“It’s the Interface, Stupid” Revisited: If X-Box Can, Why Can’t our EMRs?

I wrote about this three years ago, which is long enough to make a cell phone outdated, if not downright obsolete. From what I can see, nothing has changed in terms of what EMRs look like. In one of my practices we have a new (?!) EMR that’s even clunkier than its predecessor from the same company (Greenway, you know who you are: Why do you make me SCROLL down Every Blood Test Known To Man instead of starting to type in a search box???).

Doctors are still mostly charting on laptops or even desktops. Haven’t the EMR companies heard of iPads? eCW has a fair app, but with bugs that haven’t gone away in the last three years and new ones that are appearing. Nobody has an interface that works like a doctor thinks, and nobody has the user interface simplicity of the technically sophisticated games my grandson plays on his Xbox. Actually, video games allow you to do everything without awkward commands or click boxes. And they go back to the early 90’s (see post script below).

If I open a patient’s “chart” today and try to prescribe a drug, the software asks what day’s encounter and what type of encounter I want this to be under. Excuse me: It’s today and I’m sending in a script. Why do I have to tell my multimillion dollar system that?

The technical unsophistication of EHRs is mind boggling, but even more appaling is the worse-than-DOS-era interfaces we have to deal with. My nurse gets a paper depression questionnaire from my patient. It is abnormal. She enters the details and the score in the computer. I don’t get a pop-up. Instead, I have to remember to click FORMS-Nurse Work Flow-Screening-PHQ9 and then see the score and click one of the boxes to document my action. How sad, how nerdy, is that?

I would like to know what the excuse is for the fact that children’s games have better interfaces than EMRs. And don’t tell me that medical records are more complex. They are not, at least not yet. I can mark a patient as allergic to iodine and having stage 3 or 4 kidney disease but many systems would still let me order a CT scan with iodine contrast. Someone (many of them) is making indecent amounts of money selling indefensibly inadequate, incompetent software to the nation’s health care providers. And laughing all the way to the bank.

P.S. Historical footnote: My Brooklin home was once owned by Mark Lesser, who was the programmer behind NHL 94, one of the most famous video hockey games of all time. His office on the third floor of the barn was my “man cave” for several years.

1 Response to ““It’s the Interface, Stupid” Revisited: If X-Box Can, Why Can’t our EMRs?”


  1. 1 Charlotte Duncan September 15, 2020 at 9:55 am

    It’s the money. People who are not medical professionals write software that will not interface with any other software. Its purpose is for billing, not keeping track of patients (hence it allows you to order the CT scan because it will bring in money, not protect the patient). It is just part of the US “healthcare system.”


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