EHR Adoption and Usability – The Critical Five Elements Every Physician Should Consider

Posted on by Frank J. Rosello

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) reported 100,000 physicians and hospitals had registered for the Medicare or Medicaid electronic health record (EHR) incentive program.  This resulted in more than $850 million in EHR incentives being paid through September 30, 2011.

While these statistics may look impressive, consider the fact that there are approximately 500,000 total eligible providers and 5,100 hospitals throughout the United States.  With such a low market penetration, the data suggests that the U.S. healthcare system still has a long way to go in achieving one hundred percent adoption of EHR technology.

Currently, there are several factors that negatively impact EHR adoption, but dissatisfaction with usability is surfacing with greater frequency. While effective implementation and training plans affect EHR adoption rates as well, poor usability negatively impacts practice productivity, user satisfaction, and error rates.

EHR usability is typically associated with user satisfaction, but usability is actually more aligned with physician and patient workflow integration. Physicians and practice administrators place a significant amount of attention on the number of keystrokes, clicks, and screens.   But what many fail to consider in assessing usability is how and when patient data is presented, which ensures the EHR platform provides physicians with the right information at the right time.

So what determines if a particular EHR platform is useable?

Before answering this question, it is important to note and recognize that the perfect EHR platform does not exist in the marketplace.  And instead of physicians seeking the perfect template allowing for every patient visit to be recorded, their time is better spent looking for the template that fits the majority patients they see.  Suffice it to say there is no 100% solution.

However, here are five elements every physician and practice administrator should consider when evaluating EHR usability:

1. Physician and Patient Workflow Support: The EHR platform should support both physician and patient workflows. The technology should be broader than any single user or patient, and should be flexible enough to support the entire operation top to bottom.  When evaluating EHR platforms during the selection process, a best practice is to present the vendor with three clinical scenarios:

  • The most common patient scenario at the practice.
  • The most challenging patient scenario.
  • The patient scenario with the most number of interactions among the staff. 

Simply using the three examples in the early assessment phase will significantly help understanding how the EHR platform will support core workflows.

2. Degree of Difficulty:  To insure the EHR platform won’t require substantial changes to existing practice workflows and processes, physicians should pay particular attention to how they interact with nurses and staff when using the EHR in a demo environment. This goes for encounters with patients in the office, on the telephone, and with how incoming documentation is handled. A good best practice is for the physician and their team to visit a practice and see the EHR solution in full operation. This experience will clarify changes the physician and their staff should consider for their own unique needs.

3. Flexibility: EHR usability is all about integrating the EHR into a physician’s practice day in and day out. EHR usability can be complicated so the way a physician uses the technology will evolve as they become more comfortable with improvements in workflow and overall operational efficiencies.

4. Efficiency: An EHR in designed to save time and improve physician and patient workflows. Several EHR platforms do a good job of allowing a physician and staff to easily work on the same computer. This functionality keeps an active patient record online, allowing for the physician and staff to work concurrently on parallel paths.

5. Effectiveness: Another key element of assessing an EHR platform’s usability is in how it streamlines workflows. Until now, the outcome of EHR adoption has been focused around managing patient volumes, procedures, etc. As healthcare evolves to a more value-based and consumer directed environment, it is critical for physicians to choose an EHR platform that improves overall workflows while keeping patients connected their doctor.

When it comes to determining EHR platform usability, it’s a process that’s ultimately driven by the medical professional and their patient.  As with any business, the customer is always right, and EHR technology is no different.   

Frank J.Rosello is CEO & Co-Founder of Environmental Intelligence LLC. 

Environmental Intelligence LLC is a Complete Outsourced Health IT Company providing End-to-End meaningful physician workflows consulting, integration, and implementation in (EHR) Electronic Health Records and Practice Management to private and public medical practices and facilities differentiated by our experienced, physician driven administrative staff and dedicated IT team.

To learn more about our Physician Focused – Patient Driven approach to EHR & Health IT Visit our website:


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