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Tag: #UX

My Ideal EHR

flying cadeuciiGive me technology which improves my life and that of my patients, or give me death.  Medical records must be informative, efficient, and flexible; like the physicians they serve.  For me, a medical record does not contain just a collection of problem lists, prescribed medications, and immunizations; it is a noteworthy account of the health care provided to another human being over a lifetime.

Recently, I attended a baby shower of a patient who is now an adult.  (I am a pediatrician.) I brought her medical chart wrapped with a satin bow as one of her gifts.  I was her physician for many years; my father had taken care of both her and her mother as children.  Her growth, development, immunizations, and illnesses were all recorded; but so were 25 years of life experiences, trials, triumphs, and tribulations.  The back section contains drawings she had given me, newspaper articles of her achievements, graduation announcements, and her wedding invitation.  Obviously, medical records register growth parameters, vital signs, and sick visits; but they also encompass my relationship with my patients.

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Training Day

Screen Shot 2015-04-06 at 7.20.19 PMDr. Samuels’ day-long training experience is unfortunate, but it’s only the opening chords of a much longer symphony of time commitments required by electronic medical records (EHRs).  Many studies document the extra time that EHRs impose on doctors and patients. Research in U.S. hospitals and medical offices suggest that these systems can add a half-hour or much more time to a day. A study by McDonald et al (2013 JAMA Internal Medicine) found EHRs added 48 minutes/day to ambulatory physicians, and Hill et al found that in a large  community hospital emergency room 43% of all physician time was spent entering data into the EHR. This almost doubled the time spent caring for patients, and tripled the time needed to interpret tests and records. (Annals of Emergency Medicine, 2014).

Some of that extra time is spent with clunky interfaces and  hide-n-go seeking for information that should be immediately available, such as arbitrary or unexpected  presentations of data, e.g., having to find a patient’s history by clicking on her current room number, or lab reports that may be arranged by chronology, by reverse chronology, by the lab company, by the organ system, by who ordered them, or by some informal heading, such as “blood work” or “tests” or “labs.”  Then there’s the constant box clicking (or what clinicians call “clickarrhea”).  EHRs also send thousands of usually irrelevant alerts that desensitize doctors to legitimate clinical recommendations.
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Health Care Ux Design: Crucial But Conflicted

Screen Shot 2015-04-06 at 1.22.24 PMThe focus on design for health IT at the HxRefactored conference on March 31 raised several tough questions about the hazard-strewn path app developers must travel in that field. My sampling of introductory workshops and afternoon sessions (I unfortunately had the chance to attend only the first day of the two-day conference) brought up many fine design principles, but most of the presenters were general-purpose designers having limited experience in health care. Still, some important distinctions to recognize when entering health IT came up.

One factor making design is so difficult in health care is the vast variety of tasks health care professionals perform. If you’re designing an app to reserve a restaurant table or buy a sweater, how many pathways can a user take? Probably at most a dozen or two. Now think of a hospital ward: one patient whose heart has to be monitored constantly, another who needs regular injections, and yet another whose medication has put her in a delirium that leads her to jump out of bed and wander. Truly, the pathways that a doctor or nurse can take through the health care application verges on the infinite.

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Meet the Worst Video Game Ever Invented: The Electronic Medical Record …

Starcraft

Contrary to what you may think, most doctors do want to make eye contact. They aren’t antisocial. They want to engage. But they can’t. They’re too distracted by one of the worst computer games ever invented—the electronic medical record (EMR).

You may be surprised to see the EMR compared to a computer game, but there are many similarities. Both offer a series of clicks with an often-maddening array of tasks to solve. There are templates to follow, boxes to fill in & scoring. However, unlike most electronic games, the points accrued in the EMR often translate into payment—real dollars for either your doctor or the hospital.

Although these clicks and boxes may be necessary to document your visit, it’s distracting. And your doctor begins to feel more like a librarian cataloging information rather than, say, a historian capturing your story.Continue reading…

“Putting Care In Context” Design Challenge Winners Announced

Innovations Help Patients Share Their Lives with Health Care Providers

The California HealthCare Foundation (CHCF), Mad*Pow and Health 2.0 today announced the winners of the “Putting Care In Context” design challenge which sought innovative ways to help patients take an active role in sharing information about hurdles in their lives that impact health.

The three winning solutions each empower patients to share information about issues like hunger, poor housing conditions, stress, and isolation with their health care providers. The winners are:

  • First place: Healthify is a web-based platform used to assess patients’ social and behavioral health needs, refer patients to appropriate resources to meet those needs, and engage patients around their social determinants via interactive texting. The platform also provides dashboards for managed care plans and case managers to use, allowing them to better manage the social needs in their population and to efficiently search for social services.
  • Second place: Share4Care is a design prototype of an iPad app that would allow patients to document stress levels and issues in their life while in a clinical waiting room. The Share4Care app would then calculate a “Life Change Score” and assign a color (green, yellow, or red) that would be immediately available to the patient’s physician, prompting them to ask about factors that could impact the patient’s health.
  • Third place: MyDay Media Messaging Journal is a web-based platform that patients use to document their barriers to health through photos and text messages. The MyDay website and mobile app allow providers to view patients’ journal entries and follow-up to build patient-provider rapport, clarify journal entry content, and connect patients with resources.

The creators of these ideas will share $10,000 in prize money for their thoughtful, original work.

“We believe that healthcare providers must understand the hurdles in a patient’s life that can be a barrier to good health,” says Amy Cueva, Founder and Chief Experience Officer at Mad*Pow. “These winning concepts can help engage patients to share this important personal information, leading to more effective care.”

The challenge was first announced at the HxRefactored conference on May 14, 2014 in Brooklyn, NY. A healthcare experience, design and technology conference, HxRefactored fused the technical and creative elements of Mad*Pow’s Healthcare Experience Design Conference and Health 2.0’s Health: Refactored.

“The winning solutions – all at varying stages of development – demonstrate different ways that patients can be engaged to share information about their lives outside the clinic walls” said Giovanna Giuliani, senior program officer with the California HealthCare Foundation. “From a one-time assessment in the waiting room, to a daily social media-inspired approach, to a more developed web-based screening tool, these solutions will spark new ways to think about promoting conversations and care that addresses the whole person.”

For more information on the design challenge and the winning entries, visit http://bit.ly/CareInContext.

About the California HealthCare Foundation

The California HealthCare Foundation works as a catalyst to fulfill the promise of better health care for all Californians, supporting ideas and innovations that improve quality, increase efficiency, and lower the costs of care. For more information, visit www.chcf.org.

About Mad*Pow

Mad*Pow is a design agency that improves the experiences people have with technology, organizations and each other. Using human-centered design, Mad*Pow creates strong multi-channel experience strategies, intuitive digital experiences and streamlined processes for its clients. The company has offices in Boston, Portsmouth, NH and Louisville. For more information, visit www.madpow.com.

About Health 2.0

Health 2.0 promotes, showcases, and catalyzes new technologies in health care through a worldwide series of conferences, code-a-thons, prize challenges, and leading market intelligence. Visit www.health2con.com for more info.

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