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The Health IT Safety Center Roadmap, recently released from the Office of the National Coordinator (ONC), presented a plan for taking important steps toward improving the safety of Health IT and, therefore, patient safety. Its purpose, clearly stated, is because “Today, thousands of health care professionals, hospitals, and their patients enjoy quality and safety improvements from electronic ordering, decision support, results reviewing, and other EHR functions”. Electronic Health Record EHR software has dramatically improved patient safety e.g. by improved legibility of writing (no more trying to figure out doctor prescriptions and dosage), communication flow within clinic (no more hunting/looking for paper charts) and automatic drug-to-drug and drug-drug alerts etc. “At the same time, safety organizations and researchers, health IT users, and other stakeholders have found risks and hazards to patient safety associated with these systems and the complex environments in which they are implemented and used.”
 

In a recent blog posted on the ONC’s website, Andrew Gettinger, M.D., Chief Medical Information Officer, Acting Director, Office of Clinical Quality and Safety emphasized that “doctors, nurses, and other clinicians that are all part of the care team are frustrated by health IT systems that are not coordinated or optimized to their workflow. Many of these systems will benefit from better usability and feedback from user community”
 

The complexities woven into this statement incorporate the facts that EHR use and the resulting new workflow processes can be very new and disruptive, many healthcare providers are not tech savvy and most EHRs are cumbersome and tedious to use. Thus, it is important to have an EHR which is easy to use and learn. For example, smartphones with app technology is easy to use and yet provides very complex functions. Similarly, newer EHRs use apps technology to build an EHR. These newer EHRs allow one to customize and personalize a user workflow by simply moving and rearranging apps or widgets on the screen. For example, if you are nurse, you can have only the widgets (family history, vitals, allergies, etc.) you need, in the order you do your work. This is similar to rearranging and personalizing apps in your smart phone. Newer EHRs also allow you to make your screens clutter free by only having what you need on your screens. Thus EHRs using apps technology, by allowing personalization of your screens and making them clutter free, can further improve patient safety.
 

The ONC report states, “The safety of health IT can be improved, and the improvement should be continuous, as part of a learning health system.” Thus you wish to partner with an EHR vendor which provides ongoing learning and collaboration opportunities with other customers, for example, via user focus groups. User focus groups can provide advanced learning as well as improve processes based on peer-to-peer learning.
 

If you are still in the process of replacing an existing EHR or looking for a new EHR system, you need to find an EHR system which is a) easy-to-use and easy-to-learn by your staff and b) EHR vendor provides user focus groups for advanced learning as well as collecting feedback on how to improve the product further.
 

Like everything new, there are positives and negatives associated with EHRs. In the Roadmap, developed by RTI, International, Gettinger notes “Even clinicians who were completely frustrated with the electronic health records that they are currently using, if given the opportunity, few said they would return to paper and pen-based records.”