Playing the EHR Memory Game

I try to avoid navel-gazing, which to me means commenting on someone else’s commentary – a practice all too commonly relied upon in the healthcare IT blogosphere. How many blogs, articles and rebuttals have been generated, after all, as a result of the Health Affairs/Mostashari back-and-forth in the past few days? Quite a few, and yours truly happily participated in the fringe commentary. So as you can see, sometimes a topic already covered by someone else just begs for a second opinion, which I’ll happily give if the context is right.

Yesterday I came across two pieces of online content that I couldn’t help but draw correlations between. The first, a blog written by Dr. Rick Weinhaus entitled “Humans Have Limited Working Memory,” tells the tale of our poor ability to retain information, made all too obvious by a common EHR design feature – the utilization of a row of clickable tabs at the top of a dashboard to designate the different categories of data that make up the patient visit.

Dr. Rick laments that since humans are capable of only retaining four to five unrelated elements in working memory, the row of one-click tabs, though logical, doesn’t work very well. In fact, it drives him “crazy.”

I certainly believe in our limited capacity for remembering unrelated things at any given time, and I’m sure other working parents will agree. Our capacity for keeping everything straight is finite – the more kids, colleagues, coworkers, patients, tabs, bells and whistles you add, the more likely you are to forget something, leave something behind, or, if you’re like me, leave your car door wide open in a parking lot while grocery shopping with two kids in tow. But I digress.

The second piece of content revolves around the results of a survey put out by CDW Healthcare on what clinicians find frustrating about implementing new health IT systems. Surprise, surprise, “too many passwords to memorize” came in at the top, emphasizing what Dr. Rick pointed out in his unrelated blog post.

So what’s a clinician to do? Especially those that work in multiple facilities on different EHRs? Are you like me, scribbling down usernames and passwords on a master paper document, which just screams “privacy breach waiting to happen?” How are vendors helping to address these issues – single sign-ons? Better, overall design? Whose doing it the right way when it comes to designing an EHR, or as Dr. Rick says, designing one “based on what humans are good at — using our visual system to make sense of the world?”

Please let me know in the comments below.