Posted in EHRs

How implementation decisions, nursing informatics impact EHR usability

Chris Nerney
Chris Nerney, Contributing Writer |
How implementation decisions, nursing informatics impact EHR usability

The usability of electronic health records (EHRs) is one of the key factors in a healthcare organization’s ability to treat patients effectively and enable employees to work efficiently. EHRs that are clumsy to use or difficult to explain to employees slow down clinicians and administrative workers, creating unnecessary costs and potential gaps in the care continuum due to data and workflow barriers.

In the Office of the National Coordinator for Health Information Technology’s (ONC) blog, ONC Chief Nursing Officer Rebecca Freeman writes that while usability problems frequently are blamed on regulatory requirements, “many issues are the result of implementation decisions.”

“I like to say that a system will not be usable if you don’t know how to use it: a training, knowledge, or support deficiency often underlies inefficient use of the system,” Freeman says. “Many meetings called to address documentation burden, in the form of too many clicks, have little to do with the system and more to do with pre-implementation decisions such as customized content, mandatory fields, pop-up alerts, flow sheet rows, etc.”

And while Freeman argues that implementation is key to usability, she adds that nursing informatics is  the key to EHR optimization.

“Nursing informaticists transform the usability of health IT systems in their facilities and practices,” she writes. “Trained with a diverse set of tools to expertly triage and correct any system, workflow, training, and accountability issues, they lead the partnerships between their frontline clinicians, super users (i.e., bedside clinicians who receive additional health IT training), and IT clinical analysts and builders.”

Freeman cites several real-world examples of how nursing informatics analyses led to dramatic reductions in time lost to unnecessary clicks and documentation, enabling providers to shift more of their time to patient care.

“Nurse informaticists possess the ability to mediate and moderate governance and interdisciplinary committees to align practice, health IT, analytics, and outcomes, and they are capable of significantly impacting the usability of health IT across the health care system,” Freeman concludes.