Achieving EHR Usability: The Need for Empathy

Defining usability for an EHR is easy: The user interface must be easy to learn, efficient to operate and pleasant to use. Achieving usability is much more complex. It requires a core competency grown within all team members who have a hand in developing an EHR, and vendors must constantly invest in it. It’s important that your team possess top-notch design and engineering skills, and it’s easy to prioritize technical prowess above all else when building a product. But the most critical way to ensure you’re constantly investing in usability is to focus on identifying and fostering a key emotional characteristic in all your employees: empathy.

The work environment and habits of physicians are so unique, complex and utterly different than what we as technologists and designers are used to. Creating a usable tool for busy, practicing physicians requires us to disregard our needs and consumer tendencies and put ourselves in a physician’s shoes.

One example is the complex working environment that physicians are immersed in each day at the office. Physicians have two stark operating modes to deliver care to their patients that an EHR must accommodate to be “usable”:

  • Live, in-person interaction with the patients scheduled to be seen that day

  • Reviewing, digesting and acting upon information flowing into the practice regarding one o the physician’s patients

When a physician’s in the exam room, the patient and the physician-patient interaction is priority number 1. As the patient is describing her condition, the physician is constantly shifting between documents in a patient’s chart, referencing tidbits of information to inform her clinical decisions and recommendations, jotting down critical notes as bread crumbs of her decision-making process, all while maintaining eye contact and a comfortable rapport with a patient. Imagine you’re in a job interview and the interviewer is using his laptop or iPad not only to look at your resume, but also to review your LinkedIn profile, Twitter feed, Facebook activity, blog posts and comments, while simultaneously writing notes about your responses to his questions.Outside patient appointments, physicians are receiving reams of clinical information about many patients every day. Physicians need to view a patient chart to provide context for what the new clinical information means for that particular patient. The name of the game is to digest and act upon the massive volume of clinical information a physician receives about their patients as quickly as possible, in between seeing patients in the exam room. Imagine you’ve accumulated hundreds of emails in your inbox on any given day, and you only have 90 minutes, broken into in 5-10 minute increments, to get to zero-inbox by day’s end. If you don’t check every email, someone’s life may be hurt.

That’s why empathy is so important. What physicians do, what they need and in what contexts they need it are foreign to the average person. Empathy is essential to understanding physicians’ needs and build a tool to address them. And identifying and creating empathy is precisely the reason we at Elation have built a key step into our hiring process: shadowing a physician.

Read Elation engineer Phill Tornroth’s account of his shadowing experience.

[Above image: Core principles of usability. Graphic courtesy of Flickr user Jon and Barb via Creative Commons.]