Computers, Medicine, Usability, viewed from the ED
If you're new here, you might like to look through this introduction to the site first.
Are you interested in how computers can reduce medical error?
Did you know that many early medical computer systems increased medical error? (Some current ones, too.)
From your own experience with your own computer at home, do you think that some computers and programs crash on a regular basis? Do you think that most software is hard to use, rude, and frustrating to work with? Based on experience, what you’ve heard, or simple extrapolation, do you suspect that medical computer systems are even worse?
Did you know that the best place to test medical computer systems is the ED, because people working in the ED don’t have the time to deal with bad computer systems, and are intolerant of BS? (If it works in the ED, you can make it work anywhere else in the hospital.)
Do you want to learn more about how to make medical computer systems usable, so as to prevent medical error?
If the answer to any of these questions is “yes,” then read through the Medical Computing series. Although looked at from my viewpoint in the ED, it all applies to medical computer systems wherever they are used, in a hospital, in a clinic or in an office.
If you need a backgrounder on Healthcare IT concepts and terminology, see Healthcare IT in a Nutshell.
There’s also a series of “word” essays that focus on particular and generally more advanced medical computer issues.
To keep up with new postings, you might want to subscribe to my RSS feed.
One final note: Once explained, most of the suggestions on this site seem simple and obvious. But as one is creating a program, or even as one is using a program with a high level of frustration, they are still not obvious until pointed out.
I hope you find the site informative and, perhaps, a bit mind-expandingly entertaining.
Keith Conover, M.D., FACEP
I was recently invited to sit in on a meeting of the American College of Emergency Physicians (ACEP) ED Health Information Technology Safety Task Force. We were talking about medical error related to technology. (I
n your mind, substitute “technology” > “the @#$@#$ computer”). We were discussing how to make it easy to report errors and near-misses, and who should get these error reports. I opined that it depends on the seriousness, and that there is a continuous spectrum from “kill-the-patient” errors/near-misses to “annoying, slowed me down so I made a mistake,” and that usability contributes to “computer” errors. I will now demonstrate that this is true.
Emergency physicians are frequently interrupted.
Computer systems with high cognitive friction take longer to use.
Therefore, if you take longer to complete tasks on the computer, you are more likely to be interrupted.
Interruptions cause errors. In multiple ways.
Therefore, poorly usable computer systems cause increased medical error.
Quod erat demonstrandum.
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n your mind, substitute “technology” > “the @#$@#$ computer”). We were discussing how to make it easy to report errors and near-misses, and who should get these error reports. I opined that it depends on the seriousness, and that there is a continuous spectrum from “kill-the-patient” errors/near-misses to “annoying, slowed me down so I made a mistake,” and that usability contributes to “computer” errors. I will now demonstrate that this is true.
