Why is our EPR so frustrating to use?
Last week one of our medical consultants came to see me and the Group Chief Executive to share his frustrations with the technology he has to to use. He gave a detailed an impassioned description of the stress of running his outpatients clinics. He told us:
Dr A prepares his clinic spending 2 hours on the screen before clinic
Dr B goes to clinic 45 minutes early to be prepared in case!!!
Dr C says “I need to cut down my number of patients to run smoothly”
Dr D has already reduced his clinic activity.
That situation is not good enough, for our staff and the patients we serve.
One of the suggestions he had was to have an anonymous survey. Step forward the NHSX national EPR usability survey for Acute Trusts.
But aren’t all EPRs terrible?
Back in 2019, I attended a conference and heard Rachel Dunscombe talk about the work of the Arch Collaborative at KLAS. She shared some fascinating research from the US where there was a massive range of satisfaction across different organisations using the same system. As my sketchnotes (below) from the session reminded me that one of the drivers for low satisfaction is in organisations that view tech as a solution, rather than seeking to meet clinician needs.
So I was delighted when this year NHSX announced that as part of the What Good Looks Like framework, Acute Trusts would have an opportunity to take part in the KLAS usability assessment for EPRs.
In the University Hospitals of Northamptonshire Digital Strategy that was launched in March 2021, we have a stated principle of putting our users first:
But what does putting user needs first when it comes to EPRs?
One of the things I’ve been disappointed to find is the lack of user analytics from clinical systems. Not only is that information not available to us as buyers of the software, it is not available to the software vendors themselves. I’ve even had a blank look when I’ve asked about the analytics, and despite building it into our EPR contract, that data has yet to materialise.
Furthermore, we have stuff built into the contract about user research/hack sessions — it’s not been taken up.
So what do we do?
Having the data from this survey will be a help. I’m really keen to have this information to help drive the conversations with our suppliers at a local and I hope at national level.
Am I worried about the results and what it will say about the systems across University Hospitals of Northamptonshire? Yes and No.
- Yes: We’re in the middle of moving to an aligned Group EPR across our two hospitals and currently we have a disconnected set of systems that clinicians have to battle with every day, so I think that frustration will come out in the results.
- No: I’m really keen to see how our approach compares to the same EPR users elsewhere in the country, as the research from the US shows, that the same supplier can have very different satisfaction levels, so I’m keen to hear from the clinical users on what they think so we can do something about it.
The other important development that this survey links to within the wider What Good Looks Like framework. The areas that need improvement will receive funding to bridge that gap. For the first time there’s the potential to target funding based on user needs, not just on who can create the shiniest business case. Furthermore, I’m encouraged by the prospect of this being repeated regularly and supporting a continuous improvement cycle. Too often, technology in the NHS has been approached in a “Once and done” way, which helps no one.
Please take action!
I’d like to encourage every clinician at my Trusts and wider to complete this survey. We hear many things about the systems we have, but this survey gives us the opportunity to collect data in a careful, systematic way, enabling comparison across the country for the same supplier.
The national NHSX EPR survey is currently open to all clinicians working in acute Trusts. There’s is a helpful communications toolkit to support organisations to promote it.