Dr. Jacob Reider: EHR Usability Remains Top Priority for ONC

During his last week as acting National Coordinator for Health IT, Jacob Reider, MD, reflected on a major challenge still faced by ONC: making electronic health record systems more user-friendly for physicians.

He cited several reasons for the usability issues that have persisted in EHRs for more than a decade since they were first introduced. Because the end users usually aren't the ones making the purchasing decisions, usability becomes a less significant component in purchasing decisions. Multiyear EHR contracts make it financially and logistically difficult to walk away from an underperforming system. User interfaces and design have to be adapted slowly by developers, lest a sudden change lead to physician errors that could compromise patient safety. Additionally, poor configuration on the hospital's end can make the best EHR systems difficult to use.

Physicians, he said, want an EHR that easily allows them to perform necessary tasks, such as writing notes and prescriptions and managing lab results. Working with experts in the field, ONC has been working to steer the health IT industry to focus more on EHR usability, hosting hearings and conferences and including usability requirements in the ONC's 2014 Standards and Certification Criteria.

However, Dr. Reider acknowledged the ONC's work is not finished. "We are working hard to both understand these issues and define an appropriate balance for the government's role in helping evolve health IT toward better efficiency and safety through enhanced usability," he wrote.

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