Health information technology: Keep it simple

Introduction

Making electronic record-keeping systems easier for health providers to use can help prevent dangerous or even fatal mistakes, says the draft of a project by the National Institute of Standards and Technology (NIST).

The draft, titled “Technical Evaluation, Testing and Validation of the Usability of Electronic Health Records,” is available for informal public comment until Nov. 10, 2011. It provides guidance from NIST, a technical research agency within the Department of Commence, for testing electronic health record-keeping systems to make sure they are understandable for health care practitioners. The draft was released last month.

One of the aims of simplifying the devices is to avoid potentially dangerous medical errors, says the report. At the moment, though, there is no government agency specifically directed to regulate or enforce the safety of the devices being sold to medical offices.

“We didn’t specify in the report who should use the guidelines,” said Svetlana Lowry, NIST’s project leader on usability for health information technology. “This is for anybody who would like to apply the structure — government agencies, industries, academia — anyone involved in the development of electronic health records.”

A variety of studies have concluded that the use of health information technology may improve health care outcomes and improve patient safety, but the electronic systems can also facilitate problems. An allergy might be omitted from a computer record, for example, or the name of a medication might be entered into the wrong portion of the patient record because the system is daunting to practitioners. Health care providers might also be confused about how to access the information they need.

User error can decrease when the systems are easier to use, the report says, but guidelines must be established to ensure that the devices are tested by both those who use them and by experts.

Making the systems simpler to operate can increase efficiency, reduce user frustration, lower costs and cause fewer workflow disruptions, says the draft.

“We wanted to provide a methodology for the world of health information technology,” Lowry said.

Millions in federal dollars have already been pumped into the offices of doctors, hospitals and clinics under a Recovery Act provision encouraging the widespread use of electronic health records. The government will begin deducting Medicare payments from providers if they do not go digital by 2015.

However, the money isn’t flowing as quickly as predicted.

That may in part be attributable to the perplexing nature of the technology, the report says. Health care providers have been deterred from going digital, other researchers have said, because the systems are too difficult to understand and operate; the way the technology is laid out may not be representative of what physicians do every day, or it could slow down users and frustrate them.