The AMA has called for solutions to electronic health record (EHR) systems that have neglected usability as a necessary feature. Responding to urgent physician need for better designed EHR systems, the AMA released a new framework outlining eight priorities for improving EHR usability to benefit caregivers and patients.

“Physician experiences documented by the AMA and RAND demonstrate that most electronic health record systems fail to support efficient and effective clinical work,” said AMA President-elect Steven J. Stack, MD. “This has resulted in physicians feeling increasingly demoralized by technology that interferes with their ability to provide first-rate medical care to their patients.”

While AMA/RAND findings show physicians generally expressed no desire to return to paper record keeping, physicians are justly concerned that cumbersome EHR technology requires too much time-consuming data entry, leaving less time for patients, the AMA noted. Numerous other studies support these findings, including a recent survey by International Data Corporation that found 58 percent of ambulatory physicians were not satisfied with their EHR technology, “most office-based providers find themselves at lower productivity levels than before the implementation of their EHR” and that “workflow, usability, productivity, and vendor quality issues continue to drive dissatisfaction.”

To leverage the power of EHRs for enhancing patient care, improving productivity, and reducing administrative costs, the AMA framework outlines the following usability priorities along with related challenges:

  • Enhance Physicians' Ability to Provide High-Quality Patient Care
  • Support Team-Based Care
  • Promote Care Coordination
  • Offer Product Modularity and Configurability
  • Reduce Cognitive Workload
  • Promote Data Liquidity
  • Facilitate Digital and Mobile Patient Engagement
  • Expedite User Input into Product Design and Post- Implementation Feedback

Despite usability issues, physicians are mandated to use certified EHR technology to participate in the federal government's EHR incentive programs. Unfortunately, the AMA said, the very incentives intended to drive widespread EHR adoption have exacerbated and, in some instances, directly caused usability issues. The AMA has called for the federal government to acknowledge the challenges physicians face and abandon the all-ornothing approach for meeting meaningful use standards. Moreover, federal certification criteria for EHRs need to allow vendors to better focus on the clinical needs of their physician customers.

The AMA recognizes that not all EHR usability issues are directly related to software design itself. Some issues are a result of institutional policies, regulations, and sub-optimal implementation and training. The AMA will continue to move aggressively on these fronts, including empowering physicians to work with vendors and other to develop and implement more usable products.

To advance these goals, the AMA plans to utilize the eight usability priorities to lead EHR improvements for physicians, vendors, federal and state policymakers, instithe tutions, healthcare systems, and researchers, which could ultimately lead to increasing professional satisfaction for physicians.


The August issue of Practical Dermatology® magazine offers many ideas for building a successful practicing, including ways to save money and improve profitability. Joel Schlessinger, MD and Nancy Schlessinger, MS offer pearls for saving money in your practice in their article “Staffing Strategies for Long-Term Practice Growth and Profitability.”

“Cost savings measures are an important part of any practice. These are achieved by closely scrutinizing all aspects of financial exchange in your practice to ensure that the practice is allocating its resources wisely,” they wrote. Ahead are four tips from the article to help your save now:

Selecting an Electronic Health Record provider: “One of the major decision points in the process is whether to select a cloud-based system or a centrally located serverbased system. Cloud-based systems tend to be much less expensive initially, however, the eventual outlay can be significantly more expensive due to recurring charges.”

Choosing a Bank: “Large savings may be realized by the simple act of phoning a bank and asking a few important questions, even if your original choice seems adequate. This takes time, but it is ultimately reflected on the bottom line, and savings continues to accrue over time.”

Managing Bills: “Close scrutiny of all bills, but especially those from phone/Internet companies and Yellow Pages advertisers (and Yellow Pages is a very questionable expense these days!), can help ensure that you are not being billed for unnecessary services. Such billings have been proliferating lately and are commonly tacked-on to a phone or Internet bill.”

IT Support: “The benefit of an in-house IT staff member will vary significantly from practice to practice, but it is a huge asset on an everyday basis for our practice and likely to be a positive in many other practices.”

To read this and other features from the issue, visit www.


Jay A. Shorr, BA, MBM-C, CAC I-V and Mara Shorr, BS, CAC II-V of The Best Medical Business Solutions warn against the common mistake of cutting back on or not investing in staff. There are better ways to save money without hurting your practice. Jay and Mara Shorr shared their advice during the Vegas Cosmetic Surgery conference in June.

“We never ever recommend underpaying your staff or making it that the amount of money you're paying your staff is the first place to cut. … That's not the first place you should look at cutting because you don't want to drive your staff out. It costs far more to bring in a new staff member and to train them than it does to keep your existing staff member.” says Mara Shorr. She suggests you make sure you're not overpaying for things like office space or new equipment. Have a third party review the lease on your space if you're opening a new office or expanding your practice or the lease for new equipment to see where you might be able to negotiate a better deal, she advises.

For more, visit Search Key: Money.


Modernizing Medicine, Inc., creator of the Electronic Medical Assistant (EMA), has initiated its inaugural EMA Nation Users Conference. The conference will provide a venue for users of this specialty-specific electronic health record (EHR) system to network and learn how to use EMA's expanding capabilities for improving provider workflows and patient outcomes, and to address compliance mandates such as Meaningful Use and Physician Quality Reporting System (PQRS). Dr. Zubin Damania, more popularly known as the inspiring and energizing thought leader, speaker, and entertainer ZDoggMD, will provide the keynote for the event, which will be held on November 7-9, 2014, at the Hilton Orlando Bonnet Creek in Orlando, FL.