Standardization Needed for EHR User Interfaces

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 - Robert Budman, MD
Robert Budman, MD

While some EHR systems are more widely deployed than others, a broad variety of systems are in use at hospitals and practices across the country. For clinicians who see patients at multiple organizations, how can patients be assured professionals effectively and safely operate in all these different systems?

The push for transparency in healthcare on many levels has been hailed as a great thing for patients.  However, comparisons of transparency and operational needs in healthcare to airlines, rental cars and toothpaste aisles need to go by the wayside. Ordering interventional procedures, complex pharmacologic drips and insulin regimens for our loved ones is far more complex and materially important in my opinion.

I have experience using several different systems, and they all have vastly different workflows and user interfaces. That puts patients in harm’s way for physicians inadequately trained, infrequently using the systems or working in several different healthcare settings with varying digital solutions and possibly hybrid electronic/paper records.

Even as an experienced EHR user, I can’t thoroughly master one EHR much less three, four or more because they are simply too complex. What is most important is that each user gets adequate training, support and reinforcement in his or her specific workflow. Doing that across multiple systems simply magnifies the challenge for modern healthcare facilities.

As we progress and mature in the EHR world should drug name, dose, route, frequency, reason, length of therapy, dose checking, duplicate therapy and interaction warnings be vastly different from system to system as an example of the disparities between vendor solutions? We need some standardization so that patients aren’t put in danger because physicians aren’t familiar enough with the system user interfaces (UI) that manage all the specifics of treatment. How much is this vast differential in UI and workflow among EHRs impacting quality patient care and safety? Training for one EHR system can take a lot of time so how are we to find time to train adequately for multiple systems?

To bring the discussion full circle with a new comparison, the construction industry has many standards for hardware, plumbing, electrical wiring and more, but the standards for basic EHR builds are significantly lacking. The vendors, not the government, need to create a standards council to address the deficiencies, in this writer’s opinion. Then the future systems can be more user-friendly, safe and efficient in delivering state-of-the-art high quality care.

Robert Budman is CMIO of Yuma Regional Medical Center in Yuma, Ariz.