I want to add the following. I'm an IT professional. In the course of my professional duties, I'm expected to…
Morning Headlines 10/15/13
Mostashari shares concerns, ‘insider clues’ in first speech since leaving ONC
In a keynote speech at the CHIME Fall CIO Forum, ex-ONC leader Farzad Mostashari, MD spoke candidly about ONC policy. He reports that the Stage 2 timeline will likely stay on track as planned. He also discussed usability, saying, "“I do worry about usability. Not that it isn’t getting better…but I wonder if the market is incentivizing usability as much as it should."
National eHealth Strategy Review to be Considered This Year
In Australia, Deloitte has been contracted to run a mid-point review of Australia’s national 10-year eHealth implementation, which kicked off in 2008 and which Deloitte is also running. According to Linda Powell, first assistant secretary for eHealth policy, the review will focus on clinical adoption to ensure the systems in place are resulting in "meaningful use."
Petersburg Gets New Hospital Computer System
Petersburg, AK-based Petersburg Medical Center goes live with its $1.4 million CPSI EHR.
I find Dr. Mostashari’s comment, “…but I wonder if the market is incentivizing usability as much as it should.” to be a bit surprising. The Market has done relatively little regarding the usability of healthcare software. I think if you talk to any doctor or nurse using an EMR over the past 10 years they’d agree. But that is because ‘the market’ still incentivizes products to buyers who define usability in terms of available functionality (CPOE, eMAR, Documentation, etc), Meaningful Use analytics, and Integrated Platforms… etc. Also changes such as ACO’s which favor large EMR vendors, whose products where built long before usability became a topic, continue to favor the growth of products whose usability is still lacking for the front line clinicians who use them today.
As a former designer on one of the major enterprise EHRs, I can tell you that usability is relegated to a luxury on folks’ roadmaps due to (1) mountains of technical debt from aging platforms and rapid consolidation/product mergers and (2) MU requirements for certification. The ONC’s addition of demonstrating usability testing as a requirement for stage 2 (i.e. submit a report showing that you got usability feedback) does very little to actually fix usability (and frankly, it took away resources who could have otherwise been improving the products or completing functional MU2 requirements faster).
The glimmer of hope, however, is better fungibility of data through interoperability initiatives and MU requirements around HIE and data portability, in addition to natural market forces. The government forces the vendors’ hands to the HIE table, which will eventually loosen the footing of entrenched mega systems in healthcare settings, as better products can come in and do the job better, faster, safer, and with better customer satisfaction.