Like many physicians, Stanley Wainapel is having to learn new ways of documenting patient care as Montefiore Medical Center implements a new electronic health record system. He faces some unique challenges in the switch over, however, because he's spent the past 20 years functionally blind-the result of a progressive retina degeneration disorder diagnosed when he was a child. He's been using computers since the mid-1990s. Screen-reading software lets him navigate the Web and reads him his e-mail at up to 400 words a minute, and he can type up a storm while his computer reads his work back to him. "It's less impressive to some that I'm a doctor than that I can type," he says. He's developed a host of templates and shortcuts for the software he uses to save him from having to mouse. Testifying last year on EHR usability before an Office for the National Coordinator of Health Information Technology workgroup, he warned the industry not to become too enchanted with icons and graphics-heavy interfaces, which just complicate life for those who can't see. EHRs that can accommodate people with disabilities may actually work better for everyone. "Look at audiobooks," he says. "They're a marvelous resource for people with vision loss, but you can also read them in the car during a long commute. There are curb cuts at corners so that people in wheelchairs can get into the street, but if you're a Mom with a stroller, you're happy they're there."
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