Giving Up on the EHR

Alloy Update #19 – Week of July 20, 2020

Robert Floyd
Founder, Designer
Jul 20, 2020

I’m going to guess that most people who will read this will be at a desk of some kind. It might be a desk in an office (hopefully a home office right now), it might be a table, it may be a counter, it may even be your lap.

Desks are where we get our work done. They are an amazing space that can adapt or change depending on your specific needs. They may have books on them, they may have pads of paper, a mouse and keyboard, a monitor, speakers, or any number of tools for you to do your work. The placement of those tools allows you to access them when you need them.

One thing that I think about when it comes to designing an EHR, is a clinician’s habits and office environment. Many clinicians do have a reserved office with a desk, but the majority of their most important work doesn’t happen in their office. It happens in the exam room, it happens in the hallway. But most importantly, not at a space where they have control. Most exam rooms are outfitted with desks. However, they aren’t a place where a clinician is most comfortable. Furthermore, clinicians don’t feel that their computer is a great place to get their work done. Because an EHR is designed to collect data. Data to get paid, data to ensure meaningful use compliance, data to make sure clinicians are working as much as possible. EHRs aren’t about work, they’re about verifying work.

This is where my point about desks comes together. EHRs are, quite frankly, outdated. Both in execution and our understanding of what they can be. The EHR nomenclature hasn’t even changed since the 90s. It’s time for something new. It’s time for something that speaks to support and empowerment.

For the last few weeks, we’ve been working on some key areas of our app. We’ve been working on the flow of patient information, how a “homepage” operates, and how appointments are managed All of these things are things that support a clinician’s work. However, they aren’t the work.

Let me say that again.

Appointment management, notifications, messaging, patient information, that’s not the work that a clinician does. They support what a clinician does in their diagnosing, their relationship management, their problem solving, their examinations, their prescribing. The work of a doctor is to help people. To problem solve. To listen. Those are things computers are traditionally bad at.

This is why it’s so important to see an EHR as more than just a tool for data. It has to be something that supports a clinician’s work. This is why we’re no longer going to refer to what we’re building as an EHR.

We’re going to call it a HealthcareOS.

A HealthcareOS supports where the work gets done. An OS is a system that supports smaller spaces that are intentionally designed, much like your desk, to support various types of tasks. An OS manages notifications and messages. It supports your focus in the way you want. But an OS still does the heavy lifting. It can run many things simultaneously.

HealthcareOS is made up of what we call “Spaces.”

A Space can be defined by action. I need a Space to manage appointments.

It can also be defined by a thing. I need a Space to manage a patient.

They adapt depending on the context. I need my messages Space while I’m working in my patient Space. Alternatively, my appointments space automatically surfaces the next patient and provides me the overview I need.

Spaces can live individually, or they can be combined to make new ones.

There are still a lot of details to work out but I’m excited about the possibility of Spaces. In the future, we want to be able to define custom spaces based on workflows, tasks, or other needs. But for now, we’ll be sticking with a few preset spaces.

We’re working hard to make our MVP a reality. We’ve got a soft launch date of early September. It won’t be publicly available. But it’ll be available for testing. Much more to come on that soon.

Additionally, I hope to give you a preview of Spaces in the next week or so.

I know I’ve promised designs several weeks in a row now and have yet to deliver on them, however, I’m confident that next week we will.

Until next week, ✌️

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