Why does Healthcare need to be (re)designed?
I’m going to talk about healthcare in the United States. It has been called the most complex industry for a decade now. The complexity exists and is only growing. It’s important to look back a few years to understand why doctors and patients aren’t happy about the state of healthcare.
If you are not in the US or don’t know a lot about it, here’s some context:
- Healthcare in the US is digital,
- Healthcare is taken far more seriously,
- Most patients are insured and don’t generally pay much out of pocket (10–12% expense is out of pocket),
- It’s really expensive if you are not insured, and
- The country spends about 18% of its GDP on healthcare.
Going from paper to digital
In 2009, the US government made it mandatory to record all patient records digitally by 2014. Almost everyone was on paper before this. It started a race to build what we know as Electronic Health Records (EHR). A lot of early healthcare IT work was about the digitization of paper, so it didn’t see a lot of innovation in the workflows.
There was a huge demand for setting up EHRs and the infrastructure around it. Software vendors with little or no Healthcare experience started building EHR solutions.
Software vendors with little or no healthcare experience started building EHR solutions.
By 2014, most providers and healthcare organizations were compliant, but the experience of using an EHR was painfully bad. They were slow and required doctors and nurses to spend more time feeding data rather than focusing on the patients sitting in front of them. Even with the amount of effort, chances of human errors were very high — the standards became the industry’s biggest nightmare.
Healthcare missed the intimacy of a patient-doctor relationship
Most companies spent nearly the next few years applying software patches and re-writing the EMRs as they learned more. There was still a problem that remained unsolved — designing healthcare for the unique patient-doctor relationship.
The industry nearly failed to model the humane nature of the care delivery system.
Physicians and nurses are burdened by data-thirsty EHRs, spending so much of their time entering information into these systems and searching for it. This was the time they should have been focusing on the patients. The tools are decades old and practically unusable, which added to their trouble.
We hear more and more that doctors hate their computers. Patients complain that their doctors don’t listen to them anymore. Do a google search, and you will find articles on how to make yourself heard. It’s sad to see patients asking these questions — may be even unfair.
The industry nearly failed to model the humane nature of the care delivery system. The people who were building technology solutions for healthcare did not have much interest in creating value or a long term vision. It was a small window and all companies wanted to tap into this opportunity.
EHRs are a necessary evil
One of the main benefits of electronic health records is that they can be accessed instantaneously and shared with other professionals in real-time. It is important to note that the purpose of these tools was not ill-placed — it’s trying to capture data for improving care.
The purpose of these tools was not ill-placed — it’s trying to capture data for improving care.
Today, there are over 200 EHRs out there, each having a different way of managing and storing patient data; each having a different way of storing and none completely talk to each other (even though regulations mandate it).
A doctor is required to select the appropriate codes and enter them into the healthcare information tool for processing. There are about 68,000 diagnosis codes. The nature and design of EHR is so that it tries to interrupt the intimacy of the doctor-patient relationship. A Forbes article titled “Death by a thousand clicks” describes how a patient died because the EHR did not record the lab test a doctor ordered.
In the 15 minutes that patients get with their doctors, they want to feel heard.
Again, the intention is not ill-placed. But, in the 15 minutes that patients get with their doctors, they want to feel heard, be understood and get the care that fits their needs. Doctors want to build great relationships with their patients. It is, therefore, necessary to recognize the complexity of the system and improve it.
Healthcare needs a more intuitive medium to capture what is done and pull out the right answers when doctors need it the most.
Designing for trust and relationship
As humans, we like to be able to see a full view of our lives to build trust and feel safe. It’s already happening in the consumer space. Designing for trust and relationship has been a major focus in social media, electronic retail, and finance. You get the right information when you need it most.
For decades, healthcare technology has been restricted by age-old enterprise software and compliance. Softwares can be hard to use and lack a good user experience.
If you think about it, doctors and nurses are accustomed to well-designed products from iPhones to Facebook in their personal lives. What excites me the most is to give them the same experience while they are at work!
This is only a glimpse of everything wrong with healthcare today. Complexity will always be a part of healthcare. The question is not if it can be eliminated, but rather how to make the process easy while optimizing its benefits. It hasn’t been a priority. But it’s possible.
Until later.
I never considered working in healthcare as an option. It was technical and full of concepts I didn’t understand. But while I could be designing for consumer tech, or finance, or many other startups, I’m at Innovaccer designing for healthcare. It’s truly fulfilling to build products that make lives simpler for doctors, patients, and care teams.
We are constantly growing, and looking for designers who are equally passionate about solving problems. Reach out to me on varun.dhawan@innovaccer.com if you’d like to join.
