Fear & Loathing On the Audit Trail

April 27, 2010 at 3:31 pm Leave a comment

Adoption-Certification Workgroup of the HIT Policy Committee released a report on April 21, 2010 concerning what measures need to be taken to improve EHR and Health IT as a whole.  This comes at a time of contention for the electronic implementation as there have been various reports of injuries and deaths connected to EHRs. However, as the report warns, “the biggest risk to patient safety would be to either avoid or delay the proper implementation of EHR and CPOE systems.”  The conclusion isn’t meant to minimize or gloss over the errors that have caused these problems – it is, however, meant to be the starting point for discussion and for improvement.  For even the loudest detractor has to realize that all information systems are trending towards being electronically hosted and that only through digital means can we hope to have the information we need in the speed we need it.

There is a good reason to be concerned if physicians and hospitals are simply rushing to purchase EMRs to take advantage of the federal funding available for physicians.  As I’ve stated before, electronic health solutions are being adopted at a much faster rate than before due to a confluence of federal funding, improvements in the technology and the growth of the Health IT Sector all coming together at one moment in time.  And these changes have left many in the medical community scrambling to hastily adopt a system – a system which might have many errors or may not be the right fit for that facilities/user’s needs.

As I reviewed the findings of the HIT Policy Committee, I noticed many things that OpNote has already done, and should be best practices adopted by all technology firms (including, if not especially, Health IT).  For example, the Committee found a clear need for Support in the form of  a “feedback button” that would allow users “to immediately report any problems/concerns with information that appears on screens.”  This sounds like it should be a given – when you have a new population of users (like a brand new company, physicians or facility using your product), you need to make sure that they can easily and effectively communicate with members of the IT support staff.  If they are confused or are experiencing trouble, then that needs to be addressed and hopefully corrected.  If there is some odd circumstance that creates problems for your product, these users need to be able to let the developers know so that they can solve the problem quickly.  After all, this isn’t just a word document crashing, but it’s possibly a person’s life on the line.

While developing OpNote, we’ve kept such possible occasions in mind and have worked to incorporate the solution into the product.

We’ve included a “Support” link on every page of our product.  By selecting that link, users open a new window that prompts them to describe their problem and then they can either email or chat with members of our support staff so that we may assist them best.

Obviously the best thing a Health IT firm can do is to eliminate as many problems as possible while developing their product.  But there will be instances that no one can foresee or simple user errors that need to be addressed.  Simple solutions like having quick feedback buttons and ensuring that the users will be contacting human beings go a long way to improving the experience for users and to improving the product itself.

It’s important when creating these Health IT solutions that, as Deane Waldman writes, the “needs of the end-users must drive the design.”  That is why our medical consultants have been invaluable to our development process as we have made untold number of revisions based on all the feedback we’ve gotten from doctors.  mTuitive learned from their Pathology product that if the IT solution offered to people disrupts their workflow at all, then people will not be interested in using it.  Potential users will also balk if the product necessitates more time for training or takes longer than the current process.  Our consultants have pointed out times where OpNote deviates from the logic/process to which physicians are already accustomed.

It can be hard to remember how a product will be used – especially when it’s being developed by people outside of that user base (we are not physicians).  But it’s important that developers are in constant communication with users – that way they can diagnose problems faster and solve them easily.  Most of the Health IT solutions are dynamic – they are constantly evolving creations that are always being improved upon.  Only when companies take the user into account can they expect to have a good product and only then can they hope to be successful.


Entry filed under: EMR, Synoptic Reporting. Tags: , , , , , , , , , , .

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