Monday, April 16, 2012

EMR Innovation Should Be Spelled KISS: Keep it Simple, Stupid

In a recent post, I talked about an innovative EMR idea. I thought for this post I would back up and talk about innovation. Perhaps I can discuss my definition of innovation because the more I look around the less innovation I see.

The dictionary definition of innovation (according to the all-knowing Google)  is a create something new. I don’t like that definition. I think that is weak and limiting. Something can be new and completely useless or just plain badly designed. Would that be innovative? If it is, then I think innovative is a very sad word. To be innovative, something needs to be better, but not necessarily new.

For example, if we look at the iPod again, it was not a new concept, really. The iPod was a portable music player. That was not innovative. Walkmans were portable music players long before iPod existed. The innovation came in the fact that iPod was better than what came before it.

With that, I’d like to recommend a better definition of innovation. Innovation is a way of doing something that is better than anything that already exists. Innovation, therefore, can be an improvement on an existing concept and not necessarily something entirely new… it’s just better. An innovation should meet an unmet need, improve function, communication, and/or operations, etc.

In the healthcare IT world, there is very little innovation. For example, all EMRs do the same thing and generally that same thing is burdensome in many different ways. That is why healthcare information technology (IT) adoption is still relatively low – even with government incentives. The biggest problem in all of healthcare IT is that the current technology is not innovative (e.g. it is not an improvement). 

Now, I am not contradicting my previous posts here. There are some great ideas out there but I think the execution is still WAY off. I will share a story with you so you can see why I would say such a thing.

Some time ago, I did a site visit with a client where I shadowed my product’s end-users for a full day. The purpose of a site visit is so that I, as the product manager, can see what users need (because often they cannot really explain it clearly). During this visit, something very important happened and I had an epiphany. The nurse I was shadowing stopped her work to ask me how to perform a task on the system. The solution to her question was easy for me and the nurse was a little embarrassed so, she excused her question by saying “I am just no good with technical stuff”. What happened next struck  me.

Then, the nurses cell phone vibrated and she picked up her iPhone to answer. A few second in to her call she said let me check the bank and I will call you back and let you know. After hanging up, she used her iPhone to log on to her bank account. Then, she logged in to her email from her desktop computer, clicked on a hyperlink led to a product on She proceeded to buy the product online, then return the call to say that she had bought the product. In a matter of 3 minutes, she used multiple technologies. Not tech savvy, hu???

As a good product manager, I had answer some very painful questions. For example, why is my software harder for her to understand than iPhone, email, bank, and Then the really important question – the expensive question in the software world…. Why does my software requires weeks of end-user training and ongoing support when non-tech savvy people download and use apps, bank websites, and online retail with little to no training?

The answer is simple. Healthcare IT has forgotten about intuitive end-user design. I will admit, healthcare is complicated…but so is banking. If we want to improve adoption of IT in healthcare we need to simplify. That's right KISS, keep it simple, stupid. To do that, healthcare IT needs to include non-tech savvy users in the design and development process and in usability testing. I completely understand that such a proposal can be expensive to implement initially, but is it really more expensive weeks long implementation, ongoing support, and redesign after redesign in hopes of eventually getting it right?
Poor design in healthcare software is the problem preventing adoption. If we want to move healthcare in to the 21st century in terms of technology, we really need to take a good long look at the technology that the self-proclaimed non-techie people are using. When a healthcare IT vendor finally comes up with a software that does not take months to implement  or years to really understand, technology adoption in healthcare will skyrocket. Remember, innovation is not necessarily something new.. it is something better. Simplifying something that is complicated is better… it is innovation.

(As an amusing side note… I keep referencing iPhone in posts but I am an actually Andriod user haha.)


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