An Eclectic Gathering of EHR Usability and Project Resources

Posted on March 10, 2014 I Written By

When Carl Bergman isn't rooting for the Washington Nationals or searching for a Steeler bar, he’s Managing Partner of, a free service for matching users and EHRs. For the last dozen years, he’s concentrated on EHR consulting and writing. He spent the 80s and 90s as an itinerant project manger doing his small part for the dot com bubble. Prior to that, Bergman served a ten year stretch in the District of Columbia government as a policy and fiscal analyst.

Here are a few resources that I use to solve a variety of design, project management and other problems. Some, such as NIST’s protocols, are directly EHR related; others aren’t, but easily apply to EHR problems.

So here, as was once said, are a few of my favorite people and things:

  • Dan Bricklin. Hopper and Jobs are gone. Woz is a sage. Gates, Kapor and Norton long ago stopped being systems innovators in favor of being philanthropists. Bricklin, however, the electronic spreadsheet’s inventor, soldiers on. His personal site has much to offer, especially his video on interface development for different types of devices and users.
  • Donald Norman. If you only read one of Norman’s many works on usability, make it The Design of Everyday Things. When you do, you’ll find one of the most cogent, funny and thoughtful studies of user centered design. From his account of slide projectors from hell, to post office doors that trap the unwary, to the best ways to arrange light switches, Norman has good advice for all of us. I first read this twenty years ago, but the advice still resonates. He’s recently revised it and added a free on-line course. After Norman, you won’t look at doors, appliances, much less screens the same way again.
  • Jakob Nielsen. There are people who think if you know Nielsen’s usability approach, you need little else. Then, there are those who think if you know Nielsen’s approach, all hope is lost. No one has a monopoly on good interface design, but Nielsen’s site is a place to stop for tons of notable examples.
  • NIST Protocols. NIST works with the private sector to solve major, operational problems. After Three Mile Island close call NIST redesigned all US nuclear power plants’ control rooms. Recently, they’ve developed EHR usability standards. These are the best, most comprehensive treatment of what not to do. You’ll find them in an appendix in their publication, NISTIR 7804.
  • ONC Repository. Most those in the EHR field know ONC, for better or worse due to its Meaningful Use standards. There’s a lot more. Buried on ONC’s site is its Implementation Resources. The repository has dozens of videos, guides, white papers, toolkits and templates all centered on improving EHR selection, implementation and use.
  • Ross Koppel. Koppel is a grouch. He grouches about the dozens different ways EHRs record simple things, such as, blood pressure. Writing often in JAMA, he notes how health IT systems spawn workarounds, confusion and give users choices that are false, misleading or illogical. In short, he’s produced a treasure trove of frightening observations, embarrassing questions and pointed observations, but his bête noire findings also include correctives. All of this is written in a careful, thoughtful style that makes the subject compelling and chilling.
  • Tom Demarco. Demarco of the Atlantic System Guild has produced a wealth of insightful books, lectures and articles on project management. In the 60s, DeMarco asked himself, if a civil engineer can build a bridge from requirements to operation, why can’t we do the same thing with software. His first take was Structured Analysis and System Specification. It’s still in print and full of practical advice and approaches for project managers. Other works include Peopleware: Productive Projects and Teams, where he takes the odd position that you should treat your staff like people and help them be productive. I especially love his The Deadline: A Novel About Project Management in which the main character is kidnapped and forced to manage a project under threat of death. It’s a comedy.

Interested in EHR usability? Join my LinkedIn group: EHRUsability.