A look at what it's like to implement design change at a large-scale EHR vendor, with examples of some of the challenges, techniques for building support, and opportunities for improvement. Presented at the Healthcare Experience Design Conference in Boston, March, 2012.

1. The Secret Life
of EHRs
Scott Lind

2. 20 minutes
3 things

3. 20 minutes
3 things
+1 d igression

4. design • culture • opportunity

5. acute care environment

6. 28%
pneumonia screenings

7. 51%
catheter-associated UTI

8. 43%
MRSA infections

9. self-actualization
esteem
belonging
safety
physiological

10. pleasurable
usable
reliable
functional
− Aarron Walter

11. pleasurable
usable
reliable
functional
− Aarron Walter

13. “ Does the patient smoke? ”

16. design • culture • opportunity

17. design • culture • opportunity
increase safety
improve outcomes
reduce costs

18. thisisindexed.com

19. user roles

20. context of care

21. <digression>

22. Evaluator Effect
Jacobsen, Hertzum & John, 1998
4 evaluators
4 sessions
93 problems

23. severe problems on a single top ten list
56%

24. severe problems on all top ten lists
0

25. CUE-2 Molich, 1998
9 teams
3 weeks
310 problems

26. problems reported by more than one team
25%

27. problems reported by more than half of the teams
2%

28. problems reported by all teams
0

29. CUE-8 2009
15 teams
5 tasks
quantitative testing

30. Rent an intermediate size car at Logan Airport in
Boston, Massachusetts, from Thursday 11 June 2009
at 09.00 am to Monday 15 June at 3.00 pm. If asked
for a name, use John Smith, email address
john112233@hotmail.com. Do not submit the
reservation.

31. time on task to rent a car
500
451
375
323 328
306
250
251
210 209 207 195
180
125 157 148
133 134
108
0
A B C D E F G H J K L M N O P

32. time on task to rent a car
500
451
375
323 328
306
250
251
210 209 207 195
180
125 157 148
133 134
108
0
A B C D E F G H J K L M N O P

34. usability safety

35. </digression>

36. design • culture • opportunity

37. “ Creating good user experience is not a
”
design problem, it’s a power struggle.
− Alan Cooper

38. Dear AmericanAirlines
− Dustin Curtis

41. Everyone believes in UX

42. Everyone believes in UX

45. “ Your job as a user experience person is
to cultivate a culture where good
”
design has a leading voice at the table.
− Aza Raskin

46. design • culture • opportunity

47. pleasurable
usable
reliable
functional
− Aarron Walter

50. “ In the last six weeks, have you spent more
than two hours watching someone use your
design or a competitor’s design?
”
− Jared Spool

51. “ ”
You can observe a lot by watching.
− Yogi Berra

53. Simple Meaningful Easy to use Fast
Clean Flexible Time saving Impressive
Efficient Responsive Comprehensive
Friendly Approachable Effortless Usable

54. 2006
Marco Armant, August 2010

55. 2007
Marco Armant, August 2010

56. 2010
Marco Armant, August 2010

57. Escape Velocity
− Amir Khella

59. thank you