s130 - day 1 - 1430 - playing with it makes healthcare tick
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Health and Care Innovation Expo 2014, Pop-up University S130 - Day 1 - 1430 - Playing with IT makes healthcare tick Carl Reynolds #Expo14NHSTRANSCRIPT
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
.
.Usability in healthcare technology
Carl Reynolds
Open Health Care UK
March 3, 2014
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
...1 Introductions
...2 Usability and design
...3 Usability in healthcare technologyHow usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?
...4 Take home message and a call to action
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
Hello I’m Carl
Thanks for coming. You can shout out. It’s cool.(COI here http://www.whopaysthisdoctor.org/doctor/11)
Open Health Care UK promote health by making highly usabledigital services for healthcare professionals and patients.
Who are you? Any NHS employees? Anyone an NHS IT user?Anyone who buys NHS IT? Anyone who sells IT to the NHS?
What do you need from my talk? What can I offer? I do havea talk on usability in healthcare technology handy but I canadapt.....
Carl Reynolds Usability in healthcare technology
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OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
What meant by usability and design?
Usability is defined as the ease of use and learnability of ahuman-made object. Design is the creation of a plan orconvention for the construction of an object or a system.
Computers used to be hard to use. Now they’re not. Youdon’t even have to remember to press save in order to notlose your work in google docs and on the ipad.(http://www.flourish.org/blog/)
Affordance came along (Donald Norman Psychology OfEveryday Things)
And design priciples etc from the awesome GovernmentDigital Service (GDS)
Carl Reynolds Usability in healthcare technology
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OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
How usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?
How usable is healthcare technology in the NHS?
LL Weed (1968) Writing in the New England Journal ofMedicine: “the computer will allow immediate retrieval of allthe data . . . multiple copies at distant terminals . . . andimmediate correlation with large amounts of data on similarproblems stored in the compute”
S Stevens (2002) With IT, information can be captured onceand used many times
DoH (2012) Providers of health and care services will be ableto increase their efficiency, for example from reducedduplication of work
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
How usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?
How usable is healthcare technology in the NHS?
In my experience the usability of NHS IT is generally verypoor. This is highly suboptimal.
Unlike general consumer technology, with health technology inthe NHS one must frequently overcome bad design and poorusability to get the job rather than the technology supportingthe process with little or no hope of improving the tools orchoosing otherwise.
e.g my patient needs an MRI scan, workflow: job capture andscheduling, establishing process (inc access computer login,intranet, operator), sending a fax (c ward clark workaround),chasing, coordinating with MRI, patient, nursing staff, andporter. more chasing. add to discharge summary (will loseformatting, character limit, may not permit copy and paste)
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
How usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?
Why does poor usability in healthcare technology matter?
It has serious implications for clinical quality:
clinical effectivenesspatient safetypatient experience
The opportunity cost is immense. The status quo isunacceptably bad. It’s shameful.
Whitehead (1911):“Civilization advances by extending thenumber of important operations which we can performwithout thinking about them”
Leibniz (1685): “It is unworthy of excellent men to lose hourslike slaves in the labor of calculation which could safely berelegated to anyone else if machines were used.”
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
How usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?
Why is it like this?
Can you recognize the million pound chair?
Cultural problems? Lack of user-focus, informationgovernence/security theatre fetish e.g ISB 0086 (IGTK),ISO/IEC 27001, BS ISO/IEC 27002: 2005 etc etc.
Lack of openness, proprietary systems/black boxes, hiddenfailure modes, no ability to improve, failure to capture andmonitor bugs (and harm resulting) in a systematic fashion.E.g PACS is down (again).
Carl Reynolds Usability in healthcare technology
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OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
How usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?
How to fix?
Stepwise better than big bang
Smaller well built components better than the big systems
Build in house technical expertise
Understand the strategic importance, to an organisation in theinformation business, of understanding and being able toefficiently adapt information systems
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
Lets make NHS IT less bad
Significant scope still for optimising usability of NHS IT forpatients and healthcare professionals
User focus and openness are essential, must procureeffectively, open source, open governence, and modern designprinciples help
Can we be of service to you or your organisation?
email: [email protected]: @drcjarweb: www.openhealthcare.org.uk
Carl Reynolds Usability in healthcare technology
OutlineIntroductions
Usability and designUsability in healthcare technology
Take home message and a call to actionReferences
Credits and References
I am grateful to Louise Sinclair for inviting me to speak onbehalf of NHS England.
I am grateful to Francis Irving, Zarino Zappia, NicholasTollervey, James Stewart, Tom Taylor, and David Miller forhelping me to think about usability in the NHS. Allmistakes/misconceptions etc are my own.
Carl Reynolds Usability in healthcare technology