RX for Healthcare: UX

After each of my four surgeries at Memorial Sloan Kettering, I was told that walking was one of the best ways to ensure a good recovery and that 14 loops around the floor was one mile.

Besides enjoying compliments about my unicorn slippers, I was motivated to get home. The 14 laps became my Everest as I diligently shuffled my way back to health. The nurse’s station is in the center of the loop, and on every pass I noticed how many nurses and doctors were sitting and staring at screens.

Don’t get me wrong, the caregivers at MSKCC are wonderful and I am deeply grateful for the treatment I received (cancer-free for 2.5 years now!). But they are victims of a phenomenon that exists across healthcare: there is a plague of bad UX throughout the patient care continuum. It affects patients and caregivers, it is pervasive, and it is having a major impact on quality of care. Here are some of the symptoms:

• Common sources of dissatisfaction among doctors include poor usability, time-consuming data entry, interference with face-to-face patient care.1
• Interns now spend almost half their days in front of a computer screen.2
• Doctors using electronic health records spent about a third of patient visits looking at a screen.3

I have heard stories of doctors leaving hospitals and clinics after being forced to use byzantine EHR systems with the sentiment, “I went into this to practice medicine, not data entry.” At Modus we often ask the question:

Why is it that when you leave your home and personal experiences like Amazon, Google, Airbnb, Netflix, etc. and go into your workplace that your expectations for software and digital experiences fall to the floor?

I would argue that there is no more important arena in which to ask that question than healthcare where it is, literally, a matter of life and death.

How did we get here?

Information technology was being woven organically into healthcare (albeit lagging behind the consumer sector) until two major pieces of legislation.

1. In 1996, HIPAA and its security provisions put a massive focus on securing patient data.

2. The 2009 HITECH Act (part of the stimulus) lit a fire under providers to deploy Electronic Health Records (EHR) by 2015 or face penalties.

While these are both noble and important goals, as an unintended consequence the industry has had a decade-long, almost myopic focus on security and capturing patient data electronically in systems that check the HITECH boxes. The viewpoint was data-centric as opposed to user-centric, and the digital experiences of caregivers and patients have clearly suffered as a result.

How do we fix it?

The good news is that those laws did accomplish their main objectives: most patient data is now in electronic format and is secure. There has also been incredible innovation in the consumer, personal medicine and wearables space that can be built upon. At the same time core principles that support investment in digital UX have come onto the radar of decision makers: design thinking, patient centricity, and customer experience design.

Mobile hardware including smartphones and tablets are ubiquitous and powerful and secure APIs and ways for systems to talk to each other easily have recently emerged. These are all great conditions in which to start to recover from this UX malady afflicting caregivers and patients and bring the quality of the digital tools to be on par with the quality of care and medical science we have available today. But it is probably going to be evolutionary and not revolutionary or involve wholesale new radical platforms that will transform the healthcare industry. It’s picking off the unsexy, workaday parts of the ecosystem (EHR, scheduling, billing, CRM, intranets, records access, etc.) and creating experiences that are simple, personalized and intuitive to improve the lives of those who are suffering and free up caregivers to give more care.

At Modus we have had the honor of chipping away at the problem through our work with clients including Cleveland Clinic, Marshfield Clinic, and Memorial Sloan Kettering Cancer Center. I will be at HIMSS in Orlando next week with thousands of other folks who are working to find better ways of delivering healthcare using information technology. While I won’t have my unicorn slippers on, I do hope to find more answers there.

1-RAND Health study, “Factors Affecting Physician Professional Satisfaction,” 2013
2-The Journal of General Internal Medicine, 2013
3-International Journal of Medical Informatics, 2014