Computer aided prescribing: Decision support needs to be evidence based

How electronic communication is changing health care Usability is main barrier to effective electronic information systemsEditor-Jadad and Delamothe celebrate "the return of the human" to health informatics in their editorial asking what's next for electronic communication and health care. 1 The question is not whether we need to merge human centred and technology centred approaches: the question is how to do it.If electronic resources are to improve health they have to be accessible, reliable, and usable.More than 80% of websites are currently not accessible by all, including most primary care trust and healthcare charity sites. 2 And according to our unpublished in-house survey, few electronic resources are subject to the rigour we would expect of reliable, evidence based publications, and many of the high quality resources that exist are prohibitively difficult to use in everyday practice.Usability concerns whether an information system is structured so that users can get an answer to fit their purpose.The solution to this problem is user centred design. 3So why isn't it happening in health care?In spite of considerable evidence that user centred design results in cost savings downstream, and a clear need to assess the usability of information systems, 4 the perception remains that it is too expensive.A good first step is the creation of effective, free tools that help us assess the usability of electronic resources quickly, such as our LIDA tool (www.minervation.com/downloads.html).These are needed to show where the problems are in resources that already exist.Once the usability problem has been identified and defined and both users and commissioners have been educated to expect better from information technology systems, momentum will be gathered towards genuinely high quality electronic information systems.