usability is the key to healthcare innovation
TRANSCRIPT
USABILITY IS THE
HEALTHCAREINNOVATION
JONATHAN BARAN, MSHealthFinch, LLC@jonathanbaran
TO
I’m a physician.
But, Dr. Lyle is.
not
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I’m a designer and co-founder at HealthFinch
THIS IS A USUAL DAY OF A PCP.
24 telephone calls24 prescription refills 17 emails20 laboratory results11 imaging reports14 consultation reports
PLUS, 25 PATIENTS PER DAY
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PRIMARY CARE DOCS ARE OVERWHELMED WITH
“PAPERWORK”.
“There is only so much doctoring you can do in a
single day.”
flickr.com/photos/david_gray/459804826/sizes/o/in/photostream/
THE PROBLEM
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THE RESULT
50% OF PATIENTS do not get the care
they need.
The United States spends over 20% of its GDP on
healthcare.
THE COST
How can we fix this?
THE CHALLENGE
The US government is putting up to $40 billion
dollars into electronic medical records.
WHAT IS AN ELECTRONIC MEDICAL RECORD?
Finances Billing
e-prescribing
PHRPractice Management
Reporting
Scheduling
Call Management
Laboratory systems
Radiology systems
Health Information Exchanges
Anesthesia
Emergency Room
It’s no wonder only 10.1 percent of physicians use an “advanced” EMR.
- 2010 CDC Survey
Let’s start a Health IT design revolution.
1.... Move away from “paper-based” software.
2.... Getting back to the basics.
3.... Improve workflow usability by leveraging the team.
Let’s look at a paper medical record.
1....
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When real world analogies go too far.
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Efficient
Easy-to-use
Flexible
PAPER IS...
THE EMR IS...
Not Efficient
Not Easy-to-use
Not Flexible
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Electronic medical records mim ic the functionality of
paper.
They don’t expand upon it.
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HAVE WE DIGITIZED THE RECORD JUST TO
THE FUNCTIONALITY OF PAPER?
REPLICATE
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An example from banking...
DIGITIZATION LEADS TO FUNCTIONALITY
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Getting back to the basics.
- From the HIMSS EHR Usability Task Force
2....
An application of these principles, to the problem list.
Improve workflow usability by leveraging the team.
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“We train, hire, and pay doctors to be cowboys. But it’s pit crews people need.”
- Atul Gawande
High level consulting
CARE FALLS INTO TWO CATEGORIES:
Protocol-based care
hAp://www.flickr.com/photos/smenzel/93523557/
We can lower healthcare costs by delegating work from the
physician to other members of the team.
We NEED software to facilitate this.
We have tried this on paper.
An example from
Drilling down into
refill requests.
flickr.com/photos/nvinacco/4725385380/
Med Refill MessagePaJent Message -‐ Create Phone Encounter SOURCE: [ x ] Phone [ ] VM [ ] RelayHealthFROM: [ ] PaJent [ ] Mother [ ] Father [ ] Pharmacy Other: daughter CONTACT INFOPaJent Phone:Other Contact Info: daughter xxx[ ] Do NOT leave message in voice mail[ ] Only call paJent during special Jme (please specify):**** Pt told to expect response within 1 business day unless otherwise noted:[ ] Today [ ] Other: PHARMACY INFOName/Phone: Walgreens xxx APPOINTMENT INFOLAST Appt with Prescriber: NEXT Appt with Prescriber:Other Relevant Appointment Info: For OB Call Center Use Only[ ] PaJent is pregnant, EDC : *********************************************************************************MEDICATION INFORMATION Name and Dosage QuanJty Other InformaJon-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐1. ZOCOR 20MG 1 A DAY2.3.4.
You decide:Refill or not?
How can we use software to make this process better?
It starts with an UNDERSTANDING of the system.
THE REFILL PROCESS VARIES HIGHLY ACROSS INSTITUTIONS.
NO GROUP IS EXACTLY THE SAME.
PROCESSES CAN BE AGGREGATED.
PROTOCOLS CAN BE CAPTURED IN SOFTWARE
AND ACCESSED BY OTHER MEMBERS OF THE TEAM.
Let’s start a Health IT design revolution.
Move away from “paper-based” software.
Getting back to the basics.
Improve workflow usability by leveraging the team.
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USABILITYIS THE KEY TO HEALTHCARE INNOVATION
JONATHAN BARAN, MSHealthFinch, LLC
@jonathanbaran, [email protected]