Resolutions on EHR usability, ROI: A welcome relief, or just lip service?

Tools

I read with great interest this week's proposals to improve electronic health records in the new year. First we have Jacob Reider, Acting National Coordinator for Health IT, who published a blog post on Jan. 6 acknowledging that EHR usability continues to be an unresolved issue that remains a priority for ONC. He also notes that the agency is working to understand the issues and determine what the government's role should be regarding EHR usability.

Then we have the Institute of Medicine on the same day issuing a proposed standard model for hospitals and others to evaluate the financial benefits and costs of purchasing an EHR and its potential return on investment (ROI). The proposed model helps provide inter-organizational comparisons, identify "best-in-class" implementation approaches and prioritize process redesign endeavors.

These are welcome developments. It's about time that there's an emphasis on EHR usability and a real tool to help providers determine their ROI when purchasing an EHR. Plus, these initiatives are coming from the government and the Institute of Medicine, no less, so they're backed with notable credibility.

Still, I can't help but to be a little bit cynical here.

The worth and usability of EHR systems have been issues for years. This is nothing new. So why, all of a sudden, are usability and ROI of EHRs front-burner issues?

Wouldn't it have been better for all concerned if EHRs had been made more user-friendly and a standard tool had been developed to evaluate the costs and benefits of EHRs before now? It would have been better had these issues been addressed even a year ago, before millions of dollars were spent, more than $17 billion in Meaningful Use incentives were paid out, and Stage 2 of Meaningful Use kicked in?

To their credit, ONC and IOM attempt to address the delay in addressing these issues. Reider notes that while EHR usability is a major concern to ONC, and that the agency has taken some steps to address it, there is no regulation requiring developers to incorporate usability into their product design. IOM acknowledges that there have been previous analyses of the costs and benefits of EHRs, but said that those were inadequate because they used different, incomparable approaches.

So maybe for ONC and IOM, the time seemed ripe to reassess the usability and ROI landscape. OK, better now than never.

Just as long as "now" doesn't turn into "never," though.

These two developments, especially occurring in the first week of January, strike me as being perennial new year's resolutions that get lip service, but nothing more--you know, the ones that we make every January. We can lump them right with the other resolutions we're so familiar with: losing weight, lowering debt, getting fit, flossing, etc.

Let's hope that 2014 will be the year we will see more usable EHRs and have a standardized tool that can assess their worth, and that this time next year we can move on to new EHR resolutions to conquer. - Marla (@MarlaHirsch @FierceHealthIT)

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