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Beyond usability: Rethinking how we approach EHR design

Picture your EHR as a person. What is he like? Is he fun or boring? Is he clever or clueless?

Our user-centered design team asks these types of questions in the field, and the answers indicate that most clinicians have a strained relationship with their EHRs. While most users wouldn’t call them adversaries, they are not exactly thinking of EHRs as friends, either.

Why do EHRs continue to fall short? I think it’s because our industry spends effort on trying to make EHRs usable, instead of making them helpful. It’s why Allscripts is shifting its focus to a Helper Philosophy of user-centered design. Your EHR should be a trusted assistant – a helper.

We need to ask the right questions

Here’s an example of how a Helper Philosophy can change the way we solve problems: Let’s say users are dissatisfied with a complex calendar feature. They ask their vendor for something simpler that quickly identifies openings on the schedule. If designers focus on making the EHR more usable, they might optimize color schemes and reduce the number of clicks needed to schedule an appointment. That’s great but are clinicians happier at the end of the day?

If designers approach this request with a Helper Philosophy, they might instead ask: What would an assistant do for this person? Can we enable the system to identify open appointments and initiate scheduling with patients? It might mean removing the task entirely from the user or doing most of the work and letting the user make the final choice. These kinds of questions spark innovations that get to the heart of user satisfaction.

Usability is necessary, but it’s not sufficient

The demands of an increasingly complex healthcare environment and elevated requirements related to health IT use are affecting them every day. Studies show that physicians are burning out, which is why the industry has recently been increasingly focused on the clinician experience.

For a long time, the industry has been calling for better EHRs. A recent article in Harvard Business Review points out many of the flaws of today’s EHRs and suggests “…[Artificial Intelligence], vastly improved data visualization, and modern interface design to improve usability.” Usability has been and will continue to be an important part of this conversation, but it’s not sufficient. Neither is applying technology to the problem. We’ve already seen what happens when we just apply technology to healthcare.

To succeed, we need a new philosophy. One where technology, usability and a systems approach focuses on how the EHR acts as a helper to the user. Helpfulness should be our new measure of success.

Re-imagining our ideal EHR

A Helper Philosophy covers all design aspects from colors and fonts, to voice recognition, to information visualization and everything in between. A helper philosophy rises above these individual tactics and gets to the heart of what our users desire most

Now picture your ideal EHR as a person. Is he a helpful assistant? One that guides, predicts, warns, plans, remembers and orients you to what you most need to know? Our vision is to go beyond usability and deliver helpful EHRs.

Editor’s note: Read more about how Allscripts is working with clients to address provider wellness in a recent Healthcare Informatics article: At University Hospitals in Cleveland, MD and IT Leaders are Making Strides to Reduce Provider Burnout

Comments 2

  1. Jenn 05/23/2018

    “If designers focus on making the EHR more usable, they might optimize color schemes and reduce the number of clicks needed to schedule an appointment. That’s great but are clinicians happier at the end of the day?” This leaves out one of most important aspects of usability, “Satisfaction.” If a designer is implementing a new design feature, they should also be usability testing this change to ensure satisfaction is being achieved. We do not need to go beyond usability if we focus on the root-cause of the problem to begin with.

  2. Ross Teague 05/24/2018

    Jenn – Thanks for the comment. In many definitions of usability, satisfaction is listed as an important element (e.g., ISO 9241) and it’s important to measure. We see often that just making a task faster/removing clicks doesn’t make people satisfied as you said. The reason we talk about going beyond usability is because we often see that someone rates a new feature as easy and satisfying because it’s so much better than the current process, but that doesn’t mean we should stop there. We want to be thinking about how we can remove a task entirely from a user or change it substantially that it’s not even the same task anymore. One of our clinician leaders at Allscripts talks about this in terms of instead of focusing on making it more satisfying to do the things that users don’t really want to do, we should be spending our effort on figuring out how to remove that task entirely, so the user can focus on the things that they want to do. We want for our products to be satisfying, but we also want to push them to be as helpful as possible, even beyond what a user can imagine.

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