Does The AMA EHR Rating Have Any Value To You And Your Healthcare IT Clients?
By Megan Williams, contributing writer
EHR vendors are questioning the value and validity of the American Medical Association’s EHR rating system. The framework of the system (a result of a collaboration between the AMA and MedStar Health’s National Center for Human Factors in Healthcare), is based on user-centered design (UCD) and was generally intended to improve transparency around EHR vendor usability processes.
It is based on eight capabilities (of the dozens established by the Office of the National Coordinator for Health IT (ONC) under the Meaningful Use program) and intends to draw attention to the absence of a certification progress.According to the National Center for Human Factors in Healthcare site, “We believe that EHRs should be designed with the end user in mind and that the ONC’s requirements do not go far enough to encourage fully functional and usable products. This framework can be used by the ONC to improve their certification program, and as a method to track improvements EHR vendors make as they recertify their products over time.”
Low Scores Across The Board
Doctors report high levels of dissatisfaction with EHRs, which aligns with the early results of the program. According to Modern Healthcare, only three systems earned perfect scores (two from Allscripts and one from McKesson) out of 20 products rated. The average score came out to 11.5 with the median at 12.5. eClinical Works came out at the bottom with a score of 5.
According to AMA president, Dr. Steven Stack, “Physician experiences documented by the AMA demonstrate that most EHR systems fail to support effective and efficient clinical work, and continued issues with usability are a key factor driving low satisfaction with many EHR products. Our goal is to shine light on the low bar of the certification process and how EHRs are designed and user-tested in order to drive improvements that respond to the urgent physician need for better designed EHR systems.”
UCD Requirements Skirted
To qualify for federal incentive payment programs, vendors were requested to report to ONC about how they met UCD requirements. One of those requirements was multiple users actually testing the systems, according to Modern Healthcare.
Reports are made publically available, but contain multiple issues including non-uniform design and data not being scored against recognized best practices.
MedStar looked at the ONC filing for 50 EHRs and found that 18 percent had no public report on usability and around one third did not state the type of UCD process used, a point required for certification.
Vendor Reaction
Recently though, according to Bloomberg BNA, vendors have begun to question the validity of the rating system. A representative of the Electronic Health Record Association asserted that the AMA framework doesn’t actually evaluate EHR usability, and actually only assesses documentation.