Tuesday, November 1, 2011

What About the End-user?

I recently came across a couple of examples showing how healthcare providers still do a poor job of providing products services and even physical facilities that truly meet the needs of end-users. As a case in point, when I asked my chiropractor why he still requests film for the MRI's he has done for his patients instead of getting the images on a CD, he told me that the viewing software that is embedded on those CD’s is so hard to use that it sometimes takes him up to 30 minutes to figure out how to line up two series on his monitor. Taking a set of films out of a envelope and placing them on a viewing box is much faster. The second example was when I talked with a local primary care physician who is considering scaling down her practice because the meaningful-use requirements for implementing electronic health records require her to implement an EHR to continue to get full reimbursements from Medicare and Medicaid. The fact that she can get between $40k and $50k in grants to implement an EHR does not counter balance the additional work needed to enter all of the information into the system. She told me that she has looked at several EHR products and none of them meet the requirements for her to enter the information effectively and efficiently. The last point is when I talked with a nurse who is just moving to a brand new wing in her hospital, which was built without taking any input from the nurses who are going to be working there. Instead this brand new facility, which was most likely designed to meet all building standards, does not meet any of the potential workflow improvements that could have been made. 

The US government is trying to improve the efficiency and quality of healthcare, but the industry is lacking products, services and facilities that focus on what the user really needs. This appears to be less the case when one considers the acquisition of devices such as new ultrasounds or CT’s, but appears to be common with the software, larger systems and infrastructure. I am not sure what the solution is except for encouraging end users to continue to press the industry to focus on the end-user.