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A Need for Speed Cited for Clinical Information Systems

July 21, 2010
by John DeGaspari
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Doctors and nurses struggle with clinical IS performance

A recent survey conducted by Compuware Corp. revealed that a high percentage of doctors and nurses are frustrated with the performance of their clinical information systems. The results suggest a potential hurdle for hospitals trying to get their clinicians on board with electronic health records (EHRs) to meet meaningful use requirements under the final rule, under the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act.

The survey results, which were released at the end of June, were based on 99 replies from doctors, nurses, CIOs and CMIOs at large and small hospitals in the U.S. about the response times that clinical end-users were experiencing. Its objective was to see how long it was taking to log into a system and how often users were required to log in during an average work day.

Their responses indicated that most users logged into their clinical information systems multiple times daily and experienced significant waiting times to enter their clinical information system. When asked how many times users logged into their clinical IS each day, 30 percent said between one and five times and 30 percent said twenty times or more; the remainder reported they logged in between six times and 20 times daily. Typical log-in times varied between less than 5 seconds (13 percent) to greater than one minute (7 percent). The largest group (30 percent) reported log-in times of 5 to 10 seconds, followed by 21 percent who said 11 to 20 seconds, and 19 percent who said it took between 21 and 30 seconds.

According to Mike Wilson, senior IT director for clinical information systems at the Detroit-based Compuware, the responses underscore the fact that a positive user experience is critical to winning clinician support for EHR. “The only way to get [clinicians] through the adoption curve is to make sure they are satisfied,” Wilson says. “If we can’t get them satisfactory performance, then they are not going to use the system, and [hospitals] are going to miss out on incentive money.”

Although the meaningful use final rule has proven to be more flexible than many observers had predicted, requirements for procedures such as computerized physician order entry (CPOE) still exist, Wilson notes. Performance issues such as long log-in times will cause physicians to look for ways to work around the system, impacting both the quality of patient care and the ability of the hospital to meet its meaningful use requirement. “Even though the function and features are there to be able to do the ordering, it’s the availability and performance that really allows the doctor to be satisfied enough to continue using it,” he says.

Wilson sees a need for CIOs to recognize that performance issues exist, and then do a deep-dive analysis to fix the problems. “We need to pay attention to application performance from the view of the end-user, rather than from the view of the IT shop,” he says.