If there’s one thing we know about EHRs, users hate clicks. And for good reason. Clicking and scrolling historically have represented extra time, effort and evidence of not understanding an efficient workflow. Click reduction is often cited as the best way to improve electronic health record (EHR) usability. Our gut instinct tells us that we should do everything we can to reduce clicks. Yes, unnecessary steps are annoying and should be removed. But we have to be careful that we don’t actually increase cognitive load, hinder decision making and reduce overall efficiency and satisfaction in our zeal to reduce clicks and scrolling. There is a great deal of research available that should guide the design, implementation and customization of EHR interfaces. In the evidence-based practice of medicine, scientific evidence should also guide Health IT usability decisions. Some of these known […]

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“Improve usability…but don’t change anything!”

  • Ross Teague, Ph.D.
  • 06/08/2016

Organizations and users in the Health IT world desire products with better usability and efficiency, but they hesitate to embrace changes to familiar interfaces and interactions. Humans don’t like change for many reasons. In Health IT, changes to interaction models, layouts and workflows can mean retraining, which costs money and takes time away from work. There are also concerns that users will be less efficient using something different, or that it will reduce satisfaction. Many times what we are comfortable with is not what is best for us, even though we have adapted to it. Users may not realize the physical, mental and safety “costs” of sticking to what is most familiar. While familiarity associated with software is often related to steps in a workflow, it can also be familiarity to icons, colors and layouts. Users may not see how a change in […]

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8 seconds or less: How physician input improved usability

  • Jeanne Armstrong, M.D.
  • 05/24/2016

Physician input is vital for good Health IT design. The only way we can continue to improve adoption, usability – and ultimately patient safety – is to engage users early, often and through all stages of software design. Involving users is one of the guiding principles of Allscripts’ user-centered design (UCD) process, the subject of a recent white paper. When building new products or improving existing solutions, we follow those best practices. Formative testing catches mistakes before it’s too late All too often, users don’t get a chance to weigh in until Health IT solutions are about to be released. But we take great care to conduct formative testing for our new features and solutions. This type of testing occurs with early versions of solutions, such as wireframes, sketches or prototypes. Designers hold one-on-one sessions with actual users. They provide […]

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EHR design requires user input, early and often

  • Ross Teague, Ph.D.
  • 04/07/2016

Adherence to user-centered design (UCD) best practices is key to improving electronic health record (EHR) usability. A recent white paper reviews UCD best practices, and how they help improve usability and patient safety. Unfortunately, many EHR vendors skip a crucial step in UCD: formative testing. In this phase, software designers test early versions of the technology with actual users. They’re not testing completed code or solutions ready for market, but rather prototypes, wireframes or even early sketches. Good formative testing is iterative, meaning designers must gather and address feedback from users several times before finalizing the software. To illustrate how the formative testing process works at Allscripts, here’s a recent example from our Allscripts Sunrise™ Ambulatory Care solution. Example: Formative testing for a new task module The Sunrise team conducted formative usability tests on a newly designed task module with […]

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Guiding principles for EHR design: A 10-point checklist

  • Jeanne Armstrong, M.D.
  • 03/22/2016

As one of the clinical architects of Allscripts TouchWorks® EHR, I work hand in hand with our functional architect, product owners and user-centered design (UCD) experts. We work as a team on new designs to make sure we’re using best practices to improve usability. We developed the following guiding principles as a checklist to help us better focus our product development on what users need: 1. Let users do their work when and where they discover it needs to be done. Reduce the amount of unnecessary clicks to complete a workflow. Design navigation and workspaces to enable users to perform a wide variety of tasks, while tailoring them for the most frequently performed actions. Where possible, free cognitive resources with automation. 2. Acknowledge chaos. Consider users who perform tasks in chaotic work environments, where interruptions are expected. Make it easy […]

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Why EHR usability has fallen short

  • Ross Teague, Ph.D.
  • 03/07/2016

A recent article said that electronic health record (EHR) usability is poor because clinicians are not the ones who are designing the products: “Physicians and other clinician users of electronic health record systems commonly rate the products low on a usability scale, in large part because non-clinicians do the bulk of the work designing them.” But does usability really suffer because non-clinicians are designing Health IT solutions? When we look at other industries, we don’t see end users primarily responsible for the design of successful products. For example, accountants don’t design banking technology, and writers aren’t developing word-processing software. Why do products in other industries seem to be more reflective of users’ needs? For EHR usability to improve, do clinicians have to create and design the products, or is there another more impactful way for them to be involved? I […]

Will you be joining us in Las Vegas, Nev., U.S.A. for HIMSS 2016? Whether you’re a client, a partner or simply interested in learning more about what Allscripts has to offer, be sure to stop by the Allscripts Booth at HIMSS 2016 (Booth #2612).You’ll have the opportunity to hear from Allscripts thought leaders, meet with clients and see live demonstrations of our solutions. Here’s a sample what you can expect to find from Allscripts at the booth: 1.The Power to Innovate: Learn more about the latest innovations in health care, such as precision medicine, best practices for usability and advice from industry-leading clients. At the Allscripts booth, you’ll have the opportunity to hear from Dr. Joel Diamond, chief medical officer of Allscripts Precision Medicine, twice on the topic of how genomics and precision medicine enable providers to deliver tailored treatment […]

2016 is an important year for the healthcare industry, as clinicians look to Health IT organizations to deliver the innovation and insights they need to provide smarter care. Interoperability, precision medicine, actionable data – these aren’t just buzz words, these are the key drivers that will shape health care. Created for healthcare professionals, our magazine, Continuum, features industry insights and Allscripts client success stories. In the 1Q 2016 issue, you’ll find: Executive Insight: Taking the Lead – President and Chief Financial Officer Rick Poulton discusses how Allscripts Open architecture will help providers manage population health. Untethered: CIO Bill Phillips and University Health System – How one client combines Allscripts solutions to achieve better clinical results, earn millions and improve operational efficiency. Get Smart: Allscripts Analytics dives into big data to improve outcomes – General Manager of Allscripts Analytics Marty McKenna discusses […]

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Expect chaos: Why we designed our EHR for interruption

As a physician who practices in an urgent care setting, I know what it’s like to be interrupted all day, every day, while trying to use an electronic health record (EHR). To have to leave one screen to deal with an urgent message or lab result, then try to navigate back to where I was to finish my documentation – workflow challenges are abundant. At the end of most days, I have to spend another hour to catch up on documentation. I understand why physicians avoid steps that take three or four extra clicks, because over the course of a day with 30 patient visits, those clicks add up. Worst of all, poor EHR usability is more than frustrating; it is a patient safety issue. Thinking like our users Like most clinicians, I’m concerned about EHR usability. I’m part of […]

Obstetrics is a unique specialty in that there is an expectation of nearly 100% transition of care from outpatient to inpatient. Consequently, sharing information across healthcare settings is invaluable in obstetric and gynecological (OB/GYN) care. It is a high-volume, high-stakes specialty and providers need tools to document and identify pertinent clinical information as quickly as possible. We designed our new version of Allscripts Prenatal™ 15.3, delivered to clients on December 1, with the primary goal of improving clinicians’ efficiency and satisfaction using the application. We tested common workflows and received overwhelmingly positive results in both objective and subjective measurements of usability. Prenatal embedded in the electronic health record (EHR) improves efficiency, satisfaction Prenatal can now be embedded into Allscripts TouchWorks® EHR, so the clinician doesn’t have to leave the EHR workflow to document obstetric care. This new feature represents having […]