News Feature | February 16, 2015

AAFP: EHRs Are Failing Your Healthcare IT Clients And Their Patients

By Megan Williams, contributing writer

AAFP: EHRs Are Failing Your Healthcare IT Clients And Their Patients

Physicians have been heavily impacted by the advent of electronic health records, and one of their premier professional organizations has taken the stance that the industry-changing technology is doing them a disservice.

In its blog, the American Association Of Family Physicians emphasized, the dissatisfaction many physicians have with the performance of EHRs. They made their critique known to the Office of the National Coordinator of Health IT (ONC) in a letter to director Karen DeSalvo, M.D., M.P.H., describing the systems as “cumbersome” and not meeting their workflow needs. The letter also cites decreased efficiency and limited interoperability, if any.

Their critique didn’t end with the impact on physicians though: “Most importantly, certified EHR technology can present safety concerns for patients. We believe there is an urgent need to change the current certification program to better align end-to-end testing to focus on EHR usability, interoperability, and safety.”

Recommended Changes

The letter didn’t stop short at criticism. The AAFP, along with 40 other signing organizations, suggested changes to improve the current EHR certification process, including:

  • Decoupling EHR Certification From Meaningful Use (MU). The association had no kind words about the MU program, squarely naming it as a source of EHR system problems. They also noted that the objective places “excessive burdens on physicians and their practices” because of the way compliance is tied to forces outside physician control, like patient participation, data collection, and exchange methods.
  • Considering Alternative Software Testing Methods. The signed organizations emphasized the importance of certification demonstrating not only that an EHR can meet MU standards, but that interoperability and patient safety are also concerns. This means more emphasis on exception handling and user-centered design (UCD): “Currently, EHR certification testing is done in controlled environments that often do not mimic the flow of medical information in real-word clinical settings and is not capable of identifying safety-related issues ... It is vital that proper UCD (user-centered design) techniques are adhered to so that EHR vendors incorporate both user interface and cognitive workflow design in the development of their products.”
  • Emphasizing Education. To address the lack of inclusion of stakeholders in the EHR certification process, the letter requested that the ONC establish a “software certification learning session” that involved professionals from a variety of fields, who specifically had experience in producing, testing, and certifying software.

They also requested an increased emphasis on education for physicians and other professionals using EHRs around implementation. “ONC should routinely request implementation best practices from the field ... At the very least, educational activities should be conducted after each new EHR certification version.”