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Today on Insights. We go back to a conversation Host Bill Russell had with Paula Edwards of Himformatics. The topic of discussion was Understanding Human-Centered Design and the Workflow of an EHR. And Bill asks Paula, what  is human centered design and where does it come into play in healthcare?


Hello and welcome to another episode of Insights. My name is Bill Russell. I'm a former CIO for a 16 hospital system ???? and creator of This Weekin Health IT. A channel dedicated to keeping health IT staff current and engaged. Our hope is that these episodes serve as a resource for the advancement of your career and the continued success of your team. Now onto the ???? show.

Today on Insights. We go back to a conversation host Bill Russell had with Paula Edwards of Himformatics. The topic of discussion was understanding human centered design and the workflow of an EHR. And Bill asks Paula, what is human centered design and where does it come into play in health care.

Human centered design advocate. What is human centered design? Why does it need an advocate and where does it come into play in healthcare?

So my PhD is actually in human integrated systems which is about how do you design systems that have people and technology working together to accomplish a goal? And human centered design is what a lot of the methods and tools that are used in that space to make sure that you have your end user front and center at every stage of trying to design your system so that you make sure that it's going to work efficiently and effectively for the intended user. So a lot of what you hear now with user experience has a lot of its foundation in human center design methods. And a lot of what you see in agile methods is actually very much founded in some of the user centered design methods. It's how do you get your user and those key stakeholders involved early and often through the design life cycle so that they can provide input, tell you where you got it, right where you got it wrong really provide valuable insight into the context in which the system is going to be used. And I think your question about why is it important in healthcare? I think electronic health records are the perfect example of why we need more user centered design in healthcare because the early versions, the early iterations of the current generation of electronic health records really did not use user centered design methods when they design their systems.

And once you have poor usability baked in, it's really hard to recover from that. So that's why some of the usability is so bad there.

I'm going to get into data in just a minute but I'm going to put you in a time machine. We're going to go back and sit down with David Brailer and his team before they, they put into place the meaningful use, whatever it was.

I was going to say doctrine. It's not a doctrine but meaningful use program. We're sitting there, it's just, it's close knit group four or five people. And what are we going to say to them to say, look, let's make sure that we can do something here that changes the direction of this.

Otherwise we're going to end up with where we're at today which is essentially systems are getting better, they are getting incrementally better and they really need to take a dynamic leap forward in terms of usability and design around the clinician workflow and those kinds of things. What would we be saying back then? Or did the problem start even before that?

I think the problem started before that. I think it's going back to those early EHR developers to say, you guys need to have doctors and nurses and patient registration clerks as part of your design team that are really helping you understand how does a patient flow through our health system and what do we need to do to make it easier on the patient and make it easier for the people who are caring for them.

Paula, I did an EHR project. Have you ever put clinicians in a room together and tried to get them to agree on what the workflow should be? It's really hard. I mean what's the trick. How do you drive through that?

Go back to the beginning of our conversation. You need healthcare translators that can help facilitate those conversations and really get them to focus in on what are the commonalities and how do we build to the standards? And there is a lot of, a lot of people in healthcare historically have wanted to do it their way. And that kind of dovetails into our data governance conversation. You have to standardize to get efficiency and quite frankly, good user experience.

And so you have to be able to facilitate those conversations to get everybody to a workflow that that works well for everyone, even if it's not necessarily their ideal workflow. You got to get a little bit of give and take in there.

I want to thank Tracey for another great episode. If you have feedback regarding the content and materials that you just heard and would like to help us to amplify great thinking to propel healthcare ???? forward, please send us a note Thanks for listening. That's all for now. ????

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