The opening question was very broad, asking for input on why some implementations of Electronic Medical Records (EMR) are failing to meet expectations. The resulting conversation (over 700 comments) brought up a range of thoughtful points on the root causes of these failures, and I have summarized some of them here in no particular order:

Deployments of EMRs, and the adoption of tech in the healthcare industry generally, provide great models for understanding how to augment cooperative work in layered cultures of established work practice. And it seems that a flock of designers have tuned in: the broader thread on healthcare design is inspiring, though the emphasis often seems to fall more on patients rather than caregivers.

The leading points in the list above can be humbling for designers, emphasizing that the primary factors for success or failure in workplace applications are often in the hands of project and organizational leadership.

I’m reminded of a quote from years ago by David Childs, a SOM architect working at Ground Zero: Something along the lines of “It takes a client to make a building.” I think of it often, and read it two ways: both as a statement of crass commercialism in the face of more civic-minded design intent, and as a basic truth of design services.

I love so-called “paper architecture” and open design exploration, but I’m also driven to promote real improvements in user experiences for people practicing their chosen vocations.

In a hand-waving sense, there are always plenty of abstract arguments about the benefits of computing tools in organizations. Shared industry beliefs, fashionable truisms, and rehearsed marketing pitches. Designers generate conceptual projects that show compelling advancements in user experience. In a conference room, futuristic applications can seem like near term inevitabilities.

But to successfully implement a system like an EMR — a messy, long term bet, involving systemic interventions — requires highly motivated leaders who have bought into a big picture.

Effective designers in these situations are facilitators of pragmatic process, collaborators in service of a vision, willing to dive into the unexpected hurdles of real world adoption. Else, design’s contributions are simply more visionary images projected on the wall, mismatched to the reality of what a client will actually follow through on, to be filed away on some repository and forgotten.

Caregivers and patients deserve better.

Know any great resources on the success or failure of Electronic Medical Records? Have any of the bullet points above impacted your projects?

@J_Burghardt