S130 - Day 1 - 1430 - Playing with IT makes healthcare tick

OutlineIntroductions

Usability and designUsability in healthcare technology

Take home message and a call to actionReferences

.

.Usability in healthcare technology

Carl Reynolds

Open Health Care UK

March 3, 2014

Carl Reynolds Usability in healthcare technology




...1 Introductions

...2 Usability and design

...3 Usability in healthcare technologyHow usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?

...4 Take home message and a call to action





Hello I’m Carl

Thanks for coming. You can shout out. It’s cool.(COI here http://www.whopaysthisdoctor.org/doctor/11)

Open Health Care UK promote health by making highly usabledigital services for healthcare professionals and patients.

Who are you? Any NHS employees? Anyone an NHS IT user?Anyone who buys NHS IT? Anyone who sells IT to the NHS?

What do you need from my talk? What can I offer? I do havea talk on usability in healthcare technology handy but I canadapt.....


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What meant by usability and design?

Usability is defined as the ease of use and learnability of ahuman-made object. Design is the creation of a plan orconvention for the construction of an object or a system.

Computers used to be hard to use. Now they’re not. Youdon’t even have to remember to press save in order to notlose your work in google docs and on the ipad.(http://www.flourish.org/blog/)

Affordance came along (Donald Norman Psychology OfEveryday Things)

And design priciples etc from the awesome GovernmentDigital Service (GDS)


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How usable is healthcare technology in the NHS?Why does poor usability in healthcare technology matter?Why is it like this?How to fix?

How usable is healthcare technology in the NHS?

LL Weed (1968) Writing in the New England Journal ofMedicine: “the computer will allow immediate retrieval of allthe data . . . multiple copies at distant terminals . . . andimmediate correlation with large amounts of data on similarproblems stored in the compute”

S Stevens (2002) With IT, information can be captured onceand used many times

DoH (2012) Providers of health and care services will be ableto increase their efficiency, for example from reducedduplication of work






How usable is healthcare technology in the NHS?

In my experience the usability of NHS IT is generally verypoor. This is highly suboptimal.

Unlike general consumer technology, with health technology inthe NHS one must frequently overcome bad design and poorusability to get the job rather than the technology supportingthe process with little or no hope of improving the tools orchoosing otherwise.

e.g my patient needs an MRI scan, workflow: job capture andscheduling, establishing process (inc access computer login,intranet, operator), sending a fax (c ward clark workaround),chasing, coordinating with MRI, patient, nursing staff, andporter. more chasing. add to discharge summary (will loseformatting, character limit, may not permit copy and paste)






Why does poor usability in healthcare technology matter?

It has serious implications for clinical quality:

clinical effectivenesspatient safetypatient experience

The opportunity cost is immense. The status quo isunacceptably bad. It’s shameful.

Whitehead (1911):“Civilization advances by extending thenumber of important operations which we can performwithout thinking about them”

Leibniz (1685): “It is unworthy of excellent men to lose hourslike slaves in the labor of calculation which could safely berelegated to anyone else if machines were used.”






Why is it like this?

Can you recognize the million pound chair?

Cultural problems? Lack of user-focus, informationgovernence/security theatre fetish e.g ISB 0086 (IGTK),ISO/IEC 27001, BS ISO/IEC 27002: 2005 etc etc.

Lack of openness, proprietary systems/black boxes, hiddenfailure modes, no ability to improve, failure to capture andmonitor bugs (and harm resulting) in a systematic fashion.E.g PACS is down (again).


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How to fix?

Stepwise better than big bang

Smaller well built components better than the big systems

Build in house technical expertise

Understand the strategic importance, to an organisation in theinformation business, of understanding and being able toefficiently adapt information systems





Lets make NHS IT less bad

Significant scope still for optimising usability of NHS IT forpatients and healthcare professionals

User focus and openness are essential, must procureeffectively, open source, open governence, and modern designprinciples help

Can we be of service to you or your organisation?

email: [email protected]: @drcjarweb: www.openhealthcare.org.uk





Credits and References

I am grateful to Louise Sinclair for inviting me to speak onbehalf of NHS England.

I am grateful to Francis Irving, Zarino Zappia, NicholasTollervey, James Stewart, Tom Taylor, and David Miller forhelping me to think about usability in the NHS. Allmistakes/misconceptions etc are my own.


Health & Medicine

S130 - Day 1 - 1430 - Playing with IT makes healthcare tick