Usability: Who Knows EHR Users Better? Government or Users?

There was a rip-roaring discussion about how to get to more usable EHRs on EMRandEHR this last week. Of course, I added my two cents. One of the questions that arose was who is more “mature” about EHR usability? The government or the market?

Here is my response:

I am familiar with government successes (and failures) in engineering complex systems, including the human factors component. I’ve an MS in Industrial Engineering and spent a year working in aviation human factors.

I’ve written extensively about what EHR workflow and usability design can learn from aviation, most of which would not be known without government initiatives.

EHR/EMR Workflow System Usability–Roots in Aviation Human Factors

What Kind of EHR Would Sully Design?

Government Best Practices in System Usability: Brief History & Status

As a graduate student I worked on numerous government and military-funded programs investigating a wide variety of user interface issues.

I was at the NIST EHR usability workshop held with respect to the document you mention.

And I’ll repeat what I said (quoting Clay Shirky, in an open letter to Jacob Nielsen) in my post on leveraging market-driven means to improve EHR usability:

“There is a dream dreamed by engineers and designers everywhere that they will someday be put in charge, and that their rigorous vision for the world will finally overcome the mediocrity around them once and for all. Resist this idea - the world does not work that way, and the dream of centralized control is only pleasant for the dreamer.”

Yes, I know, a bit pointed. But it’s an important point. Don’t underestimate or disregard the market. I am convinced it can fix many of the unfortunate problems with EHR usability and workflow.

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