Dear Healthcare: Let the UX Designers In!

Lisa deBettencourt
Mar 22, 2016

Last week, I brought my 9-year-old son to the pediatrician for his annual physical. I could tell you what the experience was like but I know that, if you have kids or if you have a primary care physician, you already know how it went. Except, in this case, it was worse. Yes, we barely got a greeting as the nurse practitioner walked in to the exam room, past my son on the exam table, and straight towards the computer in the corner. Yes, we sat there patiently waiting to begin as she tried to log in – twice. And, yes, she spent the next 10 minutes feeding the machine the answers to the questions it demanded she pepper us with. This whole encounter was orbiting around the computer, as is the experience with doctors nowadays.

But then something interesting happened.

The room suddenly became silent. Then there was mumbling. And clicking. “I can’t…” “I’m not sure…” “Where did the…” I looked over. From where I was sitting, I could see over her shoulder onto the monitor and I noticed that she had somehow managed to drag the full screen EHR application she was using into the lower right hand corner of the monitor so only a small quadrant of the window was visible. And. She. Couldn’t. Get. It. Back. She had no idea how to move the window back to the top of the screen. None. This highly educated, dynamic, very experienced professional woman who could fix any of my son’s ailments any day of the year was completely and utterly stuck. With one wrong move, she could no longer do her job of making sure my son was healthy, safe, and eating his 5 daily servings of fruits and vegetables.

Ok so maybe I’m being a bit dramatic to make a point, but this is just one little example of the ridiculous burden poorly designed technology has put on clinicians.

Play this scenario out across our medical facilities throughout the US and you can see what kind of problems we face. In orders of magnitude worse than my experience at the pediatrician, technology continuously disrupts and interrupts and grinds to a halt the critical, life-saving, workflows of our ER doctors, specialists, and nurses every single day. At a time when I can order my own personal driver with a few taps on a glass screen or ask a cylinder on my counter what the weather for today will be like, it continues to stun me that an industry that can 3D print a trachea to help a baby breathe or use robots for surgery every day still hasn’t built information technologies that truly serve doctors in their mission to provide the best care to their patients.

Let’s be honest. No industry is more plagued by interruptive technologies than healthcare: Doctors and nurses can spend over an hour a day logging in and out of their computers and many more hours navigating password-heavy applications, searching for the right information, feeding it information, and playing pager-tag trying to contact other providers. If our healthcare technologies were people—interrupting, nagging, blocking, demanding, and actively disrupting doctors—they’d be hungry newborns incessantly needing care, feeding, attention.

In order to deliver the best care, doctors and nurses need to be able to focus on care, not on technology and technological disruptions. Care providers simply cannot care for patients effectively if they’re constantly being blocked by password requests, interrupted by timeouts or pager beeps, or harassed by demands for input. These violate the most fundamental principles of design, productivity, and human cognition: they create overhead and distractions for already-overloaded workers, which has only one outcome. Mistakes.

As someone who designs products and services for a living, I regularly apply – and lead my teams to apply – human-centered design methodologies to make complex technology useful, usable, and understandable for people in their everyday and professional lives. I’ve worked with many diverse teams to apply these strategies and transform how a product can be used from burdensome to enjoyable. But I’m not the only one. There are thousands of designers out there who can design within very complex systems who are ready, willing, and very eager to dive head first into helping healthcare solve its information technology problem. What we need is for the healthcare industry to partner with these designers to learn how to adopt and apply these strategies so our doctors and nurses can reap the same benefits.

Human-centered design is the key to making healthcare technologies better for doctors and nurses. And it’s not a new concept - it’s the bedrock on which our best consumer technologies are built. Good design, like good healthcare, rests on a foundation of empathy. It involves a concentrated focus on the people who would be using a product or service by understanding their needs and wants within the context of use and their limitations. The reason it is a different approach is that it figures out how to solve a problem for the way people work, or want to work, and then determines how to build it with technology instead of building something based on a technology at hand and then forcing people to adapt to it. 

Unfortunately, human-centered design is a new concept for healthcare technology and everyone can see it. Doctors walk onto a hospital campus today with their iPhone in their pocket and proceed to travel back in time. They get handed a pager and a username and password to log into a machine that looks like it was built in 1995. In fact, most healthcare technologies were created in response to a federal push to digitize hospitals in the 80s and 90s, at a time when human-centered design was in it’s infancy, businesses saw design as a cost center with negative ROI, and decent screens to display information on weren’t yet developed. The HITECH act of 2009 then forced the adoption of those technologies into the medical institutions when it was clear that the market didn’t. Ever since, healthcare technologies continue to be built to meet government regulations and privacy requirements - not designed to meet the needs of clinical users. This needs to change.

Healthcare would benefit immensely by recruiting designers experienced in human-centered design and bringing this tried-and-true approach to problem solving into the process of building products and services for this community. By using human-centered design to create new healthcare technologies, we can transform healthcare for the better. The first step in achieving this goal is to recognize that technologies shouldn’t be built to serve itself, they must be built to serve healthcare professionals and patients. To me, there’s no UX problem that’s more critically important than figuring how to help healthcare workers on the front lines save lives and care for people more effectively and efficiently every day.

When we’ve created the technologies that truly support healthcare, we can return to the human-to-human engagement of healthcare. In that world, I can then comfortably spend the time face-to-face with my pediatrician discussing my son’s diet of only beige foods instead of spending the time fixing her computer for her.