Gavin Lew Addresses National Committee on Vital and Health Statistics on Improving HIT Usability

May 1, 2009

The National Committee on Vital and Health Statistics, the public advisory body to the Secretary of Health and Human Services (HHS), held a hearing on “Meaningful Use” of Health Information Technology (HIT) in Washington DC this week. Gavin Lew, Managing Director of User Centric, addressed the committee about the importance of including usability measures when evaluating HIT.

The responsibility of defining the term “meaningful use” lies in the hands of this HHS committee, who will ultimately decide how physicians will be compensated if they choose to implement HIT in their practices. Widespread adoption of HIT is a major focus of the Obama administration’s plan for improving healthcare.

To encourage physicians to accelerate adoption of HIT, Congress is offering compensation when physicians implement and use these systems. However, before any incentives are issued, the term “meaningful use” as it applies to HIT must be defined. The hearing addressed this and debated what criteria should be considered.

The text of Gavin's remarks are as follows:

I’d like to thank the committee for this opportunity. My name is Gavin Lew from User Centric, I and my colleagues are behavioral scientists - experts in human interaction with technology. I share the vision of improved quality of care and savings through improvements in HIT. I agree with the panelists on the future benefits. However, the key assumption is that clinicians actually embrace EHRs today.

To quote Dr. Blumenthal in his NEJM article, "Many ‘certified’ EHRs are neither user-friendly nor designed to meet HITECH’s ambitious goal of improving quality and efficiency in the health care system."

My question to this distinguished committee is simple: Shouldn’t “meaningful use” address the problem that poor usability is recognized as one of the key barriers to EHR adoption?

In short, if doctors don’t use it, it doesn’t work. If doctors won’t use it, it doesn’t work. Poor usability and adoption issues are universally recognized pain points today. How will this change if “meaningful use” and certification do NOT address usability? Yes, clinicians can be forced to use EHRs. But, if EHRs continue to be difficult to use the result will be only the bare minimum interaction. Even worse, it is well documented in our field that poor design induces error. Error in a clinical setting results in disastrous consequences. Improving the clinician/user experience with EHRs, improves quality of care. “Meaningful use” MUST have a behavioral component that measures clinical interactions. EHR user performance can be measured, and criteria can be established. These criteria will will force vendors to take seriously user performance rather than simply give it lip service.

The technical aspects of Meaningful Use have been broadly and thoroughly discussed. I urge this subcommittee to understand the human aspects of meaningful use - to measure how well EHRs really work in practice to make the stimulus package realize benefits now and for the future. A more descriptive written statement will be submitted by User Centric to provide a roadmap for implementing these measures.

User Centric also submitted written testimony to HHS advocating the development of a standard framework for measuring and collecting user performance data on HIT systems, as well as for improving the usability of HIT systems. Download the Supplemental Testimony: Developing a Road Map for Addressing the Behavioral Aspects of HIT “Meaningful Use."

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