Crash test dummies and The Usability of Electronic Health Records

The big business interests of the Healthcare industry cried wolf (and lobbied hard)

against the meaningful use (now called “Promoting Interoperability”) program and enhancements to the usability requirements. Perhaps because they don’t want to spend the extra time and money to provide a healthcare system that truly follows a safety-enhanced design philosophy.

They are no better than the automobile industry that fought hard against seat belts in the late 1960 and against The United States Intermodal Surface Transportation Efficiency Act of 1991 that required airbags in cars.

In the 21st century app-based Internet twitter-verse where millions of dollars can be made in week, it may seem that ONC and the federal government is getting in the way of progress in health IT.

Federal regulations are stifling innovation, they may say. Of course nobody wants to follow a long, costly and bureaucratic process in order to bring products to market. However, we need to remember that in Health IT, much like in the Auto Industry, it truly is a matter of life and death.

The Joint Commission issued their Sentinel Event number 54 outlining the dangers of usability (and other problems) with Electronic Health Record systems. Sadly, they said that:

Incorrect or miscommunicated information entered into health IT systems may result in adverse events. In some cases, interfaces built into the technology contribute to the events.

According to the Joint Commission report (http://www.jointcommission.org/assets/1/18/SEA_54.pdf) , The top contributors to these problems were the:

• Human-computer interface (33 percent) -- Ergonomics and usability issues resulting in data-related errors
• Workflow and communication (24 percent) -- Issues relating to health IT support of communication and teamwork

According to the National Highway Transportation Safety Administration, seat belts have saved nearly 63,000 lives during the 5-year-period from 2008 to 2012 (See http://www-nrd.nhtsa.dot.gov/Pubs/811851.pdf ). In addition to the 2,174 lives saved by seat belts alone in 2012, thousands (2,213) of lives were saved in 2012 by frontal airbags.

The Auto Industry fought hard against the regulations requiring that they put these safety features into cars, because they claimed, it would make cars too expensive, reduce innovation, and cut into their bottom lines.

So, the next time you get into your car, put on your seat belt and drive off, think about your last doctor appointment and all of the various Health IT systems that your doctor is using.

Do you want "market forces" to self-regulate safety standards for these devices and systems, or do you want reasonable federal standards proposed by industry experts?

Either choice may help to improve the safety of Healthcare IT.