EMR Design

I have written about the EMR’s sparingly before, but as I look at the overall process, I realise that design principles are paramount to assess the “usability” of a product.

Here’s a primer from this blog post: (emphasis mine)

Don’t Make Me Think, Krug never refers to users in a derogatory way. He tells us how good products should work, and why basic psychology supports that. People want to reduce cognitive friction as much as possible. People don’t like unneeded cognitive friction. People skim quickly and “muddle through” products. And, most of all, people won’t undertake effort unless they believe it’s worth the cost. These are all facts backed by usability research and psychology.

How do assess the usability? Gawande wrote a huge post on New Yorker trying to explain the process of “selection” and “mutation”- as spring shoots of “hacking” the processes. It is a sad reflection of an impaired design process which requires “hacking” into it to make it usable. The problem is fundamental. Users won’t use a product unless they find it useful for their own needs. Unless you attach a cost function to the EMR (or any other app). Facebook bucks this trend somehow, and we relate it to a primal need to “connect”.

Here’s something more interesting:

So what explains the rise of products like Facebook, which have gotten a large part of humanity mindlessly scrolling through feeds of what can most easily be described as garbage content? Well, we humans aren’t perfect. If you’ve got billions of dollars, some of the brightest minds, and a lot of data at your disposal, you can get a lot of people to do what you want. If you treat users as stupid and lazy, you can turn them into stupid and lazy people in the context of your product

The author describes it as making it better, and I completely agree with his idea of creating functional autonomy and respecting the end users. EMR’s design principles (if they are any) cannot account for these fundamental issues. Hence you end up seeing a lazy copy paste solution from patient interactions.