"I hate computers," says David Gelernter, a prominent computer scientist at Yale University. "I want software to work in 30 seconds."
Those may be surprising words from a computer scientist, but they echo the sentiments of countless physicians and patients who feel the same way when they interact with electronic health record (EHR) software, patient portals, and the like.
In case you don't recognize Gelernter's name, his father is considered one of the inventors of artificial intelligence, and David has made important contributions to the development of parallel computation.
As the nation slowly recovers from the federal debacle called HealthCare.gov and its pathetic attempt to help patients gain quick access to affordable medical insurance, we need to find IT brainiacs who know how to think like technophobes, who can put aside any sense of intellectual superiority and create tools that are much easier to use and fit better into the daily routines of clinicians and patients.
[They need to work together: The Mismatch Between Healthcare Software, Healthcare People.]
Put another way, we need to find software designers who think like outsiders. The profile of David Gelernter in the Wall Street Journal offers a clue as to the mindset needed. In his words: "Any success I've had in computing is because I fit so badly in the field."
Gelernter isn't alone is his frustration with computers. Back in the early 1990s, then WSJ technology editor Walt Mossberg echoed the Yale scientist's sentiment: "Personal computers are just too hard to use, and it isn't your fault."
Over the years, Mossberg admits that they've gotten easier to use and he credits Apple's designers for much of that. Which begs the question: If Steve Jobs were still with us, what kind of EHR platform would he design? And what would his patient portal look like?
Most clinicians I've spoken with over the years would advise healthcare IT designers to take more of a crowdsourcing approach, surveying large numbers of doctors and nurses in the trenches to get a better sense of their needs and how IT systems can fit more elegantly into their workflow.
While that game plan makes sense up to a point, Jobs probably wouldn't have gone in that direction. If he were designing an EHR, he'd probably ignore much of what his customers asked for and would somehow find a way to give them what they really needed. The strange thing about Jobs's type of genius was that he knew what his customers wanted even before they did. After all, did the public ask for an iPad?
In ways, Jobs and Gelernter have a lot in common. Both never had much respect for the status quo -- and that was and is their gift. That kind of fearlessness brings to mind one of best advertisements ever to hit the airways:
"Here's to the crazy ones. The misfits. The rebels. The troublemakers. The round pegs in the square holes ... While some see them as the crazy ones, we see genius... Because the people who are crazy enough to think they can change the world are the ones who do." The vision in that Apple commercial describes that kind of software designers and vendors, the ones who will transform healthcare technology into a technophobe's paradise -- and probably become billionaires in the process.
Paul Cerrato has worked as a healthcare editor and writer for 30 years, including for InformationWeek Healthcare, Contemporary OBGYN, RN magazine and Advancing OBGYN, published by the Yale University School of Medicine. He has been extensively published in business and medical literature, including Business and Health and the Journal of the American Medical Association. He has also lectured at Columbia University's College of Physicians and Surgeons and Westchester Medical Center.
Though the online exchange of medical records is central to the government's Meaningful Use program, the effort to make such transactions routine has just begun. Also in the Barriers to Health Information Exchange issue of InformationWeek Healthcare: why cloud startups favor Direct Protocol as a simpler alternative to centralized HIEs. (Free registration required.)