ONC needs to incorporate safety into the usability of EHR reporting and prioritize safety in new certification requirements for EHRs used in pediatric care, according to Ben Moscovitch, project director of health information technology for the Pew Charitable Trusts, in a Jan. 28 comment letter to Donald Rucker, MD, National Coordinator for Health IT.
Pew’s response follows ONC’s request for comments on its Nov. 28 draft report, “Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs,” which proposes making EHRs easier for clinicians to use while at the same time easier to meet regulatory requirements.
The ONC proposal was mandated under the 21st Century Cures Act.
WHY IT MATTERS
In the report, ONC highlights two key challenges with EHRs, namely, poor system usability and ineffective data exchange.
“These same challenges can also introduce patient safety problems and hinder the coordination of care,” wrote Ben Moscovitch, project director of health information technology for the Pew Charitable Trusts. “ONC, through several policies under development, can take steps to address these challenges.”
The Pew Charitable Trusts, a non-profit research and policy organization, has a number of initiatives focused on improving the quality and safety of patient care. The organization also works on facilitating the development of new medical products and reducing costs. Last April, Pew released a report on how to make EHRs easier and safer to use.
THE LARGER TREND
Moscovitch pointed out that usability challenges can arise from the implementation, customization, layout, use, and maintenance of an EHR system.
“These same factors can also contribute to medical errors — such as patients receiving the wrong dose of a drug,” he noted.
Moscovitch explained there are two provisions in the Cures Act that ONC could use to ease EHR burdens on clinicians and improve safety.
One: develop a reporting program to collect data on a variety of EHR-related functions, including system usability. “Given the intersection of usability and medical errors, ONC should ensure that some of these usability-related criteria focus on safety,” Moscovitch added.
Two: issue regulations that establish a voluntary certification program for EHRs used in the care of children. EHRs designed for use with adults can overlook differences in the care of children — such as growth patterns — and introduce the opportunity for error, he says.
In the report, ONC said APIs can be used to improve interoperability, but Moscovitch said, “only if the interfaces are effectively implemented.”
ON THE RECORD
“Forthcoming regulations from ONC on EHRs used in the care of children and the development of a new reporting program offer opportunities to enhance usability — which would simultaneously reduce burden and improve safety,” Moscovitch added.
Diana Manos is a Washington, D.C.-area freelance writer specializing in healthcare, wellness and technology.
Twitter: @Diana_Manos
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