Pew: EHR reporting program should focus on safety, usability

Pew Charitable Trusts is asking the Office of the National Coordinator (ONC) for Health Information Technology to incorporate safety-related data into its reporting criteria for usability in its new electronic health records (EHR) reporting program.

In August, the ONC filed a request for information (RFI) on the EHR Reporting Program, which was established under the 21st Century Cures Act. The act requires HHS to ensure health IT developers submit required information in order to obtain and maintain certification. The department is also required to lead a public process to establish the reporting criteria for the program.

According to the RFI, the request is a “first step toward implementing the statute. Its responses will be used to inform subsequent discussions among stakeholders and future work toward the development of reporting criteria under the EHR Reporting Program.” Responses to the request were due on Wednesday, Oct. 17.

In its response, Pew said the program could help with reducing clinician burden while improving patient safety. The research organization then urged the ONC to incorporate reporting criteria for usability with safety-related provisions.

Additionally, Pew said usability challenges stem from several factors, including the design of EHR systems, how they’re customized by facilities, and unique workflows. Ineffective usability can lead to clinician confusion and patient harm, Pew stated, citing several reports and published studies on usability issues with EHRs.

Pew urged the ONC to consider the following usability principles in its EHR reporting program:

  • use a life-cycle approach 
  • incorporate quantitative, measurable data 
  • limit burdens on end-users
  • use transparent methods that prevent gamesmanship

Pew also asked the ONC to consider several other principles and concepts to “establish a successful EHR reporting program”: use a system or audit log data, facility resources, and stakeholder engagement.

“Pew can serve as an expert resource to help ONC and its contractor examine safety-related usability criteria for the program. As the program develops, Pew intends to assess data sources that can inform the reporting program and examine how to adapt existing efforts to serve as usability-related criteria,” the letter said.

“By incorporating safety-related data into the usability reporting criteria, hospitals, clinicians, and EHR developers would have the information they need to understand how EHRs perform to inform a range of decisions—including around purchasing, customization, and future development.”