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Usability Profile: An Oncologists Pathway to Medical Informatics

A practicing medical oncologist and computer enthusiast for over 30 years, I was initially excited about the potential for health information technology (health IT) to improve healthcare quality, until the implementation of Electronic Health Records (EHRs) and Computerized Provider Order Entry (CPOE) at my organization in 2006. I quickly realized that current generation EHR software was not properly designed or optimized to support clinical workflow. This created a challenging user experience for practicing clinicians and prevents health IT from achieving the quality, safety, and cost efficiency benefits it was designed for. It became, and still is, my passion to help overcome these barriers and see health IT reach its full potential.

I obtained an online Master’s degree in medical informatics from Northwestern University and became the founding chair of a physician-led clinical informatics committee my hospital.  I worked on CPOE order sets as a subject matter expert & clinical advisory committee member, and served as a physician champion during CPOE implementation. I continue to serve on clinical advisory committees for further developing the inpatient EHR and for developing the second generation of the oncology specific outpatient EHR used in my office. I also achieved board certification in Clinical Informatics with the first class of Diplomates in that new subspecialty.

I became active in the Healthcare Information Management and Systems Society (HIMSS) as I felt it was a good venue to encourage collaboration among clinicians, software developers, and human factors experts; three groups whose contributions will be essential for improving the usability of health IT.  I served a year on the Physician Committee, currently serve on the HIMSS Health IT User Experience Committee and Chair the Physician Community EHR Usability Workgroup. I also qualified as a Certified Professional in Health Information and Management Systems (CPHIMS) and conducted a summative scenario-based usability study of the inpatient EHR at my hospital which was presented as a poster at HIMSS15.

Looking forward, I want to continue working with physicians, nurses, and software developers to:

  • Reach consensus on what constitutes usability in an EHR and how to measure it
  • Describe clinician problems with health IT in a more objective, quantifiable form to promote open dialogues with software developers
  • Define best practices for incorporating clinician input in user-centered design processes during EHR development
  • Create representations of clinical workflow which are more clear, computable, and amenable to representation in the code which constitutes the structure of EHRs

I would also like to see clinicians more educated, empowered consumers whose demand for more usable, powerful EHRs will provide a business case that speeds up the development of a new generation of health IT. Health IT has the real possibility to increase doctor’s efficiency and truly can enable us to provide better care quality and better population health at a lower per capita cost.

If you are interested in learning more about EHR usability, a great place to start is Dr. Jeff Belden’s e-book Inspired EHRs: Designing for Clinicians (available at http://inspiredehrs.org/). A more detailed, information dense summary of the topic is given in Dr. Jiajie Zhang’s book Better EHR: Usability, workflow, and cognitive support in electronic health records (available at Better EHR). Both of these are designed to be taken one chapter at a time, making the book length works more user friendly. 

Keywords: 
clinical informaticsPhysician ProfileusabilityMedical Informatics