Live data from Hacker News

Ask HN: Why is medical software so hard to use?

news.ycombinator.com

41–46 of 46 posts

Re: Ask HN: Why is medical software so hard to use?

#41
As a patient I've given tech support to nurses that are stuck with the unbelievable piece of shit software known as epic

I wonder how much fraud and abuse is done because of that software. The lack of interoperability between different providers and even different locations from the same provider

I've never committed fraud, but I've used the systems crappyness to my advantage many times

It's a complicated ui built upon a shitty data model that wildly varies. I think the developers must have heard "ui and schema" well fuck all that noise

Re: Ask HN: Why is medical software so hard to use?

#42

Earlier quoted context omitted.

A friend used to work ER, any time the computers went down, the backlog in the waiting room would get cleared up. Paper works so much better when you're just trying to save someone's life, and don't know which of the hundreds of different forms you'll eventually have to fill out in the computer.

Wow. This is eye-opening. I'm surprised this isn't at the top. Is paper better? Why do hospitals use electronic records then?

Because paper record absolutely sucks to retrieve/interpret later, and billing/coding would be even more arduous from paper than it already is with EMRs.

Re: Ask HN: Why is medical software so hard to use?

#43
As a physician I would add:

-The UI of Cerner's product is inconsistent and maddening. A constant experience is that on some screens one must right click to open up extra data fields for entry but elsewhere they open on their own.

-The UI is often randomly changed and one must figure it out again. We would really like reliable tools.

-Latency is substantial.

-Simply reading data is frustrating because popups occur everywhere. We were told that a way to use Cerner is to hover to get a popup with more info. This is rarely useful. What happens is that popups get in the way of what you are looking for.

-Between Cerner Powerchart, the desktop login software, and dictation software there are random roadblocks several times daily. Something won't load or fails, or has a moment of 10x latency, or crashes. This is frustrating since we are trying to help seriously ill people and these tools are random/chaotic.

-Anyone using EHRs know that the EHRs make mistakes, delete things. I've caught the EHR deleting signed orders in the background that I had to reorder. Initially I thought I must be starting to forget to order things on patients or was going crazy. But, when our quality people played back my actions in the EHR (at my request) they could see that I had used it properly and the EHR had deleted orders. We have to overwatch the EHR for safety reasons.

-EHR is a recruitment issue. Some practitioners have bypassed us because of the EHR we are required to use.

-Productivity is at least 3x lower with the EHRs compared to paper flows.

-The EHR contributes to practitioner burnout for many reasons. It is frustrating and exhausting to use. It is random and chaotic.

If anyone from the EHR vendors, login vendors, dictation vendors, or overwatching government agencies are reading (and that might care) I plead with you to improve the nearly uniformly terrible EHR/EMR end-user situation.

Re: Ask HN: Why is medical software so hard to use?

#44

As a physician I would add: -The UI of Cerner's product is inconsistent and maddening. A constant experience is that on some screens one must right click to open up extra data fields for entry but elsewhere they open on their own. -The UI is often randomly changed and one must figure it out again. We would really like reliable tools. -Latency is substantial. -Simply reading data is frustrating because popups occur ev…

> EHRs make mistakes, delete things.

Wow. How do they let this happen? Google never deletes an email.

> Productivity is at least 3x lower with the EHRs compared to paper flows.

If paper flows are better, why haven't they reverted to paper.

Re: Ask HN: Why is medical software so hard to use?

#45

As a physician I would add: -The UI of Cerner's product is inconsistent and maddening. A constant experience is that on some screens one must right click to open up extra data fields for entry but elsewhere they open on their own. -The UI is often randomly changed and one must figure it out again. We would really like reliable tools. -Latency is substantial. -Simply reading data is frustrating because popups occur ev…

> EHRs make mistakes, delete things. Wow. How do they let this happen? Google never deletes an email. > Productivity is at least 3x lower with the EHRs compared to paper flows. If paper flows are better, why haven't they reverted to paper.

>Wow. How do they let this happen? Google never deletes an email.

I'll add that the deleting of signed orders in the background I witnessed occurred a few EHR upgrades ago but after we had been using the EHR for 3-4 years. However, in a high-risk setting like a hospital, once you witness that happen, you forever feel like you have to be on-guard with the EHR for the sake of patient safety. Trust but verify, etc.

>If paper flows are better, why haven't they reverted to paper.

Most of us would love a return to paper but this is not allowed in the US by government regulations unless the EHR has gone offline or is failing in real-time.

Re: Ask HN: Why is medical software so hard to use?

#46

Earlier quoted context omitted.

A friend used to work ER, any time the computers went down, the backlog in the waiting room would get cleared up. Paper works so much better when you're just trying to save someone's life, and don't know which of the hundreds of different forms you'll eventually have to fill out in the computer.

Wow. This is eye-opening. I'm surprised this isn't at the top. Is paper better? Why do hospitals use electronic records then?

A LOT of money is tied up in reporting that is all but impossible to do without comprehesive electronic versions of medical record information.
Post reply on HN