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In medical school or through years of experience a physician learns what workflow is best for their personal doctor / patient medical examination and treatment. To change this to match computer software and hardware does not seem natural and feels like doctor / computer interaction instead. It doesn't matter that the workflow is "sloppy", a physician is a physician first, most are "sloppy" in running an office but first rate at listening and patient care.
Here's an example from today with Medscribbler at a new install physician's office,
A receptionist from another physician was "on loan" for the day. Her comments are "this is so high tech" and "this is so easy". The physician has to take a few minutes to explain how she likes Medscribbler to work for her. The physician has 12 patients in the hospital which of course makes her late to start the day. A new Tablet PC was purchased and set-up the day before, unfortunately the wireless was not checked to start automatically, (a simple fix that is missed, click on the icon and connect). But there was a room full of patients who had been waiting a long time. She grabbed a backup Tablet. Unfortunately, someone has set this one to hibernate after 5 minutes so shortly after turning it on a specialist calls about a patient and the Tablet is put down and goes into hibernation. The settings are to log in again. The physician goes into panic. Now the log in name is different so the day sheet displays the wrong patients (again a simple fix that is missed, log in again or even simpler, click in Medscribbler show all patients). The next thing was a call to Medscribbler. Five minutes later it was fixed.
While we could say none of these problems was Medscribbler's, it was because Medscribbler changed the tried and true work flow that it became Medscribbler's problem. (Although this is why we strongly recommend a local network person, either by contract or on-site for larger installs)
The problem here is not the physician but a paper and pen does not require any interaction and a computer does. To use an EMR requires EMR interaction independent of the patient interaction. The more interaction the EMR requires the higher the level of training, work flow change and maintenance. EMRs should be judged on their functionality in relation to their training and maintence requirements because that will equal "work flow" changes.
We have designed Medscribbler to be as low on the work flow changes as possible with a high level of funtionality.
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