I love when doctors and medical students talk about their first encounter with EHR software. In this case, I came across a medical student who ran into Epic in the hospital and writes about it in this post. Here’s his initial response to it:
I took the training module for it and the moment it loaded, I was bewildered. My monitor had turned into a wormhole and was suddenly displaying software built in the 1990s. I stared for 30 minutes at what was basically a wall of text, trying to find my way around small buttons and clogged sub-screens. I hadn’t even learned how to use Epic yet and I was already frustrated. Perhaps it’s because Epic was a platform built upon billing practices that made it so confusing. Either way, I was done before I had even begun.
The great part is that he wasn’t just complaining about the experience. He decided to create a prototype of what he thought an EMR interface could look like. Here’s his video prototype:
Obviously, it’s lacking a lot of detail, but I love his fresh take on how you could navigate the information in the EHR. We need more people who aren’t clouded with current EHR design to offer design suggestions like this.
Less is more but as humans we tend to complicate things these days. 50 years ago today Dr.King had a dream but I am sure it’s not this complicated.
This “pretty” prototype still exemplifies the thing that makes so many EMRs so hard to use in the real world primary care setting. It has a forced linear workflow showing one chunk of info at a time. A doc in the trenches needs to be juggling lots of info concurrently with the ability to do one task without obscuring the view of other data. Pretty prototype, yes. Usable, no way!
I’ve watched doctors furiously clicking away, muttering under their breath, trying to get their EHRs to work. I’ve told of my favorite incident, where the orthopedist, after having noted that I’m male, was presented questions about my pregnancy status. It’s not just that EHR’s are often highly complex and hard to use, they have piles of problems including bugs, poor interfaces, steps completely out of logical order and more.
Obviously the video is more like a dream of EHR nirvana then any hint of where the EHR world is headed. But think, for instance, to the Star Trek communicator in the mid 1960’s; today’s cell phones are far more sophisticated, potentially a combination of communicator and tricorder. IOTW, it really is possible to find a better way!
I think the balance is somewhere in between these two scenarios. We want to abandon out-dated ways of doing things but there is a usability value in familiarity. Quickly picking up a new system is helped by familiar layouts and buttons in places where you expect them. This is why applications like browser, word processors and email clients have changed so slowly. That said, sometime older-looking systems combine an old feel with unintuitive layouts – that is when you have the worst of both worlds!