Adopting HIT is more about human machine interaction than people think!

“As clinical IT systems become more common at the point of care, new medical devices are increasingly designed to interact with them. Recognizing this shift, hospitals are moving biomed departments to IT and looking to clinical informaticists for guidance where devices, IT and clinical workflow meet.”

Explore posts in the same categories: Health Information Technologies, Human and Machine Interaction, Medical Technologies, Medicine Culture

11 Comments on “Adopting HIT is more about human machine interaction than people think!”

  1. Carmen García Says:

    Approximately four years have passed since this post was published and not much has changed, we still are facing the same problems when it comes to EHR dissatisfaction. Some of the roots for dissatisfaction are due to poor planning that contributed to interoperability issues, while others arise from limitations the EHR systems had in the moment of its inception. When implemented, physicians had an idolized idea of what an EHR was supposed to be, later faced with disappointment when those expectations weren’t met. For instance, they did not expect the face-to-face time with the patient to decrease significantly. While I agree with some of Ms. Martini’s opinions (“smooth implementation coincides with educating the clinical workforce to use the system effectively”), the fault doesn’t only lie with its users, it’s a systemic problem that includes tech and people alike. I believe the EHR ultimately needs to me more user-friendly, and its implementation and maintenance cost subsidized indefinitively by the government since they are the ones requiring the utilization of this system.

    -Carmen García

    • AngelBranaMD Says:

      Carmen… you hit the problem perfectly! Its not that much technology perse but how well technology is designed to address real workflow issues! And you’re right… years have passed and we are discussing the same difficulties attributed to the users!!!! No matter how well educated the workforce is, if the technology is poorly design it will allow human error!

  2. Roberto Kutcher Says:

    Hello Dr. Braña, I agree with what both you and Carmen said about the technology being poorly designed. Honestly, it’s going to continue to be a uphill battle for a number of years for a few reasons. Though I agree with Mr. Minton that “Successful strategic alliances between device and IT vendors can bring incremental expertise and shared insight to both parties if carefully designed and actively managed”, this doesn’t come close to what the actual problem is, which is that there is a huge gap between the providers and the program designers. Yes, it’s true that vendors need to develop a closer rapport to have a better understanding of what the provider’s needs are, however it’s the designers that need to have a closer relationship with providers. By the time the program gets to the provider, its already too late. Medical informiticists need to make sure that they have a number of doctors that are willing to help them design these systems, because the truth of the matter is that its not only about how the easy the system is to use, but rather whether it makes the provider’s life easier and it actually bears some use other than being a digital filing cabinet. Being a doctor is hard enough as it is, they need to make sure that the providers are as much a part of the development process as the sales process, because if the sales pitch is the main point where informaticists and providers meet, then its already too late and the program designers have already failed.

    -Roberto Kutcher

    • AngelBranaMD Says:

      You are right! There is a significant disconnect between developers and physicians. The problem is complex. On the one hand the developers to a great extent are trying to create a product that solves health industry problems as they conceptualize it based on what is required by who pays for the product. Since the federal government is paying for EHR that comply with Meaningful use, the developers concentrate in this rather than on the workflows of physicians and then look for the information needed for Meaningful Use. As a physician I don’t see a patient to comply with meaningful use! On the other hand it is also true that physicians -given how the system is financed to produce billable units of service have to modify their workflows to do the right thing as per evidence based guidelines that should also be used to design the EHR.

  3. While the article does bring a somewhat optimistic perspective on the advantages of these changes, in my opinion, progress has become lagging and it shouldn’t have to be this way. Physicians still face challenges with their interaction of EHR systems, despite federal strategies to try and shift to an electronic approach. By trying to understand their product, doctors invert more time on trying to understand it instead of continuing their daily tasks without any interruption in their clinical workflow. A strategic alliance can help expand the conversation between stakeholders and EHR vendors on the needs of their clients and addressing them in a logical manner. The availability of solutions for all stakeholders can bring about a slow (but likely assured) change that can benefit all parties, as well as its continuing improvement on its components.

    -Alejandro Veintidós

    • AngelBranaMD Says:

      You are right… BUT we all as a society must understand that delivering health care is not as easy as we would like to think and if we as a society need to have better documented information we have to pay for it and NOT only rest on physicians documenting! It cost time and money to document correctly and as a physician I need to be compensated accordingly!

  4. Angelica Suarez Says:

    When I read the title of the post I directly assumed this article was published during the last year. However, seeing the date of this piece I said wow from 2013. I would have to agree with my classmate initial statement: not much has changed in a three year period. The piece in the article that most caught my eye was the statement about medical devices and clinical information systems frustrating providers and the creation of new obstacles for vendors. As I have mentioned in several other assignments, one of the principal reasons why the electronic health systems ad records are not 100 percent adopted by many providers is the confusion of this systems and the cost of the same. Moreover, when there are many different vendors offering similar systems the providers become confused and frustrated, wanting to select the best alternative for there practices and patients. In my opinion I consider that these systems should be as simple as possible and compliance would be much greater.

    Angelica Suarez

    • AngelBranaMD Says:

      The problem is that we do not have yet artificial intelligence that might be the only way to mimic how the brain works integrating information! It is not that simple to make a “simple” electronic machine for such a complex problem as managing the health of an individual that incorporates so many processes including the decision modeling of a physician following evidence based guidelines.

  5. Jennifer Perales Lozada Says:

    Hola Dr. Angel Braña, esta publicación ha transcurrido 5 años. Después de varios años de la publicaciön todavia confrontamos problemas con la TI, ademas estos sistema les consumen el tiempo a los medicos hasta que le toman el dominio. En octubre de 2017, se llevo acabo un evento de Health 2.0 donde celebro su 11 conferencia anual para anuciar el MarketConnect Live en HIMSS18 para poder conectar compañías de tecnología con posibles clientes de atención médica. Su objetivo principal es acelerar el proceso para el cuidado de la salud brindando a los hospitales, los pagadores y las compañías farmaceuticas una plataforma digital para evaluar las tecnologías investigadas. Hay que tener en consideración que los EHR, nos facilita el uso y la entrada de datos al expediente electronico. En mi opinion, por más años que pasen siempre vamos a tener esta disputa entre los medicos y informatica electronica.

    • Jennifer Perales Lozada Says:

      Referencia de la respuesta anterior;
      Monegain, B. (2018, febrero 7). Health 2.0 trae MarketConnect Live a HIMSS18. Retrieved from Healthcare IT News:

    • AngelBranaMD Says:

      Comentas: “ha transcurrido 5 años. Después de varios años de la publicaciön todavia confrontamos problemas con la TI…”
      I did my Health Policy Internship in 2008 at HIMSS and during which I wrote and presented my “thesis” on Cultural Aspects of Medicine… So, It’s been almost 10 years and I think my Typology remains valid and in many ways un-attended! YES… all the reasons recognized as difficulties are valid to some extent! But I would argue that too much validity is given to resistance to the technology just because it’s difficult to use or it takes time for people to accept it! Most of the medical technology is readily accepted and used even without much evidence of its usefulness! True… BUT the real issue is lack of a serious “social compact” in which as a society we acknowledge that we have to spend time (and money) on managing disease and ailments and preventive health and its documentation -whether in paper (very deficient always JUST because we’ve been lazy) or in electronic platform (not yet well DESIGNED)… As long as access to care is managed as a commodity traded on Wall Street rather than as a social good, we will keep beating around the bushes rather than addressing the real issues. I sent to all the students the recent news about the failure of a Cadillac EHR product in the Coast Guard!

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