I recently joined the Strategic Advisory Board of an interesting organization called the Clinical Groupware Collaborative [CGC]. The CGC is a relatively new and rapidly growing industry organization uniting companies in Health Information Technology around common goals to support healthcare through communication and collaboration. It’s members share a desire to see growth in the acquisition and use of affordable, easy-to-use, and interoperable EHR technology, especially among the very large group of "non-consumers" who have found legacy EMRs cumbersome, expensive, and technically challenging to use.

Several key initiatives underway, monitored and supported by the CGC are Meaningful Use, NHIN Direct and Smartplatforms to name a few. PointClear is helping it’s EHR clients with their roadmap projects to comply with Meaningful Use, particularly as it relates to provider/patient communications and information. We are closely watching the NHIN and Smartplatform pilots.

If you haven’t heard of the CGC you might want to check it out. It’s board of directors and members are industry leaders and innovators in healthcare technology. The Strategic Advisory Board, also made up of the HCIT leaders, has recently been formed to help the CGC navigate a very dynamic and rapidly evolving HIT marketplace, obviously catalyzed as a result of the American Recovery & Reinvestment Act of 2009 and the Health Reform Bill of 2010.

Stay tuned. I plan on blogging on interesting developments as they occur.

David Karabinos
President and Chief Executive Officer

"To succeed in transforming healthcare, many countries will need to move to more personalized healthcare (PHC). Successful migration must encourage innovation, provide access to more complete patient information and incorporate advanced clinical knowledge into clinical decision making. Therefore, PHC will require a much more open, robust health information technology (HIT) environment than exists today. We have identified five major HIT-related challenges, as well as recommendations to foster HIT-enabled PHC."

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Last week I spent some time shadowing an employee of a potential client, to understand what her work day is like, how she uses the technology she has, how it could be better, and what are some of the limits and constraints of her environment, tools, and patience dealing with it all.

When I called her to set up the appointment, she said, “you know, I’m not sure how much you’re going to get out of watching me. I don’t use the laptop and software on the job. I write everything down and then go back home to use it.” What she didn’t realize is that her description of her situation is actually a gold mine for people like me. The real puzzle is why it’s better to do things twice than do them once with the available tool.

In the day I spent with her, I learned a lot of detail about “real life” in a job like hers. Because realistically, when I set out to design a system for someone whose occupation is very different from mine, involving people very different from me, I can’t do a very good job unless I immerse myself in that world. Design isn’t in the details, it is the details. Those details are the difference between something people like to use, and something they leave at home.

For example, the software program she uses expects information in a linear format. You fill in a section, click next, fill in another, change tabs, and so on. But the delivery of that information, from the customer, isn’t linear at all. Part of this has to do with the fact that the customers are elderly and generally in poor health. They forget things and then “ah-hah!” they come back to them (don’t we all). The software has to be forgiving in instances like this, and right now it’s not. The domain is a fuzzy one. Things don’t always go according to plan. Anticipating these kinds of situations and handling them gracefully is essential in an effective software application.

There’s just no substitute for ethnographic research in an unfamiliar domain. Even in a familiar one, you can always learn something when you view the situation from a different perspective. Before you set out to define requirements, take a stab at understanding context. You’ll be surprised at how much that shapes the entire endeavor.

Lee Farabaugh
Director of User Experience