We’ve got a long way to go before information technology solutions at the frontlines of healthcare fulfill their enormous potential. The suboptimal, clunky and cumbersome design of most IT systems is responsible for much misery among physicians and nurses on a daily basis. Part of the problem is that hospitals and clinics have rolled out these solutions rapidly and somewhat haphazardly to fulfill Meaningful Use requirements and gain much-needed federal incentives. Having said that, there’s reason for some optimism ahead, as a movement gains steam to improve on the current situation. While we are awaiting those “dream solutions” of the future, here are 3 immediate changes that can be made to the design of our electronic medical records and order entry systems:
1. Click Analysis
Conduct a thorough audit of how many “clicks” and screen interfaces it takes to perform any given task (start with the most common ones such as electronic progress notes and simple medication ordering). This needs to be done with full input and feedback from frontline clinicians. In almost all cases, significant reductions can be made in the number of clicks required to do any specific thing.
2. Logical screen interfaces
In a lot of instances, the screen options do not follow simple logic. For example, the most commonly chosen option will often be listed at or near the end of any given list (instead of at the top), and too much of a screen may be dedicated to things which are irrelevant and rarely looked at. Ask anyone from a successful technology company, such as Apple (or even read any book about Steve Jobs himself), and you will quickly learn a golden rule: Design is Everything.
3. Comprehensible final output
When you actually view on a screen or on a printed piece of paper, the output that is generated from healthcare IT—be it a progress note, medication list or discharge instructions—there’s few other terms that are more appropriate to describe this than computer gabble. In the past, there were intelligently transcribed History & Physicals and Discharge Summaries, that looked logical and letter-like (in other words like they were formulated by a human being). Now, instead of something that looks intelligible, we have “computer speak” which produces reams of data in an illogical format that means nothing and is very difficult to understand. If such a style of information was presented on a website, nobody would ever read it. IT folk should remember that physicians (and patients for that matter) are intelligent human beings who appreciate good grammar, sentence-construction and paragraphs.
Improving on the above 3 things will be a good start to solving this problem. Rome wasn’t built in a day, and neither will healthcare information technology improve by simply doing only a few little things overnight. But taken together with better-designed systems from the bottom up, differences can be made to make IT solutions more seamless, efficient and user-friendly.
Suneel Dhand is a physician, author, speaker and healthcare consultant. He has experience in a number of different healthcare environments, having worked up and down the East coast and also internationally. His specialty areas include hospital QI, optimizing healthcare IT, and improving the patient experience. He is the author of 3 books, including most recently “The Ultimate Patient Advocate in Your Pocket”, designed to help hospitalized patients. He is also the founder of HealthITImprove, an organization dedicated to improving and optimizing information technology at the frontlines of healthcare.