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Technology usability must improve for health care to embrace IT

Information technology might be a driving factor of change in health care, but IT needs to work with users to create improvements. Follow these ideas when implementing systems.

ORLANDO -- Technology is the driving disruptive force in health care these days, breaking the industry away from its prevailing attitude of "but this is the way we've always done it." For that attitude to change, however, CIOs and their peers must improve technology usability.

Even as health care faces new, more stringent federal oversight and stands on the brink of significant changes to the way costs and payments are decided, technology and second-generation clinical development ultimately will lead to improvements in care, say professionals at the Healthcare Information and Management Systems Society's Annual Conference and Exhibition. The HIMSS 2011 show begins Feb. 21.

"We can't reduce cost by cutting staff," said Nate Kaufman, managing director and founder of Kaufman Strategic Advisors LLC. He was talking to more than 500 chief information officers who were at HIMSS 2011 a day early to attend the CIO Forum hosted by the College of Healthcare Information Management Executives (CHIME). "We're going to reduce cost by redesign and digitalization."

To make IT work, however, systems first must be workable and usable. And that's where all the benefits of IT might go out the window if people feel electronic health record (EHR) systems aren't fitting into workflow or aren't fast or intuitive enough.

Designing technology usability is more than just understanding computer interfaces, said Janey Barnes, human factors specialist with consultancy User-View Inc. Usability factors include knowing how people process information, focus and remember, along with how they're functioning in a workspace.

We need to think about this whole socioeconomic environment.

Dean Sittig, professor, University of Texas Health Science Center at Houston

For example, the Apple Inc. iPad work well for clinicians who need to enter data routinely into systems, but how would it feel to hold such a device constantly during a 10-hour shift? "Try it and see how your wrist feels after three hours," said Barnes, speaking Feb. 20 during a symposium on usability and meaningful use at HIMSS 2011.

Knowing what the system is designed for is key as well. A pickup truck works great for taking a bicycle on a weekend nature adventure, but it's not as effective for routine family trips to the grocery store, said Dean Sittig, professor at the University of Texas Health Science Center at Houston, during the usability symposium. The same is true for EHR systems: A billing system will not function effectively in the clinical setting. "We need to think about this whole socioeconomic environment."

In addition to considering how and where an IT system will be used, Sittig offered the following tips for addressing technology usability:

  • Test EHR systems in real-world situations.
  • Ensure computers have a fast response time -- less than one second.
  • Maintain enough computers. Have one computer for each bed on a floor and two for each bed in the intensive-care unit.
  • Establish universal power supplies for systems that cannot go offline.
  • Build in redundancy in case of outages.
  • Create order sets and document templates around the top 20 admissions, surgical procedures and clinical problems seen in the hospital.
  • Consider the age of systems' users when developing interfaces. "You've got to have stuff you can see without changing your glasses," Sittig said.

Let us know what you think about the story; email Jean DerGurahian, Executive Editor.

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