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Are You in an Abusive Relationship With Your EHR?

Blog Posts   ●   February 26, 2016   ●   BY: Brandt Welker

Running a company that sells EHRs, I get to hear quite a bit about what clinicians don’t like about EHRs.

One of the most frequent complaints I receive is that EHRs make clinicians spend more time typing and clicking and less time interacting with their patients. On top of the time spent clicking and typing, they generally only get about fifteen minutes with each patient. If you haven’t noticed a theme in my posts yet, I’m going to tell you again – it doesn’t have to be this way.

Scenarios like the one above happen initially due to poor user interface design, or more commonly, the initial design was pretty good and had a whole lot of clinician involvement, but several versions of the software have been released since and the great design was lost bit by bit with each new version that came out. A new feature is added here, or another alert is added there, and suddenly, before you know it, the user interface is a cluttered mess, not to mention slow. There are people who will say this an inevitable result in the development of software. Again, that’s not quite true.

One way to combat the slow, sluggish software that results many releases down the road is to keep clinicians involved. When new features need to be added, continue involving practicing clinicians to work through the UI design process with the developers. I must emphasize practicing clinicians. I feel strongly that hiring a bunch of clinicians who are no longer involved in the day-to-day practice with patients is not the answer. You need the clinicians who are still in the trenches. Their perspectives are so important.

I’m sure it seems like no big deal to add a check box here or an alert there and just have developers handle it, but eventually these little changes add up. At MedicaSoft, our clinicians handle these new feature requests while taking into account the entire system. This is very expensive, but effective. Because we do it this way, our UI’s are easy to use.

We are very selective about who works on our clinician team. They must be practicing clinicians, but they also must have some informatics background. Not only do we expect them to be active in healthcare, but we also want them current in IT. Clinicians like these are the rock stars in Health IT.

They move seamlessly from working in our development wiki and Kanban boards to tinkering in the EHR. Having the right team handling the interaction and UI design makes all the difference. It’s simple. Who knows better how the system should work – a team of clinicians who practice medicine or a software developer/UI designer?

Another common statement I hear is that the “Brand X dinosaur EHR is the best” because it “uses a roll and scroll screen and that method of data entry is the fastest.Really? Who fed you those words and convinced you it’s true? A statement like that is only true because you have been using this ancient EHR so long that you know all the keyboard shortcut and menu commands, so it seems faster. This is just an illusion. There is no reason GUIs can’t be as fast. I totally understand the attraction to roll and scroll interfaces, I really do. As a developer, they can be more efficient, however, that is due more to a lack of quality UI design and 20 years of memorizing commands. The roll and scroll is great for ordering, but what about displaying data? They are beyond horrible for this and horrible at displaying trends. Looking at a giant table of textual data will make it nearly impossible to notice trends in the fifteen minutes you have with a patient.

So, where am I going with this? Well, I’m here to tell you that it is possible to have the best of both worlds. You can have the simplicity of roll and scroll style ordering that only takes seconds. You can also have a beautiful UI where you can see all the patient’s data in a way that steers your attention via visualization trends and helps you spot potential problems. The human mind is excellent at spotting patterns, so why not leverage that for the patient’s benefit? There is no reason you shouldn’t be able to write orders in seconds without a bunch of mouse movements and clicking. The UI also shouldn’t strain your eyes when you’re looking at it. Most clinicians work beyond 40-hours a week, so why can’t EHR vendors seem to get this right? Stop abusing these poor people and give them something that’s easy to look at! If you want to see what good clinical UI design looks like, come to booth 11449 and talk with our clinicians.

You won’t find any salespeople in the MedicaSoft booth. Instead, we have brought our excellent team of practicing clinicians and a few of our software developers. We are at HIMSS to have meaningful discussions about how we can improve the quality of care and maximize your time with patients. If you want to be able to go home at the end of your workday without being exhausted from undue cognitive load due to poorly designed UIs and without repeated eyestrain, come talk with us. We’re here to help.

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