The Future Of Healthcare Design Is Already Here

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This is a guest post by Eugene Borukhovich. Eugene currently serves as a CEO of Initium Consulting Group B.V.  which is an Amsterdam-based, pre-eminent boutique service provider of the knowledge expertise to the healthcare and private equity industries. He has previously served as a VP & CIO of International at a Fortune 15 Pharmacy Benefit Management company with the last 2.5 years working with European clients and vendors to launch new and innovative healthcare products. He is also the founder and a community organizer of Health 2.0 NYC & Health 2.0 Amsterdam and has been a pioneer in healthcare consumerism and open health data.

Let me start off by stating, that I don’t have a clinical background and I will admit that I do not truly know how it feels to treat patients. While I speak to many practitioners on regular basis, I don’t think i can even begin to comprehend how difficult their job is.

It is tough due to our healthcare system putting pressure on the practitioners to see more patients in the same working day while providing same or better care.
It is tough due to continuous onslaught of ever changing regulations.
It is tough because getting paid is difficult and a cumbersome process that is lined with potholes.
It is tough because the tools that are used across the healthcare system lack the user interface and ease of use that we, as consumers, are now used to.

Out of all of the above the lack of user experience (UX) principles, will be the focus of this post – the utterly cumbersome systems and most importantly atrocious user experience that the practitioners have to accept.

Only a little while ago (EMR with CPOE have existed for more then 30 years), physicians started giving up their paper and pens to move to the electronic medical record systems. Some were visionaries and took the bull by its horns, because they saw tremendous value in being able to capture data and ultimately turn it into clinical insights. Those early adopters are now stuck with outdated platforms. Others were yelling and screaming that it breaks their existing process and workflow, but yet began adapting due to financial incentive or penalties imposed.

Healthcare system is ripe for disruption as a whole, but one interesting aspect that can be focused on is making even today’s silo’ed medical information actionable. And the solution does not lie in costly integrations nor in regulatory changes. It has a much simpler answer – focus on the user experience.

The ONC and the Department of Veteran Affairs have asked graphic designers to help them put a new patient-friendly spin on printed Blue Button records. The design challenge asks artists to “rethink how a medical record is presented visually, making it more readable, downloadable, and easy for patients to use,” wrote Ryan Panchadsaram, a fellow at the ONC in a blog post.

Well ONC, these designs already exists. They exist all around us in tools we, the digital citizens use every day. I am an avid user of mint.com and from day 1 I enjoyed my user experience while making sense of noodles of transactions. I have actionable reminders for payments, it made it actionable to switch to other providers for better offers, it made it actionable for me to slice and dice my information to find where I spend most of my money (sushi was on the top of my list behind mortgage payments).

Excuses are made that healthcare has bigdata and our systems are not there yet to process all of it, I would venture to say it is completely inaccurate.

Take my social networks. I tweet, Facebook, check in to dozens of places, post to my tumblr blog and upload pictures non-stop to Instagram and picassa web. This is as bigdata as it gets and somehow a small company like Memolane was able to pull all my social data into one easy to use interface, make sense of it, make it searchable and actionable.

So let’s put the excuses aside, close your eyes and imagine a truly beautiful interface, where a doctor can see a picture of the patient, but also other members of the family (so they can ask “how are your daughters doing today?”). Where she can see with clear demarkations, your history that is browsable by dates with just a swipe of a finger. Where she can be certain that while you were admitted to the hospital 3 months ago, there was no re-hospitalization. Where she can look at your potential drug interactions and change the script at the POP (point of prescription). Where she can look at your most recent MRI and pull up the image right on the screen.

Sure all of this requires integration but simplify outputs and only imagine the clinical information that is available to you, as a service provider to the patient in your office – your notes, patient’s visit history, prescriptions and maybe lab results.

I spoke to Eric Lagier, CEO of Memolane and he happily approved for me to mock up what an EMR can look like memolane-style. And here it is. Eric has some news coming out, where this gorgeous UI which I have been a huge fan of from day 1 will be opened up to accept any #bigdata. The search capabilities are astounding and it would be great to have the open health data community use this to prototype clinical rules behind every event as well!

So ONC, don’t look too far, the right user experience already exists, and it is hidden in the tools we, the consumers, already use in our daily lives.

5 COMMENTS

  1. “Excuses are made that healthcare has bigdata and our systems are not there yet to process all of it, I would venture to say it is completely inaccurate.
    Take my social networks. I tweet, Facebook, check in to dozens of places, post to my tumblr blog and upload pictures non-stop to Instagram and picassa web. This is as bigdata as it gets and somehow a small company like Memolane was able to pull all my social data into one easy to use interface, make sense of it, make it searchable and actionable.”

    it’s probably just me whose skin crawls when I hear/read the term “big data” used in any health care context, but especially by people who are neither  clinicians nor hardware or software authorities (most of those who qualify in these categories seldom use ‘all natural’ terms like “big data” – but I digress)
    Facebook is not “as bigdata as it gets”. With respect to health, Facebook, Twitter, Instagram are…. gaahhhhh. 

    Forget it. 

    Just ignore this well-meaning guy and his gawdawful ugly ‘easy to use’ health information interface (no offense, memolane; it’s not you – it’s me). Eugene’s right; aggregating one’s health information should be easier than it is. Eugene’s very, very wrong when he imagines it is as easy as he’s imagining it out loud here.

  2. Hi and thanks for the comment. I love constructive feedback and a hint of cynicism with a side of controversy so would love to continue the conversation.

    Sure  – “bigdata” just like “cloud” are the industry’s way to re-market the use of technologies that have existed but not at the scale of unprecedented growth that we are experiencing now.

    I recently read a quote “Innovation happens when two ideas get intimate with each other”. I had a few ideas above and would welcome ideas from you to build on. What I heard in your comment is that you dont like “non-experts” to use the term “bigdata” (would like to heard why software or hardware companies only are considered experts??? dont people work there?). The second thing I heard is that you dont like the interface – would you like to sketch something out ? Would love to see it!

    And finally – sure nothing is easy and it takes ideation first and many hard working people to execute from many different disciplines!

  3. Hi Eugene, yes, sometimes the most straightforward solutions are right before your eyes, and it is great when they get recognized and used. But, there is a reason healthcare interfaces are complex: Healthcare is complex. But, that does not mean one necessarily follows the other. Take a PhD dissertation we recently published, for instance: Thyvalikakath, Thankam/Paul Designing Clinical Data Presentation Using Cognitive Task Analysis Methods (http://d-scholarship.pitt.edu/13518/). The analysis shows huge complexity of the clinical workflow and decision-making for dentists.

    What kind of design did we create from it? Check out http://www.dmdproject.com/ – exactly the interface that you espouse. But, let me tell you, getting to that was no mean feat.

    Titus

    Titus Schleyer, DMD, PhD
    Assoc. Professor and Director, Center for Dental Informatics
    http://about.me/titusschleyer

  4. @twitter-85294175:disqus Thanks for the feedback and the comment! Indeed it is all very very hard work and my 10 minutes of photoshop does not do your research & project justice. Workflows are complicated, clinical rules are complicated, right information at the right time for the right patient is also key. Your extensive research that yielded in a similar interface just goes to show that we can learn from other industries. 

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