • Top 25 Minority Leaders Gala (2020)
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
November 25, 2017 12:00 AM

Providers and vendors team up for user-friendly EHRs

Rachel Z. Arndt
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print
    Getty Images

    Before an Allscripts electronic health record appears on screen, it first appears on a storyboard—sometimes even a paper one. That's where Allscripts developers can test new ideas on providers, figuring out what should go where.

    "The design on paper is still at the basic level where we can change on a dime," said Ross Teague, director of user experience for Allscripts Healthcare Solutions. Users usually feel more comfortable offering feedback on a design when it looks unfinished.

    THE TAKEAWAY

    Electronic health records are notoriously clunky. Vendors, with the help of their provider clients, are out to change that.

    Such interaction is crucial, given that clinicians spend about half the workday working with EHRs. And many of those hours are during patient encounters. A study in the Annals of Internal Medicine found that ambulatory physicians spent more than a third of their time with patients on EHR and desk work tasks. That makes many providers unhappy, and not just because it affects their face-to-face time with patients.

    "The challenge of established EHRs is that so much functionality gets piled onto these complex systems," said Dr. Titus Schleyer, a research scientist with the Regenstrief Institute.

    But as providers complain, vendors respond. Allscripts, Athenahealth, Cerner Corp. and Epic Systems Corp. are among those constantly tweaking their software after getting feedback from the source of those complaints. They're consulting with and observing users inside and outside of their natural work environments to build EHRs for efficient—and pleasant—workflows, layouts and functionality.

    Most, if not all, major EHR vendors rely on a combination of formal user testing, informal feedback, and what might be called ethnographic research. The result isn't just happier clinicians but safer healthcare delivery.

    "Many of the same issues that can lead to clinician frustration with EHRs can also lead to safety problems," said Ben Moscovitch, manager of health information technology for the Pew Charitable Trusts. For instance, if a clinician accidentally orders a medication for the wrong patient, correcting the error can be cumbersome, requiring multiple steps, he said. The EHR can be tweaked to address that.

    A partnership

    With healthcare perpetually inching toward value-based care, EHRs are more important than ever in helping patient care. Vendors are working with providers to improve their offerings, going beyond meeting the bare minimum federal requirements for their software.

    Athenahealth, Allscripts and others have formal programs to gain insight from their provider users both while software is in development and after. "That relationship has really improved the way the system works for us and, I would presume, because of the way Athena works, for all of its customers," said Steven Kelley, CEO of Ellenville (N.Y.) Regional Hospital, which, as an Athenahealth development partner, tries out prototypes with new features.

    That kind of relationship also helps vendors, which learn from their users early on what kinds of features they're interested in and how those features should work.

    "In a good user-centered design process, you're involving your users early and often," Allscripts' Teague said. His company does formative testing with its users during which they engage in the aforementioned and try new versions of the software. "This is the No. 1 method by which we collect patient-safety issues before they ever become patient-safety issues," he said.

    Allscripts also gets new product ideas by observing clinicians in care settings. Sometimes, for instance, to get an objective sense of how well its software works, Allscripts will measure how many users can complete a certain task without any training.

    Observational research is particularly helpful given how providers talk about what they want from their EHRs. "Sometimes, what people say only reflects part of what their goal is," said Janet Campbell, Epic's vice president of patient engagement. "If you give a doctor a list of 10 activities in the record and you say, 'How many of these would you like to see on the screen?' they'll say, 'All,' " she said. "It's not until you watch how they interact and move back and forth that you realize that they only need three of those things."

    When Athenahealth is testing a feature in the alpha or beta stage, the company uses behavioral analytics to glean how users are interacting with it. "One of the benefits of being cloud-based is that all the data across our network is very accessible, and we can see the actions people are taking," said Scott Mackie, Athenahealth's executive director of strategy design and user experience.

    For instance, when the company was developing a timeline feature, users complained about how many clicks it took to see everything that had happened to a patient over time. Athenahealth developers watched how the timeline affected workflow so developers could lay it out to highlight the most useful and appropriate events and data. Giving clinicians the information they need when they need it could help them better care for patients, since it would reduce their workload and help identify important elements quickly. "Physicians want the right information at the right time at the right point of care, and that helps them provide better care," said Rich Berner, Allscripts' senior vice president of health systems and population health solutions management.

    Presenting information, not data

    Part of the reason vendors must revise and tweak EHRs is because of their complexity, Schleyer said. It's hard to design a program that's usable "right out of the box."

    To deliver a more consistent patient and user experience across its facilities, SSM Health consolidated its three versions of Epic into one. "We called the project that we worked on 'simple elegance,' " said Philip Loftus, SSM's chief information officer. "If it took you five screens to do something, we tried to bring that down to two or three screens."

    The improvements came from Epic's collaboration with SSM and from SSM's own developers, who get regular feedback from physicians and from consumers surveyed after the health system updates software.

    One request was to display all information relevant to patients' care on one screen.

    Physicians want all of that information at the top level, Mackie said. "They want less digging," he said. A solution could be building artificial intelligence into the EHR so it learns the most important information, he said. Another solution might be voice, especially as it becomes more common in consumer life.

    Increased population health efforts also have vendors considering how new kinds of data should be presented.

    "People aren't asking for data—they're asking for information," Teague said. "That means fitting it into their workflow and making sure it's presented in a way where they're not spending a lot of cognitive effort determining what it means."

    In general, despite these efforts to address problems, providers still have gripes with their EHRs. "Hospital-based physicians consistently conveyed that EHRs have a negative impact on their interaction with patients," wrote the authors of a study published in the Journal of Innovation in Health Informatics. And in an AMA study from 2016, "meaningful use, EHRs and desk work were identified as dissatisfiers twice as frequently as any other item."

    But vendors have to be careful to respond to providers' needs while keeping larger goals and demands in place.

    "There's this constant balance between doing the things we're told we should do by the government and doing the things we're begged to do by our client base as well, and they frequently do not line up," Athenahealth's Mackie said.

    While healthcare can and does learn from digital consumer technologies and trends, those can also be misleading. "There are sometimes unfair comparisons to a lot of very high-quality consumer apps out there," said Paul Weaver, Cerner's vice president of user experience. Those developers are not thinking about patient safety, he said. "We can't just concentrate on making things look nice. The overriding element for us in design is to make sure that no harm occurs. I'd rather we measure twice."

    Consumer-app developers also don't have to take into account the demands of federal EHR programs. Though EHR certification requirements have again been delayed, and meaningful use has been turned into the advancing care information category of the Merit-based Incentive Payment System for physicians, federal EHR mandates still exist.

    There's also what vendors themselves want to do on their own. Vendors must maintain some independence from their users, Regenstrief's Schleyer said. "Getting feedback is a very valuable activity for vendors, but it doesn't release vendors from the need to innovate on their own," he said. "If you just do what your customers tell you to do, you're probably not going to be around much longer."

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    Modern Healthcare
    Copyright © 1996-2019. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Special Features
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Data Points
      • Modern Healthcare Metrics
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Nominate
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Critical Connections: Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
      • Galas
        • Health Care Hall of Fame Gala
        • Top 25 Women Leaders Gala
        • Best Places to Work Awards Gala
        • Top 25 Minority Leaders Gala (2020)
      • Webinars
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing