Hope for stressed nurses and physicians: The science of design improves the experience of technology use

Not just during the current COVID-19 pandemic, but for a long time, doctors and nurses have expressed concerns and frustration with the administrative work of clinical documentation. An article from December 2019 speaks to the continued dissatisfaction many clinicians have with electronic health records:

“[F]or many clinicians, they're a daily annoyance – a reminder that, for all its potential to improve quality and improve safety, health information technology can also contribute to frustrating workflow impediments, alert fatigue and burnout.”[1] 

With all the advancements in technology, it’s unfortunate that a study of usability of EHRs concluded:

“The usability of current EHR systems received a grade of F by physician users when evaluated using a standardized metric of technology usability. A strong dose-response relationship between EHR usability and the odds of burnout was observed.”[2]

But there are rays of hope. A crisis presents an opportunity to reflect on how we do our work and how we might improve the efficiency of that work. One aspect of efficiency is making it possible for physicians, nurses and other health care professionals to have more time to care for the needs of their patients. 

Health care digitalization can be done well or badly.  In some cases, it adds so many check boxes, alerts and drop-down menus that it distracts clinicians.  In other cases, it facilitates the flow of the work and makes it easier. The difference is in the design. We are all likely familiar with well-designed technologies that are a joy to use and badly designed technologies that are confusing.

Imagine the 50,000 data elements for a typical ICU patient. This is where the science of design can be applied. Design experts can follow an ICU nurse and doctor to see what information they access and in what order. Through careful research, good design can help surface the right information and make work easier. If we intentionally design technologies based on knowledge of how they will be applied, the end result is likely to be better.

I very much enjoy learning about the positive impact science can have on a person’s experiences and life. Listen to Anna Abovyan describe the research and science behind the design of good software.

L. Gordon Moore, MD, is senior medical director, Clinical Strategy and Value-based Care for 3M Health Information Systems.

More time with patients, less time with technology. That's creating time to care.

[1] https://www.healthcareitnews.com/news/ehrs-2019-still-source-frustration-getting-better-bit-bit Accessed 6/19/20

[2] Melnick et al. The Association Between Perceived Electronic Health Record Usability and Professional Burnout Among US Physicians Mayo Clinic Proceedings  VOLUME 95, ISSUE 3, P476-487 https://doi.org/10.1016/j.mayocp.2019.09.024