Usability and Workflow Analysis are two passions of mine. Anyone who has been following my blog for any length of time would note that these are common themes I return to again and again. In the office, I also have a reputation for asking tough usability-related questions. I’m not afraid to ask why things function the way they do, or point out that the way a future enhancement is designed is going to present challenges to users based on my experience working with them. Sometimes my observations bring about real change, and sometimes they do not. Either way, I view it as planting a seed to bring usability into the conversation on a regular basis.
Healthcare IT is also something I am very interested in. Several members of my immediate and extended family work in the healthcare field, which has given me insight into how healthcare works on the ground level. My job in banking/finance software gives me experience in utilizing, training, deploying and supporting software solutions to help an organization operate in line with their goals. To that end, I obtained a Healthcare IT Training & Workflow Management certification, hoping to marry these things into one in the future.
I’ve also seen several examples of EHR systems from various vendors that are, to put it mildly, terrible from the usability side of things. I watch as nurses and doctors enter information into the EHR, running a mental analysis for the things the software makes them do to complete record entry. It’s not uncommon for me to have conversations with the nurses or doctors about the usability of their systems, and every time I’ve done it (after explaining my experience in the arena and why I am interested) the results have been the same: no one is happy with their system, and they are all frustrated.
That’s why it was refreshing this week to read A Look Inside Epic’s EHR Design and Usability Teams from Healthcare IT News. The magazine interviewed Janet Campbell, Vice President of Patient Engagement and Sumit Rana, Senior Vice President of R&D at Epic on how they think about and do usability in their EHR system. I will note that I have never seen Epic’s EHR system, so I have no specific comments on its usability. But I will say that I admire their approach, because I feel that it will address a common usability issue I have run across in my career experience: Designing for Programming vs. Designing for Users.
The article notes that Epic has a formalized program requiring program developers to spend at least four days, and not more than 18 days, testing applications they are developing in the field. In real, live environments with real doctors and real workflows. Rana stated that this has the effect of forcing programmers and technology specialists to see how their work fits into the real world, and what kinds of challenges a specific design presents to users.
“I think what it teaches programmers is to care,” Rana said. “Because when you see someone struggling with something, it really bothers you, and you want to come back and say, ‘How would I do this so it functionally is doing what the user expected – how do I make it more intuitive?’”
– Sumit Rana, Senior Vice President of R&D, Epic Systems via Healthcare IT News
Every facility will have its own challenges and its own workflows. It is not possible to design one program which will fit everyone, and workflows will have to be adjusted. Just as in art, it is impossible to please everyone. But I applaud Epic for recognizing the importance of usability and taking this formalized shadow-based approach to help combat this major usability hurdle. Well done!