“Don’t ask Doctors what they want, they have no idea what they want!”
As a Doctor new to the industry of software development, this statement irked me somewhat. Of course doctors know what they want! As do nurses, pharmacists, and the wealth of other highly-trained professionals working in our hospitals.
More specifically, they know that what they’re currently getting is not meeting their needs.
I came to realise the problem isn’t that Healthcare IT users don’t know what they want, the problem is they don’t know how to communicate their needs to those who are choosing their software for them.
The result is usually a well-meaning buyer implementing an expensive system that infuriates and frustrates the users as it falls short of their poorly communicated needs.
This 5 point checklist is intended to bridge the chasm between these buyers and the end users. When evaluating a new system, it can be applied quickly to avoid headaches down the line. Consider it a form of preventative medicine, for Healthcare IT systems implementation.
- Interoperability
This is the ability of computer systems to exchange and make use of information. From a technical perspective, interoperability can take a foundational, semantic, structural and/or operational form. For the end user this means taking all of the different elements of a patient’s care and collating them into one place where they are easily accessed by the user, regardless of their location.
Government and other Healthcare Management Organisations are recognising the value of interoperability on both an individual and population health basis. Interoperability not only streamlines the frontline user’s experience, but it allows for holistic, contemporaneous data capture. This feeds epidemiological analytics, fuelling more informed decision making and resource allocation. Before implementing any EHR system it is critical to evaluate how it is addressing this key requirement.
Actively involving clinical users in this appraisal is crucial, and often overlooked by Healthcare IT buyers. Clinical users will provide you with real-world insights around how interoperability can be catered for in the context of their practice.
- Trusted, Actionable Data
Ask yourself: is this system providing me with trusted, actionable data, or is it simply a “digital paper record”.
If it is the latter, your organisation is missing out on the wealth of clinical data that could be informing analytics, updating registries, informing research, managing point-of-care billing, providing targeted guidelines, and much more. Far too often, users are presented with data which is siloed, unstructured, and “flat”. This leads to duplication of effort; either in an attempt to verify untrusted results, or as a consequence of unrecognised previous efforts buried in the quagmire of the “digital record”.
By taking user entries and mapping the clinical findings to unique ID’s, modern healthcare IT systems provide users with a single, verified, actionable instance of the truth. By providing a single point from which all users draw information and to which all users enter data, one has the luxury of a single, trusted instance of the truth. There is elimination of effort duplication, reducing the clinical and administrative burden caused by untrusted, unstructured data.
- Usability
There are three considerations that fall under this checklist item; single sign-on capability, user interface, and flexibility.
Your users will not want a system that adds another silo to the mix. They will want a solution that does the opposite.
True interoperability should exist in your solution. Users want to access all of the patient’s data from a single point, eliminating the burden of password management and adding to the concept of a single source of the truth.
Whilst accessing the various systems from one point, the user should be presented with a single user interface which has been designed specifically with healthcare professionals and their workflows in mind. This interface should be structured enough to allow accurate data collection, yet flexible enough to facilitate the nuances in healthcare practices. Your clinical users won’t tolerate a “solution” which is overly prescriptive in its implementation or method of data capture, so either should you.
Any modern system will also facilitate efficient healthcare provision by mapping clinical workflows. Once again, actively involving your clinical users in the decision process can yield fantastic insights here.
Let them pick up the solution and play with it, you’ll know instantly whether the interface is going to work for them (and even more instantly if not!).
- Patient Platform
Does this system account for the most important person in the room? Does it recognise that this person is not the clinical user?
If not, why not?
Users want a solution that not only delivers for them, but also delivers for their patients.
Let’s consider the modern patient. I use the term “modern” rather than “young”, because many of our more senior patients are becoming just as adoptive of modern technology as their youthful counterparts.
The modern patient makes use of the devices available to them to augment every aspect of their life. Banking, socialising, leisure activities, communicating, updating and shopping can now be done securely from a device in their pocket.
These users are ready, willing and able to utilise this same technology to augment their healthcare.
Patients want to become real partners in their healthcare, they may not want to be in the driving seat, but they want to be right up there in the cockpit beside their healthcare provider, overseeing decisions that will profoundly impact them.
Clinical users want to mine the wealth of information that is being lost between clinic visits or hospital admissions. By utilising technology this could be achieved, and the wonderful thing is that all the building blocks already exist. For example, we already have methods of ensuring secure, trusted data transfer thanks to financial software, so why not cherry pick what we need and devise a system that empowers our patients?
The challenge here lies in engagement; How do we initiate and then maintain patient engagement in the patient platform.
“Friendliness” and usability are oft cited as the main reasons patients initially engage with their clinical portal app, with face-to-face human interaction being a key reason for them to come back.
Does the solution offer patients the components required to not only grab their attention, but to maintain it over time? If so, you are sitting on a potential goldmine of patient generated data, patient empowerment, patient education, and preventative medicine.
- Enhance, rather than replace
Finally, consider that the answer to your user’s woes may not be to replace existing system(s) completely, but rather to add a solution which works with the current ones to fulfil the user needs highlighted in this blog.
Consider that the costs of adding another system to enhance what is currently in place may be entirely justified when compared to the potential costs – financial, time and human – of removing entire IT eco systems and replacing it with another.
We in healthcare IT need to evolve from the antiquated idea of utilising a “Jack of all Trades”. Very often, the answer lies in effective and co-operative collaboration by a number of “Master of One” solutions, united through a shared ethos of interoperability.
I don’t envy the task of decision makers within healthcare IT today. There are a myriad of solutions all vying for our attention, all promising the moon and stars.
The purpose of this blog is to bridge the gap that so often exists between those choosing healthcare IT solutions and those using it, so as to hopefully ease the burden felt by these well-intending decision makers.
Users DO know what they want, and they should be listened to.
At Infocare we work hard to “Get it Right” for our Users, by providing a solution through which all five of these checklist items can be achieved.
References:
- HIMSS What is Interoperability 2019 https://www.himss.org/library/interoperability-standards/what-is-interoperability
- Department of Health and Human Services Fiscal Year 2019 Office of the National Coordinator for Health Information Technology Justification of Estimates for Appropriations Committee https://www.healthit.gov/sites/default/files/page/2018-04/ONC%20CJ_2019_FINAL.PDF
- Patient portals and health apps: Pitfalls, promises, and what one might learn from the other; Jessica L. Baldwin, Hardeep Singh, Dean F. Sittig, Traber Davis Giardina; Healthcare Volume 5, Issue 3 https://www.sciencedirect.com/science/article/pii/S2213076416300124
Writer – Dr. Sarah O’Reilly
