NSIT: Ambulatory EHR Vendors Not Adequately Integrating Clinician Workflow

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Spurred on by federal incentives, electronic health record adoption in ambulatory settings has grown significantly. However, usability issues that often necessitate physician workarounds have slowed adoption, and will continue to do so unless EHR vendors modify their products to better fit clinicians' workflows, according to a report from the National Institute of Standards and Technology.

NIST researchers analyzed recent literature on physician workarounds, identifying those used most commonly, for example, copying and pasting a patient's previous progress note to serve as a template for the next time that patient is seen. These findings helped to identify the clinical activities that require more relevant and flexible workflows in EHR designs to better serve physicians' needs.

Researchers then held discussions with physicians and other experts to discover opportunities for EHR vendors to improve usability, including incorporating the ability to drop or delay tasks during high-volume periods, the ability to redact and summarize laboratory results and the ability to distinguish between new information in a progress note and information copied from a previous note.

The researchers believe including these functionalities in EHRs could not only foster EHR adoption among physicians but also help the EHRs achieve their stated goal of improving care quality and delivery.

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