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> This one is big for product designers. I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is imp

> This one is big for product designers. I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is impossible for reasons far outside the control of any product designer or developer currently on the team. This software is old, has byzantine requirements, probably cut costs all over the place, and conceived in a board room without the benefit of an adequate development lifecycle or stakeholders advocating for the users. It probably takes 3 months to move a button around, and instead of moving that button executives are having them push a feature that earns a few more million, or a feature that the customers want more then a UX improvement.

citizenpaul 4y ago
>executives are having them push a feature that earns a few more million I've worked here before... Half our customers are complaining about feature X that doesn't work right/ is inconvenient. Exec: we don't care they are already paying us on a 3 year contract. Hack this new feature into the program that a potential new customer wants. Horrible places to work they are. Thats why I avoid using any long term contracts like the plague. The second I see call for pricing I close the window.
mfer 4y ago
> I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is impossible for reasons far outside the control of any product designer or developer currently on the team. A developer working on something is different from a product designer. For product designer I don't mean a UI/UX developer. I mean someone empowered to design the thing. This is often a leader or product manager. Product design isn't something taught well in most schools. It's often out of sight and mind. An engineer who was good at building hardware or writing code didn't learn the skills needed for product design through that. Product design requires looking at the whole system differently. > It probably takes 3 months to move a button around, and instead of moving that button executives are having them push a feature that earns a few more million, or a feature that the customers want more then a UX improvement. A better UX would reduce the amount of time nurses spend using these systems. That productivity could be used to do more other work (like taking on more patients). I don't like this argument but it's easy to make in terms of cost effectiveness. I don't think the cost effective conversations are happening. I expect there isn't that level of depth to these. It's hard to do when a purchasing organization (like a hospital) only have a few options and they are all bad. This is an opportunity. To build software that is both compliant and has a good UX. There's an opportunity to disrupt all the crap software here.
- tmp_anon_22 4y ago
  I think what you're describing as the Product Designer who can get shit done would need to be at the VP or C level to actually accomplish this within an enterprise organization. > I don't think the cost effective conversations are happening. I think it would take years to overhaul these products and the conversations on that and how the price would roll down hill to the healthcare organizations have happened, and been summarily shut down. I also think startups have tried to sell software via this value prop but have not managed anything close to feature parity or sales-org-maturity as the dominant enterprise players. > This is an opportunity. I think various startups and other organizations are trying but there is a reason enterprise-style organizations exist and dominant their various verticals. Its not only about a good product, its about navigating painfully expensive sales cycles of multi-year or even near-decade, political wheeling and dealing at the municipal, state, and federal levels, dealing with compliance and legal liabilities etc. > This is an opportunity. Is it though? Hospitals still run. Yeah its expensive as hell, nurses are quitting, but I don't see the horsemen of the apocalypse quite yet. Healthcare outcomes are ok-ish. Young people are still entering the medical field as a viable profession.
- ajmurmann 4y ago
  I think this might be more of a symptom of administration being detached from the work on the ground. Even if one app had UX that was significantly better (within the realm what's possible within regulation. Others here make the point that the laws and regulations make the UX unregenerate bad), the sale might highly likely go to the solution that has more checkboxes filled in the feature table.
- histriosum 4y ago
  > This is an opportunity. To build software that is both compliant and has a good UX. There's an opportunity to disrupt all the crap software here. The thing that everyone is overlooking here is that EMR software is not designed with patient outcomes as the top priority. Every single EMR software I've seen in the field has been designed with BILLING as the top priority -- everything is organized around making sure that you can bill for the maximum number of services. I don't think this can possibly change without regulation. The incentives are all wrong at every other layer.

citizenpaul 4y ago

>executives are having them push a feature that earns a few more million I've worked here before... Half our customers are complaining about feature X that doesn't work right/ is inconvenient. Exec: we don't care they are already paying us on a 3 year contract. Hack this new feature into the program that a potential new customer wants. Horrible places to work they are. Thats why I avoid using any long term contracts like the plague. The second I see call for pricing I close the window.

mfer 4y ago

> I think this is looking at the problem wrong. The problem is that implementing positive change in these systems is impossible for reasons far outside the control of any product designer or developer currently on the team. A developer working on something is different from a product designer. For product designer I don't mean a UI/UX developer. I mean someone empowered to design the thing. This is often a leader or product manager. Product design isn't something taught well in most schools. It's often out of sight and mind. An engineer who was good at building hardware or writing code didn't learn the skills needed for product design through that. Product design requires looking at the whole system differently. > It probably takes 3 months to move a button around, and instead of moving that button executives are having them push a feature that earns a few more million, or a feature that the customers want more then a UX improvement. A better UX would reduce the amount of time nurses spend using these systems. That productivity could be used to do more other work (like taking on more patients). I don't like this argument but it's easy to make in terms of cost effectiveness. I don't think the cost effective conversations are happening. I expect there isn't that level of depth to these. It's hard to do when a purchasing organization (like a hospital) only have a few options and they are all bad. This is an opportunity. To build software that is both compliant and has a good UX. There's an opportunity to disrupt all the crap software here.

tmp_anon_22 4y ago
I think what you're describing as the Product Designer who can get shit done would need to be at the VP or C level to actually accomplish this within an enterprise organization. > I don't think the cost effective conversations are happening. I think it would take years to overhaul these products and the conversations on that and how the price would roll down hill to the healthcare organizations have happened, and been summarily shut down. I also think startups have tried to sell software via this value prop but have not managed anything close to feature parity or sales-org-maturity as the dominant enterprise players. > This is an opportunity. I think various startups and other organizations are trying but there is a reason enterprise-style organizations exist and dominant their various verticals. Its not only about a good product, its about navigating painfully expensive sales cycles of multi-year or even near-decade, political wheeling and dealing at the municipal, state, and federal levels, dealing with compliance and legal liabilities etc. > This is an opportunity. Is it though? Hospitals still run. Yeah its expensive as hell, nurses are quitting, but I don't see the horsemen of the apocalypse quite yet. Healthcare outcomes are ok-ish. Young people are still entering the medical field as a viable profession.
ajmurmann 4y ago
I think this might be more of a symptom of administration being detached from the work on the ground. Even if one app had UX that was significantly better (within the realm what's possible within regulation. Others here make the point that the laws and regulations make the UX unregenerate bad), the sale might highly likely go to the solution that has more checkboxes filled in the feature table.
histriosum 4y ago
> This is an opportunity. To build software that is both compliant and has a good UX. There's an opportunity to disrupt all the crap software here. The thing that everyone is overlooking here is that EMR software is not designed with patient outcomes as the top priority. Every single EMR software I've seen in the field has been designed with BILLING as the top priority -- everything is organized around making sure that you can bill for the maximum number of services. I don't think this can possibly change without regulation. The incentives are all wrong at every other layer.