EHR Spitballing - Can’t We All Just Get Along? (Part II)

November 16, 2011

The debate rages on between the technical creators and the users of EHRs as to who should change their behaviors for smooth implementation.

A few weeks ago I posted a blog about a HIMSS discussion group on LinkedIn, where someone blamed the folks in doctors’ offices as the reason technology was such a problem in healthcare. The resulting us-versus-them debate had the technology zealots and the users tossing spitballs at each other, with the result being a kind of mutual effect of canceling each other out.

In essence, each side was technically right (and righteous) in their arguments. There are many instances of healthcare technology that either isn’t really ready for “primetime,” or that causes users to take extra steps to complete simple tasks. So the user is right - or believes he/she is right - in that healthcare technology doesn’t meet their needs. On the other hand, there are many healthcare users who don’t know (or refuse to learn) how to use the technology properly to actually automate their tasks and become more efficient. So the technologist is right - or believes he/she is right -healthcare users refuse to learn how to properly use healthcare technology.
By citing real-world examples on both sides of the argument, one can easily substantiate their argument.

But the net effect is not helpful, because it serves primarily to reinforce existing stereotypes and experiences, and fails to move towards progress by both sides - the creators/promoters of technology and the users who rely on it to do their jobs.

There is another LinkedIn discussion group post entitled, “Top ten reasons why EMR/EHR implementations are failing” which also caught my attention.

This post is even more interesting and livelier than the other one. In fact this post has generated so many entries (well over 2,000 and growing daily) that it contradicts the title - it would appear that there are way more than ten top reasons why EMR/EHR projects are failing.

And as you might expect, the lines are drawn primarily between the technology side - who want users to change their attitudes and behaviors, and the user side - who want the designers and promoters of technology to change theirs.

In reality, they both need to change, adopt, and optimize their positions, their attitudes and their approach. Rather than the pro-technology side constantly explaining and re-explaining how things work (or are supposed to work), what if they listened to practitioners and users and really tried to understand what their daily life is like? Rather than scoff at the idea that a tab or menu item should be moved from one screen to another, or from the top of the screen to the bottom, what if the technology crowd actually considered the change? And for users, rather than complain that the system doesn’t work to fit their processes, what if they took the time to analyze their processes and see how they could be optimized to take advantage of improved logic that might be built into the system(s)? After all, it is likely that most EHR systems have had the benefit of being implemented in multiple practices, and therefore there is a strong component of lessons learned/best practices built into these systems.

It's going to take time to learn how to use them effectively. And in the meantime the two "sides" (technical and users) need to get on the playing field together and cooperate and collaborate more and not shoot spitballs at each other from the sidelines.

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