Emergency Department

Reinventing the Usability Wheel in the ED

The emergency department (ED) has proven to be one of the last established markets to have best-of-breed vendors, holding out against the ever-expanding enterprise options for hospitals. Several factors have contributed to the tenacity of these smaller, ED-focused sellers. To begin with, the ED environment poses a number of unique challenges – from the culture of the physicians and end-users to the demands of quick action and flexibility in their IT resources. Until recently, the need for usability and a tailored tool has kept the enterprise expansion at bay.

Recently however, KLAS took a dive into ED Usability. During the course of this research, I was asked, “Where has design thinking been applied well in healthcare?” Design thinking, of course, is the process of innovation with users at the center. Historically, healthcare software has been designed with regulation in mind. Meaningful Use was the driver behind the EMR, and as a result much of the structure of healthcare IT feels administration-focused. A common phrase is, “the EMR is great for billing and terrible for care!”

In a break from the EMR, ED systems have long felt like the answer to the question “Where has design thinking shown up in HIT?” Because of the life-or-death, fast paced environment of an emergency room, focusing software on the end-users meant the difference between saving lives and losing them. This is where best-of-breed ED vendors have come to shine, and where those facilities who have swapped from a best-of-breed vendor to an enterprise solution feel a bit like they’re reinventing the wheel.

ED Chart

As usability issues begin to creep back into the ED, it makes me wonder, “who will these problems impact the most?” The only conclusion I can come to is that a poor usability experience will impact everyone from the end-users to the administration. The ED has the highest rate of physician burnout by specialty. From the conversations that I’ve had with providers, I feel it’s safe to say that the IT these physicians work with plays a role in exacerbating that burnout. In the rush of emergency care, the high documentation time takes its toll.

Unfortunately, this will be a problem that gets worse before it gets better. Between 42-52% of providers who use best-of-breed vendors told us that they don’t see their ED vendor as part of their long-term plans. As Integration gets prioritized beyond functionality and usability, more and more organizations will opt to move away from their tailored ED solutions in favor of data flow. Thankfully, the discussion of usability has increasingly moved into the spotlight in recent months. The added pressure from the market may just be the push vendors need to stop talking about making usability a priority, and actually prioritizing it.

If you’re interested in seeing more on ED specific usability from KLAS, you can read our recent report. KLAS has also recently launched the Arch Collaborative, which is an effort to bring organizations together to solve their EMR usability concerns, regardless of what vendor they’ve contracted with.