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Observations on a journey from nurse to solution manager

As early as 2002, when I was an Emergency Department (ED) nurse implementing a standalone health IT solution, it was rare to find a clinician in IT. Clinicians used to joke about people who moved into technology roles – people like me – and say that we had gone to the “dark side.”

Thankfully, it’s no longer seen that way. Now, it’s far more common to have clinicians involved with electronic health record (EHR) design and development. The industry recognizes the value of clinicians being part of these teams, because that representation helps create far better technology solutions.

Now, more than ever, we need clinician involvement in health IT design

Clinician burnout is a well-documented problem. It is a complex issue with many contributing factors, including poorly designed health IT solutions. For example, if an EHR can’t offer workflows that meet the specific needs of different clinician roles, or it isn’t configurable enough to meet the needs of different service lines within an organization, it will place more burdens on users.

A common refrain from EHR users is frustration with the number of clicks it takes to complete tasks. This is just one way to measure time clinicians spend interacting with their EHRs. If you can cut the number of clicks, you reduce clinician burden and free them up to spend more time on patient care.

The most important consideration is, of course, patient safety. Clinician burnout has been linked to a two-fold increased risk of medical errors. By involving clinicians at every stage of EHR design and development, we will increase usability and reduce burnout that leads to potential patient safety risks.

Calls to action for health IT companies

I rely on my ED and critical care experience to guide my evaluations of workflows and solution roadmaps. Having spent years as a clinician, and now as a health IT solution manager, I have observed a few steps health IT companies can take to better engage clinicians and improve user experience:

1) Commit to best practices in user-centered design. Allscripts earned a perfect score in an American Medical Association (AMA) and MedStar Health evaluation of alignment with best practices for user-centered design and testing. We have expanded our commitment to users by going beyond usability and rethinking our approach to design EHRs that are more helpful.

2) Ask for feedback. We stay connected to clinician needs by consistently talking with people from various disciplines to understand their experiences and translate that information into ways we can improve features.

3) Offer multiple ways to deliver input. Allscripts engages end users early and often throughout our EHR design process. Our portal, ClientConnect, enables clients to suggest improvements and vote on recommendations from other clients. We have solution-focused client councils and regional user-group events where we seek feedback from clinicians from all levels.

4) Continue to innovate. Regulatory requirements have required a lot of time and attention from EHR designers over the last several years. But we must continue to address user feedback and deliver the features and functions that simplify day-to-day workflows for clinicians.

One of the main reasons I left clinical practice to work for Allscripts was because it was an opportunity to help improve usability of solutions, and positively affect a lot of patients and clinicians. I’m proud to work for a company that has made a public commitment to clinician well-being and continues to strive for better.

Comments 3

  1. Paul Minton 08/13/2018

    Steve, thanks for your feedback, as a clinician yourself Where have you seen a positive impact from nursing involvement in IT?

  2. Shari Wood 08/18/2018

    Pleased to see ClientConnect mentioned; very proud to be a part of this community which fosters collaboration and relationships with our client clinicians.

  3. Steve Kalafut 08/13/2018

    Excellent article and I completely agree. With over 40 years in various health care roles and as a nurse myself, I cannot say enough about the need for clinical input as we progress in the health IT solution development.

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