In 2013 the average emergency department physician performed 4000 clicks during a 10 hour shift. This equated to 44% of their time spent in front of an EMR entering patient data orders, 28% of the time with patients, 12% of their time reviewing charts and testing results and 13% of their time in discussion with colleagues.

For people in healthcare this is old news, perhaps to the point where we have stopped thinking about it.

Can you imagine clicking a mouse 4000 times a day while trying to talk with people who are trying to deal with their health issues? This must be amazingly stressful.

At times I wonder how we arrived at this situation.  Were things really this bad back in the late 90s when EMR software has it’s roots?   How is it possible that in the intervening 15 years EMR companies have not rewritten their software to reflect modern trends?

My opinion is that this was largely a consequence of meaningful use.  In short, there has been such a focus on HITECH monies that companies such as Epic have scrambled to gather the windfall and neglected their users.  Now that the money has dried up it will be interesting to see what happens.

One thing we can expect to see a great deal of is hospitals picking completely new EMR software.  According to KLAS fully one third of hospitals plan to do just this prior to 2016.  This trend is consistent with the levels of user dissatisfaction that we’ve seen.  However, in many ways it’s a zero-sum game because the market is shared between five major players none of whom is particularly compelling from a user interface perspective.

So, where to from here? If the status quo prevails, it appears likely that for the next five years we will see new features added to EMR’s but no significant change in the underlying technology, and no real resolution to the user interface problems. Without a comprehensive redesign the best we can hope for is a small reduction in clicks.

I’m hoping for true disruption. I’m hoping that Athenahealth will continue to push into this space and force the incumbents to move into the modern world.

I’m hoping for change.

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