We’ve had some time now to process our first whirlwind trip to the HIMSS conference, held this year in lovely but still recovering New Orleans. While we saw much improvement and recovery throughout the city, we were disappointed to see a lack of improvement in most of the health care tools and services that were on display.
HIMSS is a health information technology industry organization founded to provide leadership and management practices to improve heath care. This is the show where everyone struts out their latest electronic medical records (EMRs), health information exchange systems (HIEs) and other technical tools designed to bring down medical costs and improve efficiency and outcomes of care.
Across the board, it was apparent that the technologies we saw at HIMSS were designed from the inside out, meaning that engineers took a data-centric view towards functionality rather than observe how these tools are used by real people. As we sat through multiple software demos, it was clear that much of what we saw was not intuitive to use. While there was a lot of gleaming hardware that looked modern, ergonomic and patient-friendly, the software either had a late last-century aesthetic or looked like a spreadsheet meant to manage data for the bean counters. Most designs didn’t even follow basic hierarchical practices like guiding the eye toward the most important information on the screen—a critical consideration for tools used in medical environments.
We understand that these are complex systems. They manage a great deal of data for diverse audiences, sometimes in life and death situations, but the same can be said for air traffic control systems. The financial services, logistics and retail industries are managing incredible depths of data that connect to regulators, consumers, and risk assessors. Not that these industries have mastered everything, but there are players within who understand that the management and transfer of information needs to be designed from the outside in. Most people working in North America are now frequent users of technology. Google, Facebook and YouTube are used ubiquitously. We demand a high level of design and intuitive functionality that doesn’t require technical manuals and extensive training to understand.
EMRs, HIEs and other health care technologies can improve care outcomes and reduce costs, but only if they are more widely and effectively used. To encourage adoption, technology companies need to start adopting human-centered design processes. Systems have to be designed for the environment they will be used in and for the people who will use them. How can we help get health providers away from a keyboard in an exam room? How can we ensure they can get the right information into the system without sacrificing eye contact with their patients? How can we make providers’ jobs easier, not add another administrative annoyance to their daily schedules?
Health care technology developers should beg, borrow and steal all they can from the best-designed, consumer-focused software, apps and web services we are surrounded by every day. Designers should be in the room from the very first discussions about a new health technology. Users should be observed working with technology in their jobs as heath providers or administrators. Product development teams need to be intimately aware of where their technology will be used, by whom and in what context. This orientation would go a long way toward correcting the issues with health technologies on the market today.
Great post, Lisa. I also attended HIMSS and was overwhelmed by the lack of a user-centered approach. That said, it's very difficult for people to know what they don't know. The onus is on us, design practitioners, to inform, educate and inspire the HIMSS community with our approaches and methodologies. I hope we can work together to make this happen at next year's conference.
We here at CalHealth, Inc. are building remote patient monitors that are specifically designed around regular people. Our monitors ( blood pressure, glucose, pulse ox, etc, ) are built inside computer mice and are as simple to use as .....well, computer mice.
We didn't make it to HIMSS this year but maybe next year.
@chemobrainfog they removed my comment from that post about HIMSS... that sucks.
@drbetsyb Thanks, Betsy for the tweet!
@l_scott_brown The first co that integrates human-centered design processes, service design, and keeps things human scale will win big!
@LarrySieb The real insights come when you get the data and human-centric observation and research working together.
@_firebone I think patients are missing, providers too! Human-centered design processes get them back in the equation.
I am an emergency physician and I have been using electronic health records for almost 20 years. I am continually amazed at what a poor job most EHRs do with respect to making the capture of important information quick and easy and the viewing/display of the information intuitive and informative. Your suggestions for placing the needs of the user front and center when figuring out What? to capture Where?, When?, and How? is one of those 'simple truths' that is too often ignored. True Meaningful Use as a common occurrence awaits the design and deployment of more capable technologies that get out of the way and support rather than confound the exchange of information that is the essence of medical care. See a recent post of mine on the same topic. http://bit.ly/13ViGpk
AMEN AMEN AMEN!
I swear, walking in the HIMSS showroom was like walking back in time to the late 90s- I don't know where these companies have been hiding during the last ~20 years of computer and internet improvements. It's no wonder most doctors hate their EHR/HIT system: it was built by techies for techies, with (seemingly) little regard for the end user's processes or capabilities.
User Experience and User Interface (UX & UI) Design is surely tough, but it's not magic and most web or application developers employ or work with UX/UI experts to ensure their/our clients are empowered, rather than overwhelmed, by the tech systems they use.
Hi Lisa - great perspective. I didn't attend HIMSS, but happened to write a similarly themed article about EHRs yesterday: http://futurehealth.360lean.com/2013/04/in-the-real-world-ehrs-are-too-often-obstructions/ - hope you will take a look. I would enjoy talking with you sometime.