Everyday, I interact with clients, prospects, external and internal stakeholders, multiple, large and capable installed vendor systems, and plenty of real visionaries.
We’re often arguing over dated device strategy issues. We’re walking away from adopting new approaches to usability, even when their costs are comparable to the alternative status quo methods. And we’re basing our thinking on existing workflows, rather than becoming committed to discovering better ones. Better ones, like the GPS and phone examples in Part 1 of this post that do more, simply, with fewer steps.
There’s a humorous way of looking at the emergence of new technologies. Often, we become only vaguely aware of them, possibly through science fiction. They defy norms, the laws of physics and the practices of economics. Then, they’re socially evolved into a joke, " What idiot would want to ride in one of those awkward Model T Fords when we have these ubiquitous horse and buggies." Those who associate themselves with the vision are considered not credible, untrustworthy, and laughable oddballs. Next, the new technology is perceived as a huge threat. It will lead to horrible things for society, including reduced employment, shifts in power, erosion of economic investments. And, by definition, these new technologies are unproven and incomplete. Lastly, as they mature and prove themselves, the new technologies are deemed as obvious improvements and steps forward. They sell in record numbers in short periods of time, replacing the prevailing paradigm, or supplementing it.
This is what’s happening with HCIT devices, usability and workflows. The rates of change and adoption have accelerated from 4-to-10 years per cycle, down to 9-to-36 month cycles. They are fueled by consumerism (lower costs and rising demands), rising expectations from buyers and payers, and the powerful governmental policy changes to reform healthcare.
1. Consider what might be obvious as you never have before. Get experience with the emerging Smartphone and Tablet technologies. Get a smart-device that’s less than a year old. Don’t just make phone calls. Share your calendar with your family. Discover and use some location-aware apps that have real potential for you. Take and send photos and high def video. Experiment with letting your friends know where you are (link to Google Latitude http://www.google.com/latitude/intro.html ). Routinely use video conferencing from your office, kitchen and anywhere it might make sense. Notice where it speeds you up and where it slows you down. And perhaps as importantly, notice where it energizes you and where it depletes you.
2. At home: Aggressively move to paperless approaches to your current work and transactions that are supported on low-cost, consumer grade mobile platforms. I have had good luck with NeatReceipts over the last two years; there are many alternatives.
3. At work: Start looking at the basics of HCIT: patient lists (rounding, sign out, other tasks), and patient-level work, such as chart review, ordering, documentation and decision support. Ask yourself and your colleagues, “ What are the obvious next steps for us?” I’ve participated in three advisory boards in recent weeks. That’s exactly what we’re doing. Surprisingly, tighter and tighter integration is becoming the dominant theme. Just wrapping information and services together through portals or adding drill-down buttons is now being viewed as intolerable. Until recently, those actions were seen as logical next steps.
4. Think twice before being dismissive when a friend, colleague or spouse wants to show you something "interesting." By all means, don't fall into the trap (that we all have at one time or another) of condescendingly telling them that you're disinterested but you're "glad their enjoying their little iPhone, Droid, or other new toy." These innocently intended behaviors are energy-depleting and slow the progress toward better, faster, and cheaper solutions.
A Recent Example of Consumer Functionality Destined for Common HCIT Use:
A friend showed me last week that they had a new Smartphone, a Droid X. They said, hey, look at this. They picked up an article of packaged grocery store food, held up their phone, aimed its camera light at the embedded bar code and, voila, the item, by brand name showed up on their shopping list. The app, by the way, has been available on the iPhone, long preceding the availability of this Droid X. The specific technology is not the point. The faster and easier construction of an accurate shopping list isn’t the point either. The point is the shift to the obvious.
Here's the paradigm shift:
If the user you want to support is a patient, nurse, or doctor, already carrying their own mobile devices and already using them for increasingly common tasks (like a shopping list), what are the implications of handing them a solution from a decade ago? Are you going to ask them to visually scan a rich (i.e. complex) Windows app or a Web page and figure out where to point and click? Or, are you going to honor their content, their intentions, location, and capabilities of their resources, including device capabilities? Are you and your team going to figure all this out without getting your own first hand experience?
In closing, I'd like to point out that the GPS described in Part 1 of this post, and in the pictures throughout, illustrating dramatically improved connectivity and decision support, has been rendered obsolete by the smart devices I've discussed here. (Yes, it's still perfectly functional.)
I replaced that three-year old GPS last month with a GPS-integrated, Internet-connected smartphone that mounts in the same place. The dedicated GPS was a dinosaur, replaced with functionality integrated into many of the new mobile devices (phones and tablets). There's no net-new cost to the GPS. One can now say the name of the place desired, voice-recognition will present the options, whether or not they are in a personal address book, and a path is plotted.
How long will it take us to adopt the obvious?