Electronic Medical Records (EMRs), have been hailed as the solution to our healthcare delivery woes. The healthcare industry has often been criticized for its lack of adoption of information technology, strikingly evident in the fact that it sends millions upon millions of faxes.
Epic, one of the most widely used EMRs, is for the most part, configured onsite by the hospital or healthcare system’s IT team. As a result, an individual physician’s experience with their EMR is largely dependent on the extent to which their internal IT team can assess the needs of, customize to, and change workflows to make the EMR work for the physicians.
EMRs are often been criticized for not caring about usability, however, the EMR vendors themselves (such as Epic), have little they can do help, outside of releasing major updates that seriously overhaul the entire user interface. Even in these cases, end users, including physicians, could still become frustrated and complain of inferior usability simply due to the comfort level that they had attained with the previous version of the interface.
So why are some physicians happy with their EMR experience, while some hate it? Let’s dig into some possible reasons a bit further:
1. Poor initial system configuration and workflow design
At the heart of many an EMR user’s frustration with their system is the initial backbone from which it was designed. As mentioned, multiple-instance EMRs like Epic are largely configured by the IT analysts themselves, who may have rushed to get a usable and working system in place during the hurry of the implementation. A poor foundation can lead to a system of patchwork improvements. In some cases, it may make sense to completely rip the system out and redesign it, with workflow use-cases in mind. An EMR that was designed simply to mimic prior-state workflows is going to be inherently less efficient than one that was designed alongside workflow redesign.
2. Subpar physician training
A user’s comfort level with a software system, and therefore their assessment of its usability, is going to be based on the extent to which they know how to use the system. If users don’t know how to quickly navigate and operate the system, they’re going to complain that it doesn’t work. Flexibility is key. A system must be designed to be customizable at a personal level, yet still be able to adhere to the rigid conditions in which healthcare often has to operate within. Users should be able to give feedback on the learning styles and documentation techniques that they prefer to use, and a system can be created that embraces those personal differences. Sometimes, just an hour or two of focused training can allow users to discover new shortcuts and techniquest that with enable them to become more and more comfortable using Epic.
3. Inadequate communication and optimization processes
Finally, software systems, and EMRs in particular, are active ecosystems that need to be able to change and adapt to the conditions within which they operate. Having a solid plan and process in place to make system changes and communicate these changes with the end users is paramount to making sure that you have an EMR that people like to use. The best and most comfortable users are the ones that feel that their voices are being heard, and that changes are being made to enable them to do their jobs more efficiently.