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Why user experience is critical to advancing HIT adoption

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I have a friend who lives in New York City. For the sake of protecting the innocent, let’s call him Sam. What follows is his experience during a recent appointment with his urologist for a post-surgery check-up as well as some pertinent observations.

Sam uses a big group practice affiliated with a large teaching hospital in Manhattan. He’s more technically savvy than most, so the idea of working through a portal to make an appointment or check on test results doesn’t faze him. He even uses the HIPAA-compliant messaging system to ask questions of the doctors in the practice. He finds it amusing that an emailed notice of a bill sitting somewhere on the portal shows up a day or two after the same bill in paper form shows up in the snail mail.

Now let’s get back to his recent visit.

Sam gets past the waiting room and is now in the exam room with his physician. Because it’s a post-op session, there’s mostly conversation, not examination. He answers all of the urologist’s queries, and they discuss a way to deal with the one concern Sam raises and agree on a path to address it. The doctor then sits down at a computer and starts typing away. Suddenly the doctor stands up, straight as a rail, and curses loudly. Sam is understandably shocked at the outburst since the doctor is always calm and reassuring; having a great chairside manner.

Several more inappropriate comments spew out of the doctor’s mouth. He turns to Sam and notices his patient is laughing. The doctor then says, “I hate this. It never works for me! I can’t tell you how often I have problems with this. It’s not just me; other doctors do too. And the office staff complains about having to go back and forth between this software and the one that handles billing.”

The doctor has a nurse enter the room to draw blood from Sam. As the nurse skillfully goes through the process, Sam asks the nurse when he can see the results on the practice’s portal. The nurse looks at him quizzically and asks, “Do you actually use that? I don’t. It makes no sense to me, and I guess most patients feel the same way because just about everyone asks when the office will call with the results.”

Sam asks if the nurse ever used the portal to pay bills. She tilted her head back and laughed out loud. “I can’t find where the bill is supposed to be. They made it all too hard,” she says.

Sam knows my interest in these types of stories and was only too happy to share his experience. You see, I work with group practices, ambulatory systems and hospitals as well as RCM companies to help them collect more patient payments fast and less expensively. Sam’s tale did not prompt me to chuckle or even crack a weak smile. It reaffirmed three views I hold about the healthcare industry and how it utilizes information technology:

  • The gap between how technology is embraced on the clinical side versus the business side is immense and should be narrowed
  • Most non-clinical technology deployments have occurred by way of edict, like the EHR system that caused Sam’s doctor to lose his cool
  • Much of the business-side technology has been implemented with either little thought given to the user experience or user training, or a combination of both.

I’m not the only one who feels the human element has been severely overlooked in healthcare.

Neal Patterson, Cerner chairman, CEO and co-founder, recently spoke at his company’s annual health conference, telling the audience of learning he had cancer and of the realization that “God had a sense of humor,” since the facility he was admitted to was undergoing an EHR conversion.

He shared with the conference attendees of waiting for four hours to get lab results. A woman with him in the waiting room, when asked how long she’d been waiting, replied “seven hours.” Mr. Patterson stated, “There’s no caring in that.”

If healthcare is going to fully leverage the benefits of information technology for better outcomes and, of equal importance, better patient experiences, then it must find ways for non-clinical and business-related systems and processes to be far more user-friendly for all who interact with them.

Healthcare providers and the IT professionals that work in such organizations should be rightfully proud of the myriad technologies in use today, to conduct tests, aid in diagnosing conditions, produce digital imaging that can be viewed with utter clarity from multiple locations and even conduct surgery robotically.

However, as fantastic as all that may be, this is an industry that still uses the U.S. Postal Service to send nearly nine out of 10 bills to patients, despite 70 percent of patients wanting electronic billing and payment options, according to Deloitte. It is an industry that barely gives notice to the user experience for both the providers and patients.

I am not so foolish as to suggest all in-place applications need to have their user interfaces redone, even if there’s merit to that thought. However, the nurse who expressed bewilderment at her group practice’s portal means more focus must be placed on user experiences or such systems won’t be used and, besides being a waste of time and money, won’t do anything to make providers more productive and patients more engaged or more satisfied.

My guess is Sam, his doctor and nurse can only hope their practice management and hospital information systems are either improved soon or a new solution that provides a better user experience gets developed.

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