Why Electronic Health Records Aren't More Usable

It shouldn’t come as a surprise that most doctors are unhappy with their electronic health record (EHR) systems, which tend to be clunky, hard to use and may actually get in the way of truly excellent patient care. Here’s why that’s not likely to change anytime soon.

Federal government incentives worth about $30 billion have persuaded the majority of physicians and hospitals to adopt electronic health record (EHR) systems over the past few years. However, most physicians do not find EHRs easy to use. Physicians often have difficulty entering structured data in EHRs, especially during patient encounters. The records are hard to read because they're full of irrelevant boilerplates generated by the software and lack individualized information about the patient.

Alerts frequently fire for inconsequential reasons, leading to alert fatigue. EHRs from different vendors are not interoperable with each other, making it impossible to exchange information without expensive interfaces or the use of secure messaging systems. EHRs are designed to support billing more than patient care, experts say. They add to, rather than reduce, the workload of doctors. And they don't follow the principles of user-centered design (UCD), which puts the needs of the user at the forefront of the design and development of products and systems.

The American Medical Association in 2014 issued an eight-point framework for improving EHR usability. According to this framework, EHRs should...