Achieving EHR Usability: Efficiency and Empathy

Original post: July 1, 2013 Updated June 25, 2024

What is EHR Usability?

Digital EHR systems have been around since the 1970s, but they have been fraught with poor EHR usability scores for just as long—many a clinic experiences frustration tied to their electronic health record (EHR) software because if EHR usability problems.

Defining electronic health record usability is easy: the software that manages your electronic health records must work brilliantly (for starters) to elevate the level of your clinical workflow and, as a nice byproduct, improved patient care. But for day-to-day operations, it's important that EHR users find the visual display pleasing and the number of clicks required to get a job done must be kept to a minimum in order to work in a timely manner.

Successful EHR systems but be

• • easy to learn

  • efficient to operate (system automation and EHR alerts)

  • pleasant to use (nice interface)

  • backed by amazing EHR workflow support

No one wants to learn a new EHR system that has a difficult implementation process, requires loads of data entry, or takes too many steps to complete tasks.

It needs to work efficiently for the EHR user.

EHR Usability Score

Usability is a measure of how effectively a product performs its designed function. For health care facilities, there are many health systems that practitioners use to deliver effective healthcare, and electronic health record software is just one (albeit a very important one).

"Poor [EHR] usability has a direct consequence and opportunity cost in staff time and resources that could otherwise be employed in patient care... Previous studies have shown that poor usability can pose a risk to patient safety whereas a highly usable and flexible system can increase efficiency and contribute to a feeling of being valued at work."—BMJ Medicine Journal

In a study conducted by BMJ in 2021, 1663 EHR usability scores were analyzed and no EHR system achieved a median usability score that met the industry standard of acceptable usability.

Elation Health's EHR Usability Score

Elation Health's EHR certification by the Office of the National Coordinator for Health Information Technology required a usability study, conducted by Drummond. Read more about the study here!

Elation Health addresses this unacceptable usability and safety problem head on. We built EHR software with a clinical-first mindset. We have the radical idea that technology can provide you the freedom to focus on your patients (by addressing usability issues).

Elation Health addresses this unacceptable usability and safety problem head on. We built EHR software with a clinical-first mindset. We have the radical idea that technology can provide you the freedom to focus on your patients (by addressing usability issues).

In keeping with this philosophy, two of our most important design objectives are intuitiveness and efficiency.

Electronic Health Information Technology: EHR design

The biggest barrier to entry is that any change requires getting used to; EHR adoption is no different. Human factors come into play here.

So a focus must be put on core competency across team members, and this is where quality EHR training goes a long way toward user satisfaction.

The problem is, EHR systems aren't typically built by EHR users.

Across all industries, the developer/user gap is the reason why systems sometimes fail. So it's a big advantage when those who have a hand in developing an EHR are users themselves. Dedicated EHR developers add top-notch design and engineering skills to clinic healthcare team knowledge, building a product that takes raw data and turns it into a beautiful interface.

Health care organizations provide the most relevant data analysis when it comes to EHR usability. But second to that, EHR usability scores rule the day because healthcare research shows that EHR usability issues are associated with higher odds of clinician burnout.

Addressing EHR Systems Usability Challenges

Constant improvement is a critical step to staying at the forefront of EHR software. A collaborative effort between EHR vendors and the health teams who use it is the best way to optimize EHR software for clinician satisfaction, safety performance, and reduced medical errors.

But it's not all about code. And it's not just about efficiency, either. There is one critical aspect that drives Elation EHR to improve upon usability issues—on top of a regular systematic review. It's a focus on professional satisfaction and identifying and fostering empathy in your employees.

The work environment and habits of physicians are so unique, complex and utterly different than what most technologists and designers are used to. For Elation Health, creating a usable EHR system for busy, practicing physicians requires us to disregard our needs and consumer tendencies and put ourselves in a physician’s shoes.

One example is the complex working environment that physicians are immersed in each day at the office. Physicians have two stark operating modes to deliver care to their patients that an EHR must accommodate to be “usable”:

• • Live, in-person interaction with the patients scheduled to be seen that day

  • Reviewing, digesting, and acting upon information flowing into the practice regarding one of the physician’s patients

When a physician’s in the exam room, the patient and the physician-patient interaction is priority number one. As the patient describes her condition, the physician is constantly shifting between documents in a patient’s chart, referencing tidbits of information to inform her clinical decisions and recommendations, jotting down critical notes as bread crumbs of her decision-making process, all while maintaining eye contact and a comfortable rapport with a patient.

Imagine you’re in a job interview and the interviewer is using his laptop or iPad not only to look at your resume, but also to review your LinkedIn profile, Twitter feed, Facebook activity, blog posts and comments, while simultaneously writing notes about your responses to his questions.

Outside patient appointments, physicians are receiving reams of clinical information about many patients every day. Physicians need to view a patient chart to provide context for what the new clinical information means for that particular patient. The name of the game is to digest and act upon the massive volume of clinical information a physician receives about their patients as quickly as possible, in between seeing patients in the exam room.

Addressing EHR usability challenges is crucial in this context, as it can significantly impact the efficiency and effectiveness of clinical workflows.

Think of it the same was as email: you accumulate hundreds of emails in your inbox on any given day, and you only have 90 minutes—broken into in 5-10 minute increments—to get to zero-inbox by day’s end. If you don’t check every email, patient safety and clinical health may be compromised.

Electronic Health Record Usability: Empowering Physician Groups and Primary Care Doctors to Deliver Phenomenal Patient Care

Software that gets the job done in the best way, while also leaving room for patient empathy is so important. What physicians do, what they need, and in what contexts they need it are foreign to the average person (and too many developers).

Empathy is essential to understanding physicians’ needs and build a tool to address them. Identifying and creating empathy is precisely the reason we at Elation have built a key step into our hiring process: shadowing a physician.

Read Elation engineer Phill Tornroth’s account of his shadowing experience.

We started by building an EHR for our family’s own medical practice. Now, we help more than 24,000 clinicians navigate challenges. We’ve earned the trust of both insurance-taking and direct primary care practices, and we serve solo physicians and groups with hundreds of physicians.

We are committed to technology that values your time, puts the patient interaction first, and helps you achieve economic and clinical health. We're passionate about building tools that help you do what you know is right for patients.