Wednesday, February 01, 2012

EHR Workstation Designed by Amateurs

Below is an actual workstation, in an ICU of a major regional hospital, to permit interaction with an already mission-hostile EHR system:

How many things are wrong here? (Click to enlarge)

I can charitably say this workstation, in this recent picture, was designed by amateurs. Less charitably, I would use the words 'glaring incompetents.'

How many things are wrong here? For starters (commenters are welcome to suggest additions to the list):

  • Small square (4x3) monitor, when large 16x9 monitors are available quite cheaply, even at retail let alone in bulk;
  • Monitor in front of window so on sunny days, glare causes eye strain;
  • Monitor forces user to look away from the patient, with their back facing the patient behind them;
  • Standard keyboard and mouse to help spread infection, not medical-specialty devices such as membrane-based or membrane-covered keyboards and easily cleanable trackpads;
  • Very slow, small, toy-ish nettop computer, to facilitate responsiveness delays;
  • Height of ledge with keyboard/mouse and of elevated monitor on ledge does not facilitate comfortable ergonomics when sitting, note chair in background (or standing as is intended, either, although I don't recall ever making entries in the permanent paper chart on my feet). It seems nobody ever heard of an appropriate moveable workstation desk;
  • Tangle of wires behind setup, without any protective sheath or shield, facilitates "accidents."

There are probably a few more "issues" I'm missing.

There is nothing to argue here and nothing to debate. Combined with the mission hostile virtual user interfaces presented by health IT software itself, this is inexcusable.

Apart from designers, any physicians (and nurses) who would accept such poor choices - and the cause of this workstation's problems were, in fact, deliberate choices - are either weak-kneed victims of "physician's learned helplessness" themselves, or enjoy EHR-induced medical errors and lawsuits.

The workstations are poorly designed like this all throughout this hospital, including the ED.

This is not the first time I've observed this type of amateurism in hospitals. I observed similar issues in another ICU - over a decade ago.

Hospitals are truly an IT backwater.

-- SS


Live IT or live with IT said...

Use of the small monitors is especially troubling. The cost difference is negligible. In their private offices docs have the large monitors. Why is it that resources are expended in offices where patients are not seen and corners cut in places where patients are seen?

InformaticsMD said...

I guess hospital management has no problems making doctors view medical records through the equivalent of a machine-gun bunker slit.

-- SS