Is Your EMR Too Nerdified?

William HymanWilliam A. Hyman
Professor Emeritus, Biomedical Engineering
Texas A&M University,
Read other articles by this author

A common complaint about EMRs is that while they might have technical capability, they might not have real world usability, or be “user friendly”. Thus, you might be able to enter A, B and C; but finding the previous values of A, B and C might be challenging, and seeing the history of A, B and C might not be possible. As I sat in front of one of my medical providers recently, who is a late and reluctant convert to EMRs, he created an on paper list of my previous values as he inefficiently hunted through my now online history. And unless he types them back in in a single place I expect this to be repeated at my next visit. Worse of course is when the EMR hides information that may lead to actual harm to the patient.

In this context, you may recall that back at the beginning of August a Google engineer took some heat for expressing the opinion that women were biologically unsuited for software development because they “had a stronger interest in people rather than things”. The movie Hidden Figures about NASA’s women (and African-American) coders was in commercial release at the time, but perhaps the engineer was not a movie goer for related stereotypical reasons. Putting the sexism aside for now, let’s just assume we can divide people into antisocial coders and those who care about people. In this regard, you might want to remember that you yourself are a person and that you might benefit if the products you use were created by people who actually cared about you. This distinction reminded me of a start-up conference I went to in which job-seekers were advised to not admit they had any hobbies because their potential employers only wanted workers who had no other life than working on the product.

In an interesting NY Times article of August 13th Claire Cain Miller did a good job of explaining that the loner (male) nerd programmer stereotype has serious flaws even conceptually, even if it has a measure of truth with respect to who is currently doing programming. This reminded me of the early days of imbedded medical device software in which the programmer was stereotyped as someone in the backroom living on snack cakes and soda who you didn’t want to talk to unless absolutely necessary, but who would eventually produce some indecipherable but more-or-less useable code for which you could then right the specifications.

Ms. Miller pointed out that interpersonal skills like collaboration, communication, empathy and emotional intelligence might be of great value in creating products that actually meet the needs of the real people that have to use them. The exclusion of such attributes has resulted in part in those perceived as having these skills working on the user interface rather than the underlying code. This may sound good until you read that the user interface designers are disrespected in the industry as reflected by lower salaries and the belief that they are less intelligent. Thus, the stereotype and the underlying reality might deter talented people from wanting to be part of a tech industry that currently rejects them. In turn, this perpetuates the narrowness of the profession.

Teamwork itself may benefit from interpersonal skills and diversity of thought. And the loner nerd stereotype, which may have been reinforced while growing up and in college, might not match what the real workforce needs in order to produce systems that people enjoy and benefit from using. In my days as an engineering student, and later as an engineering educator, there was emphasis on teamwork but it was also noticed by some that our teams consisted of people who were all pretty much as driven by the narrow range of experience and age group we represented along with the lack of social diversity in most engineering programs.

As with all generalizations there are exceptions. Ms. Miller cites the iPhone as a product that has excelled at both meeting user needs and creating those needs (except perhaps for certain old curmudgeons). Is there an EMR that is equally beloved?