Must the operating instructions be so complicated?


User-friendliness is widely considered a trademark of well-designed equipment.  But health IT professionals know how often that goal goes unmet when it comes to EHRs.

Does it have to be that way?

That’s the provocative question this observer asks as he considers the hoops through which providers often need to jump in order to get their new systems up and running.

He starts with a pretty basic observation.  To wit, “Every EHR implementation should begin with detailed objectives that specifically address how the organization should be different in terms of clinical outcomes measures (e.g., quality, errors), economic measures (e.g., ROI, revenues, profits) and operational improvements.  Absent a list of detailed objectives, it is difficult to tell at any point during the process how well an implementation is proceeding.”

But then he looks around at other, somewhat similar technology transitions – the rise of consumer PCs and the development of local area networking in particular – and he finds himself wondering whether all the hassles associated with EHR implementation are truly unavoidable.

He asks, “Do some aspects of poor software design arise, not from inattentive or inadequate software engineering, but rather from an unchallenged belief that software is complex and implementing it must necessarily be complex as well?  Such a mindset presupposes that EHR projects must necessarily require selection committees, project managers, multiple varieties of consultants, and be disruptive…Is EHR software (or any major software system) difficult and costly to select and implement because its design and deployment are unavoidably and irreducibly complex OR do EHR designers, assuming the presence of a cadre of consultants, IT personnel, project managers and trainers, (consciously or unconsciously) forego the extra design steps required to make implementation and optimization easier?”

Of course, if the truth is closer to the second reason than the first, then some vendors may not want even to consider the question. But it strikes us as definitely worth pondering, and we’d like to hear what you think.

Is the current complexity of EHR implementation projects unavoidable?

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