I love tech and I especially love software, but like most things that we deeply love, when they fall short, it’s very hard to not get angry.
This is one reason I have such a hatred for the current state of Electronic Medical Records. They’re abysmal. John Gruber even makes fun of them. (Minute 24:28, but the whole talk is worth listening too.)
Today I share another example of poor design.
In the EMR I use now, NextGen, I’ve been complaining about the joint injection procedure template for 1.5 years. They still haven’t fixed it.
I use a standard medication called Synvisc One. Synvisc regular is a 2ml (16mg) injection you give once a week for 3 weeks. Synvisc One is all 6ml (48mg) given at once.
Just to lay out all the numbers for you. This medication is available as:
That’s it. Two strengths. Expressed either in a volume or a mass.
You can document this in two places in the procedure template. I want to point out, that this is the first mistake, having two places to document one thing.
And here’s how they look:
First, there’s no units. Specifically it just says “units”. Is that milliliters? Liters? Milligrams? Grams? Number of injections? Is this for Synvisc or Synvisc One? If I pick one of these, what am I actually documenting or ordering? The closest guess is that this is in milliliters, but then you can’t pick “6”, the size of Synvisc One. There is a “2”, so you could document Synvisc regular. Even then, 1 in 5 available choices will always be wrong. Why even offer a possible wrong choice?!?! I also point out that this is a pop up menu, so you’ve already been removed from the screen you’re working on.
And here is how the second place to document it looks:
This one at least has units, but still has all the other problems.
I would offer the following fixes:
- Have only one place to order the drug.
- Instead of a pop up window, make it a radial button choice.
- Have two options: Synvisc and Synvisc One
This improve things as follows:
- Only one place to document.
- No choices that are wrong.
- No extra pop up menu.
- No need for the user to know the milligrams, milliliters, or any other unit. They just need to be able to read what is on the box.
I hope that before I die1, a decent EMR exists.
We have a long way to go.
It wouldn’t hurt if it wasn’t horribly ugly either. ↩