American Medical Association: 3 reasons why you need to completely redesign your EHR

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“3 reasons your Snapchat habit won’t help you master the EHR” by Brendan Murphy, Staff Writer at the AMA Wire.

“Whether you call them millennials or digital natives, there’s no denying that a generation of Americans, one that grew up along with their devices, is perceived to be more tech savvy than any that preceded it”

The born mobile generation is probably the most useful description as they were born in the Nokia Decade (even though most people still don’t yet realise a quirky Finish brand got to define the decade).

“Because of that technology and an unending roster of apps—from Snapchat to Stitcher and everything in between—today’s physicians in training seem to be more proficient in communicating and obtaining information. How does that translate to medical school or residency? When it comes to EHR training, one expert believes, it doesn’t”

I gave a lecture at the largest Medical School in Ireland on this topic recently. It’s fascinating because out of date educators and professional bodies with their out dated customs (banning mobile phones in exams as though there will ever be a day you work as a General Practitioner when you don’t have a mobile that’s at least as powerful as a iPhone X in your pocket, trying to train Doctors to work in an environment where they don’t use a mobile, etc) are being made to look really decrepit to the BornMobile who find it unbelieveable that a Doctor would even be allowed to work without a connected smartphone loaded with high quality content.

“AMA Wire® spoke with Blaine Y. Takesue, MD, a research scientist at the Regenstrief Institute and assistant professor of clinical medicine at Indiana University School of Medicine. Dr. Takesue offered three reasons digital natives may still be in foreign territory when it comes to learning the ins and outs of EHRs.

EHR data doesn’t effectively translate to devices

While smart devices have in many ways replaced clunky computers in a number of arenas, that is less the case in the EHR realm. The smaller screen is a hindrance when it comes to reading and entering data, Dr. Takesue said.“If you’re used to a mobile solution to problems, that’s a much different paradigm than sitting at a computer,” Dr. Takesue said. “It has a lot to do with real estate. EHRs haven’t translated well to a phone. You need to see a lot of data. There’s not enough real estate on a phone to do that without moving through multiple screens.””

I wonder what Dr Takesue thinks of popular smartphone apps like Skyscanner or AliBaba. Perhaps he doesn’t realise that there are people in the aviation/retail industry who were similarly challenged to see the opportunity to press a few buttons on a mobile phone to arrange their travel/shop. Perhaps he doesn’t know that it was unimaginable to millions of retails that their work could be done by customers interacting with the screen of their mobile phone? If you’re struggling to imagine the future a good exercise is trying to imagine the unthinkable things that mHealth makes possible…

Nick Mason 20 years ago it was unthinkable

It’s not a case of “EHRs haven’t translated well to a phone” it’s a case of we need to apply MobileFirst design to Health Records.

The people in the foreign country are not the Born Mobile generation it’s the medics and healthcare industry leadership who are wedded to thinking an Electronic Health Record is and must remain an unwieldy, dangerous bureaucratic billing engine that is inaccessible and incomprehensible to both Clinicians and Patients.

“Systems predate the smartphone

The EHR systems with which large health care organization’s work were created decades ago, and because of that, they don’t feature the same user functionality as newer devices.

“The problem is that many of the most widely used EHRs were not created from 2000 on—they were created last century,” Dr. Takesue said. “What we use in medicine and what we train our students on is legacy technology. There may be a solution that translates really well to mobile, which will allow questions to be answered quickly, but it’s not in wide use.””

It’s futile to hope that there is a bandaid that can offer a mere translation of EHR’s so that they work on mobile and all is well with the world. Starbucks and Walgreens didn’t find success by translating their online services they did it by rethinking what they.were doing and applying Mobile First design principles.

“EHRs aren’t intuitive

Your smartphone, search engine or voice-activated device seems at times to know what you’re going to say before you do. Products that function this way—when the server anticipates potential communications—use a form of artificial intelligence to push out answers and solutions. EHR systems work the opposite way.

“We call it a content pull,” Dr. Takesue said. “As a user, you have to go and pull content you want to see when you want to see it.

For device users, “it hurts expectations,” he added. EHRs “don’t provide the information to the user at the time that they need that information.”

It should be obvious that EHRs aren’t designed to serve the needs of Patients/Medics/Carers but to assist the objectives of profit generating businesses. This is not the reason to resist innovation but rather the design challenge. Trillions of dollars have been wasted on EHRs so don’t expect those benefiting from the status quo to be championing this or lobbying organisations like the AMA to aid their demise. Thankfully a Mobile brand (Apple – the world’s biggest and most profitable corporation) has a new product that they have set on disrupting the lucrative revenues that EHR companies are hoping to hold onto…

About David Doherty
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