Everyone has a role to play in EPR usability, what’s yours?

EPR usability

At Mayden, as people have been using the office more and more for their collaborative work, a lot of our community activities have restarted. People are playing sports together, having BBQs, playing board games, doing crossword puzzles and jigsaws and remembering what it is like to be together again. It has been organic but delightful to have such joyful activities back in the office.

One of the newest groups is the Mayden book club. This incorporates a rotating ‘host’ choosing a fiction and non-fiction book that we discuss and rate each month. Different hosts have resulted in a huge variety of books and genres.

The start of this reading club has also happened to coincide with the writing of the Mayden book. To be published in the new year, this book seeks to summarise our journey, explaining our foundations, principles and way of working and providing insight into our approaches and how (we think) they have made us successful, and hopefully benefited the wider healthcare community we work with.

This made me think. What am I? Reader? Or Author? Or both?


And what are you?

Christopher Hitchens quipped “everyone has a book inside them, which is exactly where it should, I think, in most cases, remain”, and I think he may have been talking directly to me (!), but of course the concept of authorship extends beyond books. Indeed, in its broadest sense, it can be attributed to the creator or originator of literary, dramatic, musical, artistic, [or] certain other intellectual works and is with whom responsibility for the creation exists. To be an author, a good author, is something that is revered and praised.

But what does this have to do with EPR usability?

In healthcare IT, the concept of data creation in an EPR context is not a well-loved endeavour. Although authorship of a kind, with a similar focus on responsibility, and also with the added aspects of professionalism and clinical practice, it is not regularly approached with the same commitment as even paper notes still are. Indeed, it is often that the EPR is the hated transcribed medium into which the preferred handwritten notes are added.

In this way, the EPR has failed. As those who spend their lives in digital transformation will attest, digitising things that were once paper creates the smallest value possible from the exercise. Transformation must occur in order to actually reap the benefits of digitisation. Further, in healthcare, this digitisation must be useful and usable, so that data can be authored once and used multiple times, to create genuine value to clinicians and patients.

The Transformation Directorate at NHS England recently published the results of the EPR usability survey. In the Ambulance, Community and Mental Health category, I’m pleased to say that as the authors of iaptus we had much to be proud of including:

  • Consistently amongst the highest rated systems across the NHS
  • Customer experience rated well above the NHS average
  • Users reporting iaptus a reliable system with needed functionality and fast response time
  • Users reporting the system as “easy to learn”
  • Results for “alerts prevent mistakes” and “enables patient safety” are above NHS average

And yet, this also highlighted some important learnings. First, that being above the NHS average was quite a low bar. For those areas where we were above the Arch Collaborative average it was a higher bar but still indicated how much we need to do in our industry to improve usability of EPRs for clinicians. We’ve recently moved iaptus to Amazon Web Services (AWS) and have noticed significant improvements in speed and performance as a result.

Second, that we can always do more to listen and understand our users. Our innovations platform, user groups, conferences, dedicated account management, help guides, webinars and training support are better than most, but we can always do more. How can we best help customers to share how they use the system well with others? We had less variance than other EPRs but nonetheless, some users were using iaptus in ways that seem more beneficial than others and sharing this best practice would be helpful for everyone. That’s something we know we can work on.

Third, how do we help clinicians see themselves as expert authors? How do we reduce the burden to entry? How do we make it clear what information is used for and why? And how do we ensure its highest possible value through both transformation and sharing? We continue to improve interoperability and data sharing, but how much do clinicians really see the benefit of this yet?

Certainly we perceive that the best of breed approach brings the best value to clinicians from a digital authorship perspective. The system, the whole system with which they interact, is tailored to their healthcare setting. In this way true digital transformation can be given the best possible chance at achieving its goals. Whilst systems still require clinical compromise for another clinical setting, no matter how justified, the clinical burden will continue to be a barrier to true partnership and collaboration between clinicians and the EPR.

Of course there is still a journey to go on. And this is not just about us as an EPR alone. We have a responsibility as an industry to make a change. To bring pride, not burden, to the EPR.

You can view our full results for the NHSE EPR Usability Survey here.


  • Mayden will be exhibiting at the HETT conference on the 27th-28th of September. Drop by our stand for a chat and to pick up a copy of our EPR Usability Survey results.


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