By Usha Periyanayagam, MD, ER Physician and Agathos Medical Lead
Photo by EHR Intelligence
Why do so many technology companies struggle with physician adoption? Are physicians technophobes, is it the technology, or some combination of both?
The unfortunate reality is that many physicians either dislike or do not use many health IT solutions. This is largely because physicians, like myself, have been soured by negative experiences with technology that was not built with our experience in mind.
Dr. Robert Wachter, one of the most influential academic physicians, describes this ironic reality in an interview about his book, The Digital Doctor:
“Physicians, just like people everywhere, love technology that is easy to use and well-designed. Unfortunately, most of the information technology tools that clinicians are using today are poorly designed, with nothing like the user interface that we have become used to in our consumer world.”
What if things were different?
Physician exposure to information technology in healthcare has largely been through Electronic Medical Records (EMRs). Most will agree that EMRs have been designed for billing and not for a pleasant user experience. Bulk data collected through EMRs will eventually be useful for physicians and patients alike, but the immediate value of the data for physicians is low.
While physicians are not afraid of technology, they are hesitant to use new products unless the value is obvious. We did not go into medicine to spend hours charting on computers. Recent studies have shown that most physicians today spend more time charting than actually talking to patients. Due to this reality, physicians believe that more new technologies will increasingly take away time from patient care.
Yet, at the same time, many physicians see the potential in technology to improve patient care and give back time to patients. Dr. Wachter goes on to note, “I’ve been anticipating the entry of technology into my world, because I thought it would solve many of the problems with medical errors.” Now that the technology is viable, we need to think about design.
I believe that the key to creating technology that physicians use and love is to both design for them and to include them in the design process. To this end, I have put together a list of design principles that might be helpful to other organizations.
How to Design for Physicians
1) Technology must fit into the physician’s workflow. This is a no brainer for many but crucial for physician adoption and satisfaction. Pay attention to when they use technology and when they do not use it (e.g. not in front of the patient). You will quickly learn how and if your product adds value to the physician’s workflow.
2) Technology must be efficient so physicians can spend more of their time with patients. Even engineers and designers who shadow and speak to many physicians do not understand a physician’s thought process and workflow; they must watch a physician use it in their normal clinical setting. A single bad encounter can discourage physician users so it is critical to put the time and research in early.
3) Technology should be intuitive and enjoyable to use. Physicians have been waiting for health technologies that are beautifully designed. A well-designed product and user interface has the potential to improve physician adoption, engagement, and even satisfaction.
How to Design with Physicians
1) Recruit physicians to work closely with you during the entire design process. While physicians are notoriously busy, if they understand the problems you are trying to solve and believe in your vision, they will work hand-in-hand and invest in your design process.
2) Build a clinically believable prototype. You will need to work with physicians from the start in order to create a pilot with a larger physician audience. Based on my own experience, I have seen that if content is not clinically accurate, physicians often get distracted and cannot see the bigger picture of the product’s potential.
3) Test your product with a diverse group of physicians across ages, genders, regions, hospitals, and even cultures. A good start to this practice is to recruit a diverse medical advisory board for your company.
My hope is that technology companies that build products for physicians will increasingly prioritize physician needs and involvement. Physicians deserve the same type of user-oriented design that our consumer culture has standardized.