EHR usability is among the greatest barriers to digitizing America’s healthcare system. Electronic health records present a push toward modernization – transformation even –  but to fulfill the promise, industry insiders say, the clunky technology has to be made easier for doctors to use. EHRs must be more elegant and more interoperabile.

“Poor EHR system design and improper use can cause EHR-related errors that jeopardize the integrity of the information in the EHR, leading to errors that endanger patient safety or decrease the quality of care,” Sue Bowman, AHIMA’s senior director of coding policy and compliance, wrote in an article of AHIMA’s Perspectives in Health Information Management. “These unintended consequences also may increase fraud and abuse and can have serious legal implications."

[See also: Object of beauty, or ungainly nuisance?]

Bowman essentially rolled together a half-dozen tactics for addressing EHR usability:

1. Usability should be included in the EHR certification process
2. Certification requirements should define what a vendor’s product is not allowed to do in addition to what it must do
3. Healthcare organizations and other providers should develop and implement policies and procedures pertaining to appropriate EHR use
4. Healthcare organizations should ensure that all users receive thorough training on system use, including the organization’s expectations regarding the use of the system
5. For each application, quality and safety procedures that are consistent with the degree of safety risk associated with that application should be adopted
6. An internal reporting system to identify problems using the EHR, EHR-related errors, and any other EHR-related issues should be established

[See also: Does the right EHR even exist?.]

“The current approach to EHR standardization and certification does not address system implementation, usability by clinicians (including integration with workflows), or information integrity,” Bowman noted. “Certification criteria used to establish eligibility for use in the Centers for Medicare and Medicaid Services EHR Incentive Program, while slowly starting to address EHR safety and usability issues, are not yet sufficient to ensure EHR-related safety and improve information integrity.”