Those Small Irritating Things

That can become BIG and UGLY in your EHR

I was playing around with Microsoft’s on-line personal health record, Health Vault, yesterday and it reminded me of just how BIG a seemingly small thing can become. In the case of Health Vault, the “small irritating thing” is their entry methodology for date of birth. Let me explain:
Heath Vault will let you enter Family Medical History by entering the individual’s name, condition, date of birth and, if applicable, date of death. The “small irritating thing” is the format of the date of birth (and death) entries.   There is no guidance provided – only a small button in the shape of a calendar.

So I click on the button and it is a calendar that defaults to today. Cool!

Ok, how do I get to my mother’s birth date – in April 1936? There’s a back arrow (<) on the calendar that I can use. Great!

Wait a minute! How many times do I have to click to get from January 2009 to April 1936?
You don’t have to be a genius to figure that one out. There are 72 years and 9 months between now and April 1936 – my mother’s age. Multiply the 72 years times 12 clicks to get through all the months in each year and you get 864 clicks. Add the extra 9 months and I get to click 873 clicks!

Do they have the << that allows you go back a year at a time? No. But even if they did that would still be 81 clicks (72 plus 9).

Will it let you enter the date yourself? Turns out that it will – but there is no indication in the system that you can do this or what format it will accept. With some trial and error I was able to determine the format and enter the date. Yeah!

I still spent several minutes figuring out this one item. I continued to enter data into Health Vault and found this date problem was not an isolated issue – there are many other usability problems. To be fair to Microsoft and the developers of Health Vault it is a Beta product and clearly labeled as such.

The question is – How many EHRs have similar usability issues but aren’t labeled as Beta? How will you know before you’ve bought it and it’s too late?

Here is my suggestion:

Do not judge the usability of an EHR by the standard demo alone. Anyone who knows their way around the product knows the “work arounds” and the areas to avoid so the product looks easy to use. Even other users of the product may not be as helpful as they could be because they have become used to the usability issues. If you used Health Vault every day you would discover the date work around and entering the date in the proper format would become so second nature you would probably forget about it over time.
So what to do? Get a demo where the vendor will turn over control of the system to you and let you try data entry and navigating around the system. Many vendors will resist, citing the need for prior training. But isn’t that the point? Shouldn’t the EHR’s basic navigation and standard be such that you could at least accomplish some basic navigation and entry without training?

Catherine Huddle, VP, Market Development