As someone who worked at a fortune 500 company making such EMR software: There's no incentive to …

This is so broken and depressing. I had a tour of the EMR system being used in my jurisdiction and it was shocking how bad the UI/UX was. The scenario you describe is exactly what I imagined. As a software developer I feel so motivated to fix it, I know a small team could do a better job. But I don't even know where to begin to try to enter that industry.

100% this. EHRs almost universally suffer from usability problems. people actually love having their medical records available. They hate the UX they have to go through to see them. The source of the problem is that the people deciding which EHR to use are almost never the people using it. it’s ultimately the CFO or CEO who’s ultimately going to make the call, and they do it based on metrics like price tag or how many accreditation checkboxes it fills, not on user satisfaction scores. Until those user satisfaction numbers make it into CMS guidelines for reimbursement, the situation’s never going to change.

It's not just EMR, it's just capitalism in general. Everything is about squeezing the most value out of the least budget. If there was a way to factor in costs due to downtime, poor usability, anything like that, might be able to push back and bake some of that in to begin with... but even that is a can they'd kick.

I agree. I also worked on EHR software and what people don’t realize is that the “customer” isn’t the doctor. Not to be disparaging, but the doctor is “just” an employee. The purchaser of the software is the administrator. And because of harsh regulations and legal liabilities in their industry, they need software that is compliant with regulations and limits legal liability on the institution. Full stop. If they can get that with a good UI/UX, then great! But in the end, this is just another case of “No one ever got fired for buying IBM”. It is all about incentives. Companies like Epic could make their UX better, but that costs money. And what drives sales is being regulations compliant, and that is hard. It takes a ton of time. There is little time left over to make something work well considering no other software is challenging them on that front. It really is a situation of regulato…

As someone with a similar working background, I agree, in fact, I wanted to share this same exact sentiment. The software is shit, and everyone knows it how it's shit, and the reason is that the incentive is not there to make it not-shit. The main users, and the people who they record, are not the main concern in these systems. That is why everyone feels bad while using the software. It's not about them, it's not for them. It's not even against them - it just doesn't care. And this really radiates from the UX.

I worked on EMRs for 20 years. I recently quit that sector completely, and I wish I would have done it sooner. Almost all of the features/fixes customers are actually begging for (the most popular categories being speed, reliability, reduced cognitive load and UI/UX streamlining) get dumped into the bottom of the backlog to languish. All the board and leadership care about is RCM, stupid ancillary services that patients do not give a shit about but look good in a sales brochure and have a high margin, chasing incentives from insurance and pharmaceuticals, cost cutting, and last minute, bare minimum regulatory/interop work necessary to not lose our ONC certification or violate HIPAA. Patient care and staff happiness just don’t rate that high. EMRs and the people who buy them are purely profit motivated. It was humiliating watching how angry our customers rightfully have been and knowing t…

See also the current HR story on Intel [1]. >biggest and most well funded dev team was the one that worked on Revenue Cycle > no incentive to... I am working hard to not build and fuel a fully loaded Boeing 787 into high-earth orbit and crash land it on the not-my-problem, told'ya, it's all corrupt-all-the-time, MONEY! money-is-the-measurement-of-all-things, it's bad-here-so-I-left city center fecklessness of it all. Toyota at its peek performance (say late 1980s) was making king-kong sized money top and bottom line. No manager would ever say their only incentive or even primary care is cash. "Our only incentive is walk around with cash. Cash in the hand, cash in the brief-case, cash in the pocket, cash on the boss' desk. Show me the cash." has never spoken in companies knowing about TQM. Instead there were aware of the numerous cross-cutting factors that, in net, determine what kind the…