14 ways to put your EHR to the test on usability, safety
Physicians now have ways to test their electronic health records (EHRs) to ensure they are avoiding workflow or other challenges that can affect the everyday practice of medicine.
A multidisciplinary panel that included physicians, nurses, pharmacists, EHR vendors, patients, and health information technology experts, helped create 14 safety-based, rigorous test-case scenarios for vendors and healthcare organizations to use to evaluate the usability and safety of how the system is performing on a certain task. Running a scenario takes anywhere from 10 to 20 minutes.
The test-case scenarios are included in a report from the AMA, Pew Charitable Trusts, and Medstar Health, Ways to Improve Electronic Health Record Safety. The report identifies shortfalls with EHR usability, implementation and testing, and outlines how to improve usability and safety across the continuum—from development to the post-implementation of EHRs.
The three organizations reviewed the medical literature and convened an expert panel of physicians, nurses, pharmacists, EHR vendors, patients, and health IT experts. As a result of the panel’s work, leaders from the three organizations are calling on developers and healthcare organizations to voluntarily adopt the criteria and asking oversight organizations such as the Joint Commission to drive providers and vendors to incorporate the recommendations and adhere to the best practices throughout an EHR’s life cycle.
The criteria include several factors such as safety culture, product design and development, acquisition, customization and configuration, implementation and system upgrades, and training and provides EHR developers and healthcare providers with specific areas of opportunities for improvement within each EHR life cycle stage.
The 14 test cases included in the report can help tackle the usability and patient safety issues relating to data entry, alerting, interoperability, and more.
Physicians and their organizations can “immediately leverage” example test cases to “quickly evaluate system safety to identify challenges and prevent harm,” the report says. The report also outlines what constitutes a rigorous test case, so physicians also can create their own tests. The report says a rigorous test case needs to be representative, contain concrete goals and measures, test areas of risk or inefficiency, and define the audience.
A study of incomplete lab results looked at a basic scenario to test whether your EHR will catch that a critical piece of information is missing from a patient’s laboratory work. The test takes about 10 minutes.
Multiple EHR systems have been noted to allow laboratory staff to release incomplete sets of labs without a placeholder for the unreported components of the blood test. For example, a basic metabolic profile typically contains seven elements. If only six results come back normal and the physician misses the seventh result, the patient could be discharged with a life-threatening condition.
