The software integrates with ease – it's compatible with Windows, Mac & Linux. It's great for out billing system too!

Sudhakar :
c.It makes me mad (and sad) whenever I hear someone blaming the IT system for any medical error. Doctors and hospitals should take responsibility for medical errors, period. The computer did not place the order on its own, it did not pull out the medicine from the draw on its own, it did not administer the medicine on its own. It was all a human error.
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Well, there are several instances where IT systems have caused detrimental results, beyond what any physician (or other health care worker) could be blamed for.

Notably (and well published) the increase in mortality after CPOE introduction: http://pediatrics.aappublications.org/cgi/content/abstract/116/6/1506

There are countless other examples of bad health care informatics killing people, so blaming it all on the doctors is unfair.

The idea is that the VisTA screen shouldn’t have that much populated in there — a graduated user interface, hidden areas that come to life when necessary, a persona-based screen where the layout changes based on who’s logged in, etc are all ideas that we can learn from.

You are right that it’s hard to design systems to be usable without training — but not impossible. People don’t need training to use iPods or Google but they can get lots of work done. If we think outside the box I think we in medical technology can do the same.

Thanks for leaving your comment. It was very helpful.

a. It is very unrealistic (and unfair) to compare Google search to an EMR. I challenge anyone who can really redraw the same VisTA screen in Figure 2 of this article into some ‘very user friendly screen’. It is impossible to achieve a user interface which will show all the allergy information, all of the reminders and all of the medications etc. and still be not overwhelming information and still present ‘what is the current status’ of the patient without navigating to another screen. My friends, IT industry’s current input devices (keyboard, mouse etc.) and current output devices (monitor, sound etc.) cannot possibly achieve this mighty goal.

b. It is again unrealistic to design a system so user friendly such that users can use it with no training at all. It is like asking a second grader to take up a course in algebra! The problem is once again the comparison to Google search and other such tools which are for laymen. Try instead comparing EMRs to industry standard products such as SAP or Microsoft CRM. Another problem lies with the quality of the users. One bunch of highly qualified users do not have the time to ‘spend with this new IT guys’ another set of users are a ‘floating crowd’ of temporary workers who know little about healthcare, let alone IT in healthcare. Compare this with other industries: Can a factory worker or a CFO in any other industry “refuse” to learn the software he is supposed to use everyday? Everybody needs training for software this size and this complexity.

c. It makes me mad (and sad) whenever I hear someone blaming the IT system for any medical error. Doctors and hospitals should take responsibility for medical errors, period. The computer did not place the order on its own, it did not pull out the medicine from the draw on its own, it did not administer the medicine on its own. It was all a human error.

Make an interface that is context-aware: Provide elements that are relevant to the task. If the user seeks out a certain feature during a particular task that is not already present in the initial set of features then the system should be smart enough to provide that feature again for the user. This is a great opportunity for the developer to get user feedback and perhaps feed it back into the next version of the product, or, hopefully, the product will be flexible enough that the change can be deployed in an existing installation without having to upgrade and that the change can be made by the system manager and not the software vendor.

Human-Computer Interaction is a huge field and, though there are several people doing research in this field, I don’t see any/many HIT vendors using many of their findings or of the HCI field in general.

This is a great topic and I hope you get more people to provide articles.

Design for intermediate FIRST, not the noob… especially on software/products used daily. Initially this seems counter-intuitive, but allow the repeat, advanced user to ROCK… let their skills sing… and you’ll amplify their creative and technical output… and then you have a devoted group who will preach for you.

Get the damn interface out of the way. Often the interface takes up a large amount of screen real estate (up to 60%) and the data takes a backseat = criminal design practice but seen everywhere in Health services. Also, I shouldn’t notice the interface over time. It should literally disappear (a la the photo browser on the iPhone).

Use grids, leverage great type and graphic design practices.

Beauty and elegance = a requirement for surprising and apostle-driven software. Where are the beautiful health services? We can count them on a few digits.

… and many more software interface design tenets.

Good first cut,
Juhan

I have heard the argument a lot that medical providers want to use their old way of doing things and that is the primary reason that they do not want to use HISs. While that may be true for a very small portion of providers, a great many of them see the potential benefits and want to use the software, but the systems are so clunky, and the processes in the system are so backwards and unintuitive, that it makes a lot of sense for providers to resist.

Without question, if we had well-designed systems the user adoption and satisfaction would be substantially higher. What surprises me is how few EHR companies have caught on to this–it’s a tremendous opportunity for one to really grab some market share.