AMA Provides New Framework To Improve EHR Usability

By Christine Kern, contributing writer

The American Medical Association feels adopting its eight usability priorities will result in greater physician satisfaction.

In response to widespread physician discontent with electronic health records (EHRs), the American Medical Association has announced a new framework for improving EHR usability designed to benefit both caregivers and patients.

Building on its landmark study with RAND Corp. which established discontent with EHRs is taking a significant toll on physicians, the AMA’s new framework outlines eight priorities for improving EHR usability to benefit caregivers and patients.

"Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work," said AMA President-elect Steven J. Stack, M.D. "This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients."

AMA/RAND findings demonstrate that, while physicians generally are not interested in a return to paper record keeping, they are worried that cumbersome EHR technology requires too much time-consuming data entry, leaving less time for patients. Numerous other studies support these findings, including a recent survey by International Data Corporation that found 58 percent of ambulatory physicians were not satisfied with their EHR technology, "most office-based providers find themselves at lower productivity levels than before the implementation of their EHR," and "workflow, usability, productivity, and vendor quality issues continue to drive dissatisfaction."

"Now is the time to recognize that requiring electronic health records to be all things to all people – regulators, payers, auditors and lawyers – diminishes the ability of the technology to perform the most critical function – helping physicians care for their patients," said Dr. Stack. "Physicians believe it is a national imperative to reframe policy around the desired future capabilities of this technology and emphasize clinical care improvements as the primary focus."

To leverage the power of EHRs for enhancing patient care, improving productivity, and reducing administrative costs, the AMA’s framework outlines eight EHR usability priorities: enhance physicians' ability to provide high-quality patient care; support team-based care; promote care coordination; offer product modularity and configurability; reduce cognitive workload; promote data liquidity; facilitate digital and mobile patient engagement; and expedite user input into product design and post-implementation feedback.

The AMA recognizes that not all EHR usability issues are directly related to software design itself. Some issues are a result of institutional policies, regulations, and sub-optimal implementation and training. The AMA will continue to move aggressively on these fronts, including empowering physicians to work with vendors and other to develop and implement more usable products.

To advance these goals, the AMA plans to utilize the eight usability priorities to lead EHR improvements for physicians, vendors, federal and state policymakers, institutions, and healthcare systems and researchers, which could ultimately lead to greater professional satisfaction for physicians. Through these efforts, the AMA hopes to advance the delivery of high-quality and affordable health care to improve the health of the nation.

 “We do not want to go back to paper records but today’s current EHR products are immature, costly, and are not well designed to improve clinical care,” said Stack, who added that “there are a variety of market and regulatory drivers of this current lack of usability.” Specifically, he called the meaningful use program and the regulatory structure associated with it as “overly prescriptive, rigid, and unreasonable.”