usability is the key to healthcare innovation
TRANSCRIPT
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USABILITY IS THE
HEALTHCAREINNOVATION
JONATHAN BARAN, MSHealthFinch, LLC@jonathanbaran
TO
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I’m a physician.
But, Dr. Lyle is.
not
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I’m a designer and co-founder at HealthFinch
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THIS IS A USUAL DAY OF A PCP.
24 telephone calls24 prescription refills 17 emails20 laboratory results11 imaging reports14 consultation reports
PLUS, 25 PATIENTS PER DAY
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PRIMARY CARE DOCS ARE OVERWHELMED WITH
“PAPERWORK”.
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“There is only so much doctoring you can do in a
single day.”
flickr.com/photos/david_gray/459804826/sizes/o/in/photostream/
THE PROBLEM
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THE RESULT
50% OF PATIENTS do not get the care
they need.
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The United States spends over 20% of its GDP on
healthcare.
THE COST
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How can we fix this?
THE CHALLENGE
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The US government is putting up to $40 billion
dollars into electronic medical records.
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WHAT IS AN ELECTRONIC MEDICAL RECORD?
Finances Billing
e-prescribing
PHRPractice Management
Reporting
Scheduling
Call Management
Laboratory systems
Radiology systems
Health Information Exchanges
Anesthesia
Emergency Room
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It’s no wonder only 10.1 percent of physicians use an “advanced” EMR.
- 2010 CDC Survey
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Let’s start a Health IT design revolution.
1.... Move away from “paper-based” software.
2.... Getting back to the basics.
3.... Improve workflow usability by leveraging the team.
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Let’s look at a paper medical record.
1....
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When real world analogies go too far.
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Efficient
Easy-to-use
Flexible
PAPER IS...
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THE EMR IS...
Not Efficient
Not Easy-to-use
Not Flexible
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Electronic medical records mim ic the functionality of
paper.
They don’t expand upon it.
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HAVE WE DIGITIZED THE RECORD JUST TO
THE FUNCTIONALITY OF PAPER?
REPLICATE
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An example from banking...
DIGITIZATION LEADS TO FUNCTIONALITY
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Getting back to the basics.
- From the HIMSS EHR Usability Task Force
2....
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An application of these principles, to the problem list.
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Improve workflow usability by leveraging the team.
3....
“We train, hire, and pay doctors to be cowboys. But it’s pit crews people need.”
- Atul Gawande
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High level consulting
CARE FALLS INTO TWO CATEGORIES:
Protocol-based care
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We can lower healthcare costs by delegating work from the
physician to other members of the team.
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We NEED software to facilitate this.
We have tried this on paper.
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An example from
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Drilling down into
refill requests.
flickr.com/photos/nvinacco/4725385380/
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Med Refill MessagePaJent Message -‐ Create Phone Encounter SOURCE: [ x ] Phone [ ] VM [ ] RelayHealthFROM: [ ] PaJent [ ] Mother [ ] Father [ ] Pharmacy Other: daughter CONTACT INFOPaJent Phone:Other Contact Info: daughter xxx[ ] Do NOT leave message in voice mail[ ] Only call paJent during special Jme (please specify):**** Pt told to expect response within 1 business day unless otherwise noted:[ ] Today [ ] Other: PHARMACY INFOName/Phone: Walgreens xxx APPOINTMENT INFOLAST Appt with Prescriber: NEXT Appt with Prescriber:Other Relevant Appointment Info: For OB Call Center Use Only[ ] PaJent is pregnant, EDC : *********************************************************************************MEDICATION INFORMATION Name and Dosage QuanJty Other InformaJon-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐1. ZOCOR 20MG 1 A DAY2.3.4.
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You decide:Refill or not?
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How can we use software to make this process better?
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It starts with an UNDERSTANDING of the system.
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THE REFILL PROCESS VARIES HIGHLY ACROSS INSTITUTIONS.
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NO GROUP IS EXACTLY THE SAME.
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PROCESSES CAN BE AGGREGATED.
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PROTOCOLS CAN BE CAPTURED IN SOFTWARE
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AND ACCESSED BY OTHER MEMBERS OF THE TEAM.
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Let’s start a Health IT design revolution.
Move away from “paper-based” software.
Getting back to the basics.
Improve workflow usability by leveraging the team.
1
2
3
....
....
....
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USABILITYIS THE KEY TO HEALTHCARE INNOVATION
JONATHAN BARAN, MSHealthFinch, LLC
@jonathanbaran, [email protected]