In this article, providers are asked to complete a simulated task in their standard EMR – which is Mayo’s LastWord supplemented by Chart+ – vs a “novel” EMR redesigned specifically for a critical care environment with reduced cognitive load and increased visibility for frequently utilized elements and data. In their bleeding patient scenario, their novel EMR was faster and resulted in fewer errors. So, thusly, a better EMR design is better.
While it seems intuitively obvious – you still need studies to back up your justification for interface design in electronic medical records. Their approach in testing is one I’d like to see expanded – and perhaps even implemented as a regulatory standard – evaluation on cognitive load and a certain level of task-based completion testing with error rates at a certain level. Electronic medical records should be treated like medical devices/medications/equipment that should be rigorously failure tested. While EMRs are far more complicated instruments, studies such as this one, illustrate that an EMR with interfaces designed for specific work environments to aid in effective and efficient task-completion save time and reduce errors.
The main issue I see with EMR these days is that the stakeholders and motivators behind this initial wave of implementation in financial – systems in place to capture every last level of service provided to a patient in order to increase revenues. Now, the next generation and movement with EMRs is to look at how they can increase patient safety, particularly in light of threats of non-payment for preventable medical errors. Again, financial motivation, but at least this financial motivation is going to motivate progress and maturation of medical records as tools to protect patients, not simply to milk them for profits.