Don’t forget clinical staff when shadowing Healthcare Professionals

In a recent post on EMR and EHR, John Lynn points out an up-and-coming EMR (Elation EMR) company is out there shadowing doctors. We’ve said before that physician contact is the silver bullet to success, but it’s important not to forget the clinical staff: Physician Assistants, Nurses, Nurse Practitioners and even front office staff.   Not only should the MD experience be comprehensive and expedient, but the MD should not be slowed down by limitations imposed on support staff.

In our regional cancer treatment clinic, the whole clinic must run smoothly and in sync. Information is not only trickling down from the MD, but that MD is also basing his decisions on information from other staff:

  • Is that expensive chemo pre-certified by their insurance?
  • Did the nurses notice that there was excessive nausea that should delay a treatment?
  • Have the admin staff filed the correct HIPAA agreement so the MD can talk to the patient’s son on the phone?
  • Lab staff – Has the in-house lab had time to get the BCR/ABL results back?

In order for all of these departments to function smoothly, the entire EMR system must be fast for everyone. When we have a new feature in development, it is part of our design process to put the feature on a test server, then go and sit next to the user and duplicate her work. That’s right, you bring a laptop into the exam room and duplicate the work the MD is doing (or lab tech or nurse, what-have-you). If you can’t do the work faster and better than she can, you sit back in your chair and keep developing until you can.  This is an exotic luxury that we have, as we are developing our software in-house… as in, our dev boxes are in the building.

A prime example of this philosophy was when we put our document scanning process in place. We had worked for months (between crisis-features like ICD-10) on the scanning interface, on the specifics of how to split pages, put pages together, rotate, etc.  I personally spent about a month going back and forth to medical records, spending an afternoon just scanning – eating my own dogfood.

By the time I was done, scanning documents was almost a little… fun.  And once we put scanning into production, the users really loved it.

Having my butt in the seat showed to the users that I am invested in the product and am taking considerable effort to make their lives easier, not harder. This disarms the user against reflexive negative emotions and opens the door to constructive criticism and user buy-in.

Being ‘in-building’ provides its advantages of being able to shadow anyone at any time, but it also provides the advantage of immediate feedback. Something broken? We hear about it immediately, perhaps before it affects most users.  We get to see the emotions that our software brings, both positive and negative. And as developers, it feels really good when we turn those negatives into positives.

The big-dog companies are going to stay afloat with their large sales staff, but companies like Elation EMR and Ankhos will rise up with our willingness to get down in the trenches and develop from the inside out.


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