Doctors? Programmers? Meh! — Maybe Industrial Engineers Ought to Design EHRs!

You may already be familiar with hospital management engineers. Industrial engineering is sometimes called management or health systems engineering (”Cheaper by the Dozen” is based on the lives of the first industrial engineers to study medical workflow. Read myy EHR riff on CbtD!).




An EMR designed and implemented using industrial engineering principles and techniques is a fundamentally different EMR that the traditional EMR. Instead of starting with a user interface that looks like a paper form, the user interface is essentially derived, using scientific and engineering principles, from the human body’s response to physical, physiological, and cognitive workload. Perception, attention, cognition, motor control, memory storage and retrieval all interact with work environment and job demands to result in a body of knowledge about mental workload, vigilance, decision making, skilled performance, human error, human-computer interaction, and training. (This is not dissimilar to the way in which medical knowledge is derived using scientific methods from the structure and function of the human body.)

The resulting EMR should not necessarily look like what has gone before. (In fact, the first use of computer displays in aircraft cockpits mimicked physical dials and switches. Today’s “glass cockpits” do not.) Many EMR designers are seduced by the idea that since users are already familiar with paper forms that the paper form metaphor is a good user interface. It is not. EMRs that try to mimic traditional paper medical records are not well designed for high-usability, high-productivity data and order entry.


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