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I agree. This article is off the mark. On the contrary, doctors want tools that will assist them in providing better patient care outcomes. In all my career, I'
by EB66 8y ago
I agree. This article is off the mark. On the contrary, doctors want tools that will assist them in providing better patient care outcomes. In all my career, I've never met an anesthesiologist, trauma surgeon nor a hospitalist who has ever expressed a concern that technology will make them obsolete. On the contrary, almost universally these individuals are overworked and are thrilled to hear about anything that might save them a little time or make their job easier.
That being said, doctors do not want tools that are clunky, tools that force them to change their existing workflows, tools that run slow, can't pull in relevant data in real-time, rely on fragile HL7 interfaces, etc. Doctors want tools that work for them. Doctors do not want to be fighting or struggling with tools that are supposed to help them. While that may seem obvious, it's a very difficult bar for most software makers to meet -- particularly in the inpatient and ED space.
I can understand the author's perspective -- she's a new resident at Yale New Haven Hospital and previously ran a medical software start-up that closed up shop relatively quickly. It would be convenient to rationalize the failure of her start-up due to fears of new tech. While it may have been a fear of new tech that prevented her start-up from succeeding, it was not a fear of being made obsolete -- it was a fear that her product wouldn't do the job well.
- Zelphyr 8y ago> doctors do not want tools that are clunky And yet every EMR system I've ever seen is comically bad. Why the medical providers haven't revolted over being forced to use those things is beyond me.
- EB66 8y agoThey really are comically bad (Cerner, Epic, Meditech, all of them), but they are effective data silos which is a step up from having that data silo'ed in filing cabinets. People outside healthcare really don't understand the sheer amount of time your physician spends trawling through the medical record in the regular course of doing his or her job. You can think of the patient chart as a shared "My Documents" folder on your computer. In modern multi-disciplinary care, you have many different parties taking care of the same patient and working in shifts. In order to get up to speed with what's happening for a particular patient, you need to open up each of the recent files in "My Documents" for that patient and review it. Lab results, progress notes, schedules, etc. Then repeat a couple dozen times for all the other patients you're caring for that day. Endless clicking. Constantly flipping between windows. Burn out. That's not too much of an exaggeration of what the real EMR experience is like today.
- rpcastagna 8y agoThese experiences also exacerbate the perception that I referred to before that can basically be summarized as "every previous attempt at making this better ended up being completely terrible". A whole slew of people want to improve things, but a lot of the time they don't take that responsibility seriously enough -- or know, fully, what that entails -- and when they bail that leaves the next would-be "disruptor" at a disadvantage.
- Ntrails 8y agoRight, and it turns out that the devil you know is infinitely more attractive than the next helf finished buggy piece of shit that someone assures you will revolutionise your workflow.
- sizzle 8y agoMy doctor's office just switched to the latest MyChart system and the app on Android has a pretty modern UX, decent usability and shows all my upcoming appointments, lab results, bill statements, etc. No complaints on my end, having access to my records right after my physician enters it into their computer is nice compared to requesting packets of physical paper then having to securely store them from prying eyes...
- paulie_a 8y agoMychart is really slick in my opinion. Very usable Android interface and everything you mentioned. I was definitely impreased for the patient experience. Sometimes with blood tests it can be a bit of information overload. But that is why you have a doctor explain what matters. It's also nice to see and compare previous tests to see things improve in a simple format.
- WalterBright 8y agoMost consumer software is tragically bad. For example, the automatic cat feeder I have has probably the second worst user interface I've ever seen. The worst was a thermostat. Heaven help you if you ever lose the manual.
- deleted 8y ago[deleted]
- projectileboy 8y agoBecause it’s the same situation as with any enterprise software - the buyers are not the users, and they are evaluated at how well they did or not do their job based on a whole host of criteria that have absolutely nothing to do with satisfied users.
- brownbat 8y agoBuyers? I want the makers trained as users. Everything I've optimized really well was after a week or so using the old bad solution. Programs made for me, to automate some part of my job? Invariably break some part of my workflow that promptly gets labeled an edge case.
- TeMPOraL 8y agoSame problem. Makers are not paid to think like users. Makers are paid to satisfy whoever's actually paying.
- paulie_a 8y agoIf makers dont have a fundamental understanding of how the users will utilize it, the makers are making a bad product. Every developer should do customer service and a sales call on a regular basis.
- TeMPOraL 8y ago> If makers dont have a fundamental understanding of how the users will utilize it, the makers are making a bad product. Well, exactly. That's half of the reason why enterprise, medical, restaurant and other similar software generally sucks. > Every developer should do customer service and a sales call on a regular basis. In B2C, sure. In B2B for the examples I mentioned above, a "sales call" is where the problem starts. On such a call, you'll get the opinions of people paying for software, not of those using it.
- paulie_a 8y ago
- conanbatt 8y agoIts my believe that its impossible to build the killer EMR, or at least, nobody has approached that. There are many reasons for it, just as making software to manage restaurants has been an impossible one. The use cases are operationally extremely different in all cases.
- maybecorrect 8y agoI think the common thing between restaurant POS systems and EMR is that they aren't optimized for the user, they're optimized for management.
- jayd16 8y agoIts really strange how much punishment doctors seem to receive and how much they're willing to take. The hours alone would be laughable in any other industry.
- kwhitefoot 8y agoThe hours are, to some extent, imposed by the various medical governing bodies either directly or by artificially restricting the supply of doctors. These bodies are composed largely of doctors so the problem is to some extent self imposed. In the UK doctors are not governed by the working time directive because the UK negotiated an opt out so hospital doctors work ridiculous hours. As far as I can tell this problem does not exist to the same degree elsewhere in Europe.
- qnsi 8y agoIn Poland it is also very common for doctors to work crazy hours.
- HeadsUpHigh 8y ago>In the UK doctors are not governed by the working time directive because the UK negotiated an opt out so hospital doctors work ridiculous hours. In UK doctors are treated much worse than they are in the USA.
- arkh 8y agoBecause 2 main things. First: you're dealing with humans so you have to let a lot of things possible. Which is how you easily get shitty UI. Second: everything is a legal horror. Certification, certification, certification. PS: and third. Most medical software is not chosen by its users but by management.