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The Story of EHR

Death by a thousand clicks is a very long and sad read. EHR implementation tragedy the article describes has all the markings of a giant integration project gone horribly wrong. 

Rather than an electronic ecosystem of information, the nation’s thousands of EHRs largely remain a sprawling, disconnected patchwork. Moreover, the effort has handcuffed health providers to technology they mostly can’t stand and has enriched and empowered the $13-billion-a-year industry that sells it.

As it typical in such situations, the vendors who need to inter-operate ping-pong blame and patch the most glaring defects as expediently as they can.The result is the unholy mess that is described here

What worries the doctor most is the ease with which diligent, well-meaning physicians can make serious medical errors. She noted that the average ER doc will make 4,000 mouse clicks over the course of a shift, and that the odds of doing anything 4,000 times without an error is small. “The interfaces are just so confusing and clunky,” she added. “They invite error … it’s not a negligence issue. This is a poor tool issue.”

Enterprise technology is rarely done right and even when it conforms to some version of "right", usability leaves everything to be desired. It is one thing to have problems with software that is meant to keep your sales team organized and selling - you gripe everyday, lose deals every quarter, fail to get a grip on your sales pipe-line - struggle with every last thing that this expensive piece of software promised to solve for you.

The designers of the software had some mental map of how a sales operation in a business is supposed to function and it turns out very few of the assumptions apply to your particular case. You talk to every other company that is using the software you find out they are an "outlier" too; that it takes a tremendous amount of customization to get value out of the software. So the design was not based on any kind of reality or understanding of how businesses actually sell their goods and services. The same sloppy software engineering when applied to EHR results in people losing brain function and their lives over software bugs.

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