Anticlue

Usability and Patient Care (part deux)

Jacob and I are having a public debate on usability:

Jacob’s Google=Usability, Medical Software != usability
Elyse’s Usability and Patient Care
Jacob’s Usability Again

Yesterday, Jacob posted an emotional response to the issue at hand, the cost of usability.

To me usability is the art of making a computer system smoothly integrate with the users workflow. Basically to make the system flow seamlessly with the user’s intuitive actions.

Jacob portrayed the providers problem with the loss of time from entering a patient’s name. In his opinion, the system is not interactive with the physician’s workflow.

This inconvenience during the patient selection process needs to be resolved, but again at what cost?

1. The RFP Process

The RFP is the place where the needed features are declared for a new system. Having the requirements and weighing the vendors compared to the requirements ensures that everyone is on the same page. This is an an essential step in the implementation process. It explains what is important within the organization to the vendors. We are all aware that usability is subjective. What may be a very essential usable feature to one, may be intolerably inconvenient to others. By quantifying and specifying the end result of where usability is applicable, it gives one a path to get there. By eliminating the subjectivity of usability with defined criteria through the RFP process, the cost of usability is due diligence and relatively inexpensive at this stage.

2. Autocompleting the patient selection process based upon one identifier.

Patient selection using multiple identifiers increases the quality of the choice. Autocompleting patient selection based upon only one identifier decreases the quality. The cost of usability is quality for the patient selection process.

3. Loading the MPI

In this item, the load is still a load and a delay. The cost of usability is performance.

In reading the description of the custom EMR, how is the application handling the auditing of what PHI is seen if the PHI is being displayed through the selection process? Perhaps is this another cost of usability, the cost to auditing within a security context?

4. The handling of the issue.

There is a cost of reworking/programming the selection process. Looking at all the issues and evaluating the resolution is just good practice. The cost of usability may be customer programming services and then have an affect on the live date of the application.

5. I said with, I meant with

To implement any clinical system, there is a team formed. The team consists of user advocates, IT, and the vendor. There are also a lot of stakeholders that need to be involved with the process. A project cannot survive a broken team. All parties of the team need to invest and be apart of choosing the best course of resolution for an issue. Usability is important, but as with everything there are costs associated. A team will have creative ideas on how to address items and the costs and risks associated with those items.

6. Usability is important.

We agree! My perception is that the flow of the application is important, but there are costs to usability.

Usaibility costs follow the cost pattern of everything else. They are inexpensive at the beginning of an implementation and become increasing expensive throughout the implementation process. Consider a requirement in the RFP detailing a usability function versus an implemented system that encumbers its users. A significant cost difference, defining the meaning of usability for an organization is very important at the beginning. Usability can have diverse effects on performance, security, quality and projected timelines. All of these items need to be evaluated in light of making a new functionality usable.

7. A dictionary item versus the main decision data point.

There is a difference between typing the first couple of letters of a medication in a predefined dictionary. For any dictionary item, this would be great. The need for the accuracy of the data is an evaluation as a part of making the selection usable. Pressing 1 three times is bad if not hitting 0 ends up with the wrong data point.

By the way, if you are in the neighborhood tomorrow how about dropping by for some chicken chili?