CHARTSaaS facilitates nursing role to ensure health IT usability

Usability of health information technology (health IT) systems means many things to many people.  If we look at the industry-standard International Organization for Standardization definition, usability is, ‘the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction in a specified context of use.’ …

But addressing the usability of electronic health records (EHRs) is the heart of the work done by informaticists – triage and translation. When called to address an issue with health IT, one must first triage the problem and determine if there is a true break/fix situation at hand (e.g., a button that doesn’t work or an order that displays incorrectly). I am certain I will not surprise any clinical informatics professionals when I say that most issues are not break/fix and won’t be addressed by tweaking a setting or a bit of code.

Similarly, many issues that are blamed on regulation are not actually related to regulatory requirements. Instead, many issues are the result of implementation decisions.  I like to say that a system will not be usable if you don’t know how to use it: a training, knowledge, or support deficiency often underlies inefficient use of the system. Many meetings called to address documentation burden, in the form of too many clicks, have little to do with the system and more to do with pre-implementation decisions such as customized content, mandatory fields, pop-up alerts, flow sheet rows, etc.

Nursing informaticists transform the usability of health IT systems in their facilities and practices. Trained with a diverse set of tools to expertly triage and correct any system, workflow, training, and accountability issues, they lead the partnerships between their frontline clinicians, super users (i.e., bedside clinicians who receive additional health IT training), and IT clinical analysts and builders. Nurse informaticists possess the ability to mediate and moderate governance and interdisciplinary committees to align practice, health IT, analytics, and outcomes, and they are capable of significantly impacting the usability of health IT across the health care system.

In the foregoing quote from her May 11, 2017, post to the U.S. CMS Office of the National Coordinator for Health Information Technology a.k.a. ONCHIT or ONC’s HealthIT Buzz blog (, Rebecca Freeman, PhD, RN, PMP, Chief Nursing Officer, posits “Implementation is key to usability – Nursing Informatics is key to optimization.” I agree with this proposition, based on my decades of positive experience with nursing staff generally and in IT-related matters in particular. Therefore,  I am confident that not only Nursing Informaticists but also nurses of virtually any background or specialty are particularly well-suited to ensure the usability of apps created with an IT solution compliant with the Cloud Healthcare Appliance Real-Time Solution as a Service (CHARTSaaS)™ integrated development environment (IDE) reference architecture (RA). A CHARTSaaS IDE RA-compliant IT solution is the tool nurses need to ensure usability by enabling them to participate in “pre-implementation decisions” as advocated by Dr. Freeman through hands-on participation in app design, development and deployment.

Please validate this proposition to your own satisfaction by reading the white paper at and then by reviewing the details of CHARTSaaS™ and the CHARTSaaS RA™ in these presentations:

Healthcare providers will benefit significantly from appreciating and then applying a CHARTSaaS RA-compliant IT solution. To do so will mitigate medical mistakes (currently the third leading cause of patient deaths. per Makaray and Daniel; thereby minimizing patient adverse events and optimizing clinical case outcomes while maximizing the cost-effectiveness of care and treatment, and also accelerating the accrual and facilitating the application of medical knowledge.

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