If you've been following us for any amount of time, you'll know we're very bullish on EHR's (Electronic Health Records) and more recently Universal Electronic Health Records due to the investment that's been flooding into this area over the past few years. Psychologically, no one likes change and when it comes to technology much of the "make-or-break" moments are decided on design and the user-interface as this defines whether people will use your technology or not. With this in mind, we take a look at designs and concepts for EHR's/UEHR's.
Incorporating design concepts into EHRs
A study recently published in JMIR Human Factors revealed EHR design interfaces have increased same-day entry of data by 10% per physician thus demonstrating the potential for design to improve efficiency of healthcare physicians.
Persuasive design is a to develop technology influencing behaviour by leveraging social processes. It's a first for this approach to be used to influence clinician behaviour having only previously been used in consumer-faced apps. The research was done as in primary care settings, providers face barriers to entering data into EHRs in a timely manner and they're deemed lower priority - despite the efficiency upside research consistently shows - essentially patient contact time is valued higher than actual patient healthcare in the current paradigm.
The research team cited a previous study finding that records are more valid and complete if they are entered entered into reporting systems on the same day. This study showed on average only 50.7% were recorded on the same day revealing a need to improve efficiency.
The group hypothesised that persuasive design principles would redefine EHR. Researchers had set out to find whether the design would change clinician behaviours in a primary care environment and improve the data quality.
The team designed and implemented an updated interface with the recommended design features. The updated system included an option for users to edit their data after viewing a summary screen, as well as elements to encourage same-day entry.
The group analyzed the data of 53 users over a 16-week period, comparing the data entered in the eight weeks prior to implementation for the data entered in the eight weeks after the implementation. The team found intervention increased the same-day data entry by 10.3% and improved the data validity measure by 0.7%. However, researchers found the intervention decreased the percentage of records by 4.8%.
The group stated reduction in completeness could be the result of clinicians trying to hit the "same day" metric as quick and easily as possible. To combat the issue a "completeness" metric could be necessary according to the report.
Despite this decrease in data completeness, the authors maintain implementing design elements in EHRs in the future can potentially improve data entry among providers.
“By conducting a detailed systems analysis and introducing new persuasive design elements into a data-entry system, we demonstrated that it was possible to change data-entry behavior and influence data quality in a reporting system. Our study demonstrates merit to the use of persuasive design for changing data-entry behavior in clinicians.”
Several limitations of the study focused on a small group of only 53 users, it was difficult to produce meaningful, statistically significant comparisons. The researchers response was that "it will be necessary to deploy the reporting system into additional organizations to make significant comparisons. "