Wednesday, February 25, 2009

Electronic Health Care: Engineers != Doctors

For those of you who aren't programming nerds, in the C++ programming language "!=" means "not equal to".

I was in the ER last week and noticed a significant problem with the software the hospital was using to triage, order tests, and discharge patients. The doctors and nurses, regardless of age, were having difficulty using the software. The user interfaces were not intuitive to them and they couldn't navigate their way around the program. They would try to look at test results and they couldn't figure out how to display lists of x-rays. They couldn't look at notes from a patient's previous discharges. The program they were using was new, supposedly better than their old program. However, after the staff had finally learned how to use the old program, they were struggling to find their way around this new interface.

I took a look and the program seemed incredibly easy to navigate and I ended up showing the physicians how to use the application. Think about that, a first year stduent was showing these full-fledged doctors how to use the application that they use to care for their patients.

The problem was that the software was very intuitive to me because I've spent 6 years as an engineer and only 6 months as a physician (the student version). Engineers, or computer people in general, have a different set of needs for their program. We want our applications to be streamlined so that we can use the fewest number of mouse clicks possible to get the results we need. We like keyboard shortcuts to access menus quickly. We care less about a pretty interface (not always true), as long as we can maximize our efficiency. The average user doesn't think about this and they are generally willing to replace efficiency with ease of use. The hospital staff don't want to learn shortcuts, they want everything they need displayed in front of them. They don't want to click through a set of options to make sure their layout is optimized, they just want an application that does what they need 90% of the time without being told. If they have a need that falls in the 10%, they are generally willing to wait for the IT guy to come out and show them how to do it.

If software companies want widespread adoption of their applications for use in health care settings, they really need to make sure a health care professional is involved in their interface design and user experience development. Otherwise, you get a hospital with a frustrated staff who are less efficient and the already high patient wait times increase.

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