WASHINGTON, D.C. -- An oft-heard complaint from physicians is their EHR systems are hard to use, clunky, unwieldy, and time-consuming. EHR usability is a key point for Andrew Gettinger, M.D., chief medical informatics officer and acting director of the office of clinical quality and safety at the U.S. Office of the National Coordinator for Health IT. The easier that EHRs are to use, the safer the medical outcomes that they produce in concert with healthcare practitioners, he says.
In this video, recorded at ONC's annual meeting in February, Gettinger also talks about ONC's growing role in spurring IT advances in long-term care and behavioral health settings, which are not covered by meaningful use.
Gettinger also emphasizes that interoperability -- the capacity to move health data within and between healthcare systems -- is the cornerstone of advances in healthcare on a national scale, as is the focus on the patient as the most important member of the clinical care team.
Gettinger says ONC's new interoperability roadmap is the essential guide to that process.
At the end of the road, ONC officials like to ask: Is healthcare as a "learning system?" For Gettinger, the learning system is a national healthcare network powered by a free flow of health data that allows providers to practice better medicine.
Transcript - ONC informatics official says EHR usability promotes safety
Andy Gettinger: There are a couple of different avenues to do that. First of all, I consider usability part and parcel of safety. If you don't have a system configured so that it is intuitive and helpful to the clinician using it, then it's likely going to result in some safety signals or problems. [ONC has] funded and have initiated an effort to develop a roadmap for a safety center. It's anticipated to be a public-private collaboration. I'm expecting that we will learn to what extent usability needs to be addressed in that and to what extent other aspects needed to be addressed in that. The good news is that we have some of the most prominent health IT safety experts in the country participating with us on the task force.
ONC just laid out its interoperability roadmap. How will this framework improve EHR usability and safety?
Gettinger: So the roadmap is important. It's a 10-year roadmap, not a simple thing that can happen overnight. But when I think about interoperability, I think about interoperability in a variety of ways. The high-profile way is [the example] that when you fly from New York to San Francisco, something happens to you and then instantly your health information is available to treating clinicians in San Francisco. Actually, interoperability happens day in, day out in your local community when you go to different doctors, different nurses, you go to a pharmacy and you go to physical therapy.
What we need to do is improve this system to allow all of those caregivers to become part of a single team. By the way, to date, the most unrecognized part of that team is the actual patient. So if you look at [ONC's] interoperability roadmap, we highlight the patient as an active participant in their care -- plus, other entities in the community that haven't traditionally been part of this. Long-term care providers and behavioral health are two examples of that.
ONC has talked a lot about turning the national health care network into a learning system. How does the interoperability roadmap address the learning system aspects?
Gettinger: I entered the field of health IT 20 years ago with the vision that each clinical encounter, each time I saw a patient, the experience that I had would add to a growing knowledge database of awareness of what works, what doesn't work and what works best for patients. The transition from the paper records that I started with to electronic health records is the basis for getting there. But being able to aggregate all that information, being able to in the appropriate way with appropriate deference to making sure that there is privacy and security safeguards for that record, will enable us to have insights into care that we don't currently have today.