Could Amazon or Facebook Build A Better EMR?

As we all know, few EMRs are a breeze to use.  In fact, many have such awkward, counterintuitive UIs that they ought to be thrown back into the pond.

On the other hand, superstar consumer apps like Facebook and Amazon have hooked people by the millions with intuitive, logical interface designs that simply addict users.  (And let’s not forget Apple, whose gift for consumer design has vaulted it from has-been to trend setter for the world.)

One CIO, Dale Sanders of the Cayman Island Health Authority, has taken these  examples and run with them, making what seems like a very strong argument in favor of the these giants’ approach:

In Facebook, we have a perfect framework for longitudinal documentation, collaboration, messaging, and scheduling between a patient and members of their entire care team, including family and friends.

We also have a framework for easily integrating data from other sources to enhance the value to the patient’s healthcare – there’s no equivalent of HL7 interchange going on in Facebook.  It references data located in other sources and systems. Can you imagine Facebook surviving if it required itself to house all the data that it presents?  Facebook takes great advantage of referencing and pointing to data in the source systems.

In Amazon, we have a perfect and familiar metaphor for ordering tests and procedures; tracking them; assessing their costs; rating them and seeing how other clinicians rated those orderables and referrals; and adjusting orders based on the behaviors and ratings of other clinicians, etc.

What makes his thoughts more interesting is that he actually marks up screenshots of key Amazon and Facebook pages, commenting directly on aspects he thinks EMR vendors could adopt.  It’s a thought-provoking exercise:  I recommend you check it out.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.


  • I think that this post (and the original) have it a little bit wrong. Facebook and Amazon are consumer-facing companies. It doesn’t make sense for them to build an EMR. HOWEVER, it might make sense for them to follow in Microsoft and Google’s footsteps and build a PHR (or other kind of personal health management application). Amazon and Facebook have captured the consumer masses, but breaking into healthcare IT is a different matter altogether – even if they wanted to, which they probably don’t.

    That being said, I think the real takeaway from this whole discussion is that EMR software developers and companies should be looking to successful applications like Facebook and Amazon for inspiration in user interface design. We’re all used to using Amazon and Facebook, and the user interfaces are intuitive and clean (for the most part). Some EMR/RIS/HIS software designers could certainly learn something from these great examples of web site usability.

  • Typical post of someone who does not understand user interfaces. Something that is pretty and fits one simple workflow does not fit a much more complex workflow which has far more data to be processed.

    Example – viewing 2 orders at a time on a page is fail.

  • hmmmmmm a CIO commented……….. that’s nice. CIO’s by nature of the position are required to think big and look at the big picture; and its the CTOs job then, to bring him/her back to earth.
    Agree with Damien and Silly; these are consumer facing companies and are built to scale with a huge adoption rate. They are not in the business of taking a call about an interface for a local lab that will need the interface with the Provider or that local free standing MRI Center that’s got to have the interface with the Doc. Someone might say, how about eliminating all these mom and pop labs and MRI Centers and similar to AMAZON/FaceBook – have only the chains like Quest and Lab Corp.
    How about the CIO calling AMAZON and FaceBook technology team to do a interface for one the consumer gadgets only 100 people might use………
    Fancy ideas; good to think big. But guys, please give credit to the companies that have put in effort to bring a product to market place. There were many apps similar to AMAZON and FACEBOOK and YOUTUBE in the 1990s and it took 10+ years to get to where we are with the Consumer facing apps.
    Before jumping the gun and blame everything on the app, lets get the Providers (mostly the MAs and PAs) to document at least the VITALS, capture Allergies, Family History, Social, Surgical History, ePrescribe and eConnect with Labs; let that happen over the next 6-12 months; UIs being a barrier for such tasks is a silly excuse.
    Over time UIs will be refined. Its a process and a journey; it may not take 10+ years to reach the sophistication of Facebook and YOUTUBE and AMAZON. UIs will be refined in a compressed timeframe. We at Enable Healthcare Inc are in the process of engaging PEI University to do the Usability Testing. Considered to be one of the few universities who have an Usability Lab; but the time frame they have come up with is 12 months before they can make recommendations.
    Functionality has been the key driver for all the vendors; the required functionalities needed to be integrated. Then comes the task of refining usability and take an incremental approach to enhance usability.
    Some times people are so out of touch with reality……….. I find it funny when the legacy Healthcare folks talk about HIPPA, Security, compliance, Usability, etc., and when you ask them for an email ID to communicate – it’ll be a, or………… We have some ways to catch up with basics on the part of CIOs, their referring physicians, hospital systems, etc., before blaming it all on EHR’s and the UI designs.

  • Facebook has the advantage of reference and points to the data of source systems. EMR may be functional, but not easy to use, so that their total value to health care is very low.

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