2) Design decisions should ALWAYS be made by the end user

Number 2 on the list of how to survive in Health Tech: Design decisions should ALWAYS be made by the end user. This was a hard one for me to grasp initially. Right out of school, brimming with ideas, I wanted to show the world how it should be done. I quickly realized, there is a time and a place for fancy interface and screens with all the bells and whistles. That place is not a hospital new to electronic health records.
While there have been some discussions on twitter lately about who should be making design decisions, the computer engineers, the healthIT innovators or the clinicians, I will always stand by the clinicians. It is the role of IT staff to present design decisions, possibilities to meet the functionality or measures that the hospital or clinic needs. Then it must be the role of the end user, be it physicians, nurses or ancillary staff, to make the final decisions. They must be involved in design discussions, workflow analysis and final testing. Even if you have the most state of the art application, it if doesn’t fit into the workflow of the clinician, or have clinician usability, it will fail.
The first step in ensuring that your design will fit into users workflow, is to analyze what is happening currently. Define what problem is trying to be corrected, or what metric needs to be captured and put boots on the ground to see how it is being addressed now. Follow multiple clinicians around, watch what they do, ask questions, look for inconsistencies, ask more questions. Then create a current state workflow. If pen and paper is all you have, draw it out. Viseo, from the Microsoft Office Suite, is a wonderful tool as well.
Once you have your current state workflow hammered out, then and only then should you begin drafting design options. Waiting until after workflow with save you from spending multiple hours on a design that will not fit in to current processes. Making a clinician less productive is the best way to have end users lose trust in your project. As design decisions narrow down to two or three, create future state workflows. Analyze how new functionality and design will fit into the clinicians daily activities. Use these when discussing with the clinicians design options.
Showing that you did your homework, that you took the time to investigate what works best in a clinicians particular situation builds trust. Making sure that end users have a say in design decisions not only validates that it will actually work for the purpose you are planning, but builds relationships. The sooner you engage the providers, nurses and staff that will be using your design, the more effective a product will be. User buy in can make or break a project and it is important to establish your stakeholders early and consult with them often.
There are many resources available to aid in workflow analysis. Just Googling workflow brings up tutorials, blogs and books. One hidden gem of a resource I found at the American Medical Informatics Association conference, Charles Webster MD. Follow him on twitter, not only does he have a constant stream of workflow related information, he is very responsive to questions and comments!
What are your favorite workflow tools? How has failure to establish workflows hurt you in the past?
**Originally Published on my blog BrittanyPartridge.com where I write about my experiences in Clinical Informatics, my observations of technology and lessons learned in my hospital system. Have a suggestion for a topic, or want more information on lessons learned? Shoot me an email or find me on LinkedIn**
