Zhang Responds to Lohr's NYT Commentary “Seeing Promise and Peril in Digital Records”

Dear Mr Lohr:

Thank you for your recent article submitted in the NY Times regarding the Electronic Health Records (EHR) usability work of the National Institute of Standards and Technology and the Office of the National Coordinator for Health Information Technology. Respectfully, however, I must draw your attention to another obvious comparison and offer a considerate rebuttal to the statement that usability stifles innovation.

The aviation industry has produced innovations from simple checklists for various procedures to advanced head-up displays that present data to cockpit windshields without requiring pilots to look away from their usual viewpoints – all with the goal of improving aviation safety by sound usability science. The risk of harm in aviation has been significantly reduced by these sound methods. Healthcare is a high risk industry requiring unrelenting pursuit for safer solutions to complex patient care. In healthcare there is a sad history where well-meaning intentions have produced deadly consequences and we must wake every day to the fact that 98,000 patients are unintentionally harmed each year. While electronic records hold the promise for a safer future – they will not reach that promise without standards for basic usability that follows scientific and objectively measureable usability principles.

I can’t help but ask which usability principles the opposition rejects? What we are suggesting is simple, measurable and repeatable. If they have truly spent time in the science and applied these principles to their products – they should be happy to see this effort. If they have not looked at the science of usability – then perhaps it is time they should. Ultimately it is the vendors who control the destiny of their products.

We openly invite all the EHR vendors and stakeholders to our table. We support your innovation. SHARPC, funded by the Office of National Coordinator for Health IT, is open to your participation, your collaboration, and your success- come visit us, take a usability course, get your products tested, collaborate with us on usability improvement of your products, or send a student or an intern to our program – ask us a question – we stand ready to assist you in the vital mission of keeping patients safe by making your products more useful, more usable, and more satisfying.

Respectfully,

Jiajie Zhang, PhD

Principal Investigator, SHARPC Project on Patient-Centered Cognitive Support
Co-Director, National Center for Cognitive Informatics and Decision Making in Healthcare
Professor & Associate Dean for Research, University of Texas School of Biomedical Informatics at Houston

This letter is in response to Steve Lohr’s commentary “Seeing Promise and Peril in Digital Records”, published in the New York Times electronically on July 16, 2011 (http://www.nytimes.com/2011/07/17/technology/assessing-the-effect-of-standards-in-digital-health-records-on-innovation.html?ref=stevelohr&pagewanted=all) and in print on July 17, 2011 on page BU3 of the New York edition.