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I might work in a “Hacker News bubble” but this type of story in 2023 actually surprises me. Software development has become product-driven, some may say even a

I might work in a “Hacker News bubble” but this type of story in 2023 actually surprises me. Software development has become product-driven, some may say even a little too much, and data-driven, both progress around user and stakeholder feedback. Who are these charlatans that still make applications that function so horribly?

hulitu 3y ago
> Who are these charlatans that still make applications that function so horribly? Ever used any Microsoft product recently ? Or the new xsnow which has a config screen when it starts ? Or Google with warning messages occupying half the screen ? This is the trend since about 15 years.
- hospitalJail 3y ago
  Its incredible that Microsoft has gotten worse since Windows 7. Literally more windows 7 would be an upgrade over windows 11. Whatever stuff they have going on in the background is not worth the anti-user crap.
hgomersall 3y ago
The world of medical software is, from everything I've seen and heard (from clinicians and prospective new entrants) a deep dark pit of dispair. The barriers to entry are so high that almost nobody can improve on the mess that has bled everywhere, and those supplying the mess crank the money machine at will.
- blueflow 3y ago
  My mom once managed to get into the hospital in a weird enough way that she got a bed assigned by the management software, but no food. "Software issue, can't do anything about it". I ended up bringing groceries to her room each second day.
smeej 3y ago
Having worked almost exclusively in customer-facing roles for software companies for the last six years, it doesn't surprise me at all that a developer would be surprised by this story. As far as I can tell, the number one rule of being a UX or UI specialist is that one must never, under any circumstances, actually talk with a U, nor consult the team whose job it is to assist U's with the X the designers and developers swear up and down is so intuitive it should never require explanation. Most applications are still horrible and unintuitive to the people expected to use them, especially when they're built for niche users. This is the normal experience of using software as a non-developer. Almost every company has customer support people who are beating their heads against their desks trying desperately to surface this feedback in a way that anyone in the company will care about, but support agents "aren't technical," so the developers don't think they could possibly have anything useful to say about their work. It's a vicious circle. It doesn't have to be this way. But I'm all put of ideas about how to change it.
- oezi 3y ago
  > But I'm all out of ideas about how to change it. Instead of stand-ups let developers spend 15 minutes each day in a call with a customer who has a problem or feature request.
  - loa_in_ 3y ago
    I would absolutely very much appreciate it as a developer, because nowadays,the motivational structures put in place rarely do anything for me but this would be a great: problem -> effort -> feedback -> closure -> motivation; loop element
  - hgomersall 3y ago
    Isn't this sort of the theory behind scrum - having rapid feedback loops with the product owner that is (supposedly) the one that has the deep necessary insight into the problem?
    - oezi 3y ago
      Product owners are not real customers. Extreme Programming got that part covered much better.
qzio 3y ago
These type of software is regulated, and hospitals and clinics can't easily move to a competitor if they are not happy with their current system. Journal systems "is a thing" with lots of hairy issues such as integrations between different hospitals and primary care givers, privacy issues etc. These are not really solved yet, (even on a regional basis) and on top of this comes the probably most important thing, UX for the actual users such as doctors and nurses.
gambiting 3y ago
>>Who are these charlatans that still make applications that function so horribly? The people selling this software and buying this software are ultimately not the people that use it. In developers minds and according to their spec sheets, the sofware might actually be amazing and flawless.
deleted 3y ago
[deleted]
seized 3y ago
Healthcare is it's own thing, what happens outside it software wise isn't always applicable to healthcare. The system in question is electronic health records (EHR). These are vast systems, really the comparison is "SAP for medical records" as they typically handle scheduling, billing, coding, store reports, notes, results (blood tests, as the tip of the ice berg). The tie ins to other systems are complex. And all of it is critical, as in patient injury or death if sole things go wrong. And much of it can fall under various federal laws, HIPAA is just the start. These are long lived systems, upgraded over time. Replacing one can be a multi year effort for even a small organization. So replacing one isn't done because a new shiny one exists. New entries face a long battle into the industry, and the needs of a family physician are very different from a hospital or large group of hospitals. If you want an idea of the scale and scope, the NYC Health and Hospitals project for their Epic EHR ran $1 billion over budget. Might have been more that that.

hulitu 3y ago

> Who are these charlatans that still make applications that function so horribly? Ever used any Microsoft product recently ? Or the new xsnow which has a config screen when it starts ? Or Google with warning messages occupying half the screen ? This is the trend since about 15 years.

hospitalJail 3y ago
Its incredible that Microsoft has gotten worse since Windows 7. Literally more windows 7 would be an upgrade over windows 11. Whatever stuff they have going on in the background is not worth the anti-user crap.

hgomersall 3y ago

The world of medical software is, from everything I've seen and heard (from clinicians and prospective new entrants) a deep dark pit of dispair. The barriers to entry are so high that almost nobody can improve on the mess that has bled everywhere, and those supplying the mess crank the money machine at will.

blueflow 3y ago
My mom once managed to get into the hospital in a weird enough way that she got a bed assigned by the management software, but no food. "Software issue, can't do anything about it". I ended up bringing groceries to her room each second day.

smeej 3y ago

Having worked almost exclusively in customer-facing roles for software companies for the last six years, it doesn't surprise me at all that a developer would be surprised by this story. As far as I can tell, the number one rule of being a UX or UI specialist is that one must never, under any circumstances, actually talk with a U, nor consult the team whose job it is to assist U's with the X the designers and developers swear up and down is so intuitive it should never require explanation. Most applications are still horrible and unintuitive to the people expected to use them, especially when they're built for niche users. This is the normal experience of using software as a non-developer. Almost every company has customer support people who are beating their heads against their desks trying desperately to surface this feedback in a way that anyone in the company will care about, but support agents "aren't technical," so the developers don't think they could possibly have anything useful to say about their work. It's a vicious circle. It doesn't have to be this way. But I'm all put of ideas about how to change it.

oezi 3y ago
> But I'm all out of ideas about how to change it. Instead of stand-ups let developers spend 15 minutes each day in a call with a customer who has a problem or feature request.
- loa_in_ 3y ago
  I would absolutely very much appreciate it as a developer, because nowadays,the motivational structures put in place rarely do anything for me but this would be a great: problem -> effort -> feedback -> closure -> motivation; loop element
- hgomersall 3y ago
  Isn't this sort of the theory behind scrum - having rapid feedback loops with the product owner that is (supposedly) the one that has the deep necessary insight into the problem?
  - oezi 3y ago
    Product owners are not real customers. Extreme Programming got that part covered much better.

qzio 3y ago

These type of software is regulated, and hospitals and clinics can't easily move to a competitor if they are not happy with their current system. Journal systems "is a thing" with lots of hairy issues such as integrations between different hospitals and primary care givers, privacy issues etc. These are not really solved yet, (even on a regional basis) and on top of this comes the probably most important thing, UX for the actual users such as doctors and nurses.

gambiting 3y ago

>>Who are these charlatans that still make applications that function so horribly? The people selling this software and buying this software are ultimately not the people that use it. In developers minds and according to their spec sheets, the sofware might actually be amazing and flawless.

deleted 3y ago

[deleted]

seized 3y ago

Healthcare is it's own thing, what happens outside it software wise isn't always applicable to healthcare. The system in question is electronic health records (EHR). These are vast systems, really the comparison is "SAP for medical records" as they typically handle scheduling, billing, coding, store reports, notes, results (blood tests, as the tip of the ice berg). The tie ins to other systems are complex. And all of it is critical, as in patient injury or death if sole things go wrong. And much of it can fall under various federal laws, HIPAA is just the start. These are long lived systems, upgraded over time. Replacing one can be a multi year effort for even a small organization. So replacing one isn't done because a new shiny one exists. New entries face a long battle into the industry, and the needs of a family physician are very different from a hospital or large group of hospitals. If you want an idea of the scale and scope, the NYC Health and Hospitals project for their Epic EHR ran $1 billion over budget. Might have been more that that.