Because IT said so: the lack of user-centered design in Healthcare
When technical people 100 miles away from patient care attempt to make clinical decisions, healthcare fails. Hospital IT and administration tasked with implementing EHR systems focus on meeting the required regulatory measures but not on how these systems affect the end user, and in turn how those users deliver patient care. When choosing and implementing these systems, that focus leads to poor adoption rates and discontent doctors and nurses.
Wouldn’t you be frustrated if you were told you had to go to three separate systems to get the information you needed on just one patient? If you were told that this is the state of the art and if you’re looking for more information you had to go to yet another portal to get it? These are conversations we’ve heard and exchanges we’ve seen time and time again between clinical staff and IT.
A different system for every step in the workflow is an efficient way to check off regulatory boxes for IT, but it’s frustrating for the already overwhelmed clinician. The system built without a user-centered design process is a defective one.
Working with feedback from the clinical team is the only way to provide real value. Healthcare is behind other industries in establishing this feedback process and working toward products designed around the end user. Robert Watcher summed it up nicely in this opinion piece in the Times:
I interviewed Boeing’s top cockpit designers, who wouldn’t dream of green-lighting a new plane until they had spent thousands of hours watching pilots in simulators and on test flights. This principle of user-centered design is part of aviation’s DNA, yet has been woefully lacking in health care software design.
User-centered design gives a process to the complexity of building software tools for clinicians. Its focus is collecting feedback and usage data at every stage of product development. The tight feedback loops give designers and engineers the data they need to build effective solutions that the staff enjoys using- afterall, they contributed to the design.
This tenuous balancing of regulatory requirements, technical constraints, end user feedback is supported by frequent, incremental product releases. Frequent releases allow the tool to be released sooner and feedback to be collected long before the project is out of budget. The result is increasing adoption rates and clinical satisfaction that then leads to hitting regulatory and business goals in a manner that feels effortless.
A specialist we work with coined it perfectly: “give us something we want and that works rather than saying ‘here, this is what you get and we feel this is all you need.’