ALLCAPS

This entry is part 16 of 44 in the series Words

I was just a few seconds ago scanning a page of possible tests in the program DocuTAP, a list of about fifty items, to enter an order for an EKG. On the list, everything is in ALL CAPS. Even though I knew the approximate location of what I was looking for, it took me a long time to find “EKG.” I think if all the other entries on the page, things likeALLCAPS

CHECK VITAL SIGNS
DISCONTINUE IV THERAPY
EKG
ORTHOSTATIC BP, PULSE
SET UP FOR PELVIC EXAM
AEROSOL TREATMENT, ADDITIONAL

WERE (whoops, sorry, need to hit the CapsLock key) were in Mixed Case, it would have been much easier to find.

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Layers

This entry is part 17 of 44 in the series Words

When using a point-and-click medical charting application (of which there are a zillion, and I think I’ve used maybe a half-zillion) there are many designs, but I’ve recently realized there is a way to divide them into two types. There are one-layer charting apps and two-layer charting apps. I’m not talking about computer layers, I’m talking about conceptual layers.Layers Icon

In a one-conceptual-layer app, you click on a word to instantiate it. For example, if charting about someone’s tonsils, and you click on the word

Tonsillar Exudate

then that means that there is exudate on the tonsils. Conceptually, it’s a one-step process; there is only one layer of cognition needed to check items on the page. You click on the word to validate it. If you click on Tonsillar Exudate, there are tonsillar exudates. Read the rest of this entry
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Consistency

This entry is part 18 of 44 in the series Words

Neatness counts.

Trying to find my way from the entrance of my 12 year old daughter’s bedroom to the bed to kiss her goodnight, especially if barefoot, is considerably more dangerous than most of the search and rescue and disaster operations I’ve been on.

Navigating the screens of medical software often seems like walking in my daughter’s room with the lights out, blindfolded, backwards. I’m sure you can find examples in many medical software applications, and there are many causes for such problems.

But one of the most important is consistency, or rather lack of it.

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Menu

This entry is part 19 of 44 in the series Words

Faced with a long dinner menu, it’s hard to decide what to order. (Even with a medium-sized menu, my wife always says “You go ahead and order, I haven’t decided yet.” But that’s extreme.)Chinese Menu

It’s not just an urban legend. There are scientific studies that demonstrate it.

The study When Choice is Demotivating by Sheena Ivengar of Columbia University showed this:

In a grocery store, set up a jam-tasting station.

First, put out four different jams, and let people taste, and if they wish, buy.

Four out of ten people who stop by will taste some jam. Of those people who stopped to taste, three out of ten will buy some jam.

Next, put out twenty-four jams.

Six out of ten people will stop to taste. But of those who taste, less than one in ten (3%) will buy. Read the rest of this entry
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Cost Disease

This entry is part 20 of 44 in the series Words

The Cost Disease is both the name of a book, and the economic theory espoused by this book.Total health expenditure, % of GDP

The theory is relatively simple at its base. There are two segments to our modern economy, the progressive and the stagnant.

The progressive sector makes rapid improvement in efficiency. Examples include manufacture, particularly of items such as computers and cellphones.

The stagnant sector, including healthcare, education and live entertainment, due to dependence on human-human interaction, does not improve its efficiency rapidly.

Thus, the fraction of our GNP (and your paycheck) spent on the stagnant sector will increase. Continously.

Note that I said the fraction.

This may seem depressing. But the authors point out that, in real terms, our society, globally, is becoming richer. Therefore, despite the increasing fraction we will spend on the stagnant sector, we will be able to afford it. We will be able to afford more and better healthcare, education, and live entertainment.

Nonetheless, we need to do what we can to make the stagnant sectors more progressive. They give examples in the book of how healthcare, in particular, can become more progressive.

It is apparent that there will be an excellent ROI in healthcare by maximizing the efficiency of our healthcare personnel. Some big projects like RHIOs will contribute to this, but at a massive cost. But think – how much of our healthcare personnel’s time is spent using – or cursing at – computers?  Given the sad state of usability of our medical software, we will get a lot better ROI by simply making simple changes to our software to make it more usable. The cost of these changes is small compared to a RHIO, but the incremental benefit is huge. Thus, this website.

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