This research is set within the UK medical speciality of Integrated Sexual Health (ISH), which is concerned with the prevention and treatment of sexually transmissible infections (STI) and blood-borne infections (BBI), and the provision of contraception. ISH is typical of most outpatient specialities, relying heavily on the clinician's interpretation of both subjective and objective patient data. This is whole-heartedly 'use-inspired' research (Stokes, 2011), deeply rooted in the reality of everyday clinical practice.
Clinical usability (CU) can be defined as ‘the extent to which a product can be used by clinicians in their practice with effectiveness, efficiency and satisfaction.’
The rationale for this research is unequivocal: clinical usability should be the primary, shared horizon that unifies all disciplines within the EHR interface design community. Focusing on this singular goal of clinical usability leads to the natural alignment of many secondary ones. It is not a radical rationale, merely one that signals a return to design's fundamental, time-honoured tenet of user-centredness.
Ironically, even though clinicians are the EHR’s primary users, they are a poorly understood—and therefore marginalised—group in the field of EHR interface design.
It is not so much that clinical practice is complex (flying a plane is complex but cockpits are the epitome of user-centred design) but more that clinical practice is opaque. Perhaps designers have an instinctive understanding of what it is to be a pilot (gravity, speed and direction), less so to be a clinician (chemistry, biology and physiology).
This research redresses this inter-disciplinary imbalance, with a clinician community’s worldview defining its purpose, scope and approach.
The objectives of this research are to capture, codify and communicate clinical usability knowledge in a way that resonates with, and can be situated within, the frameworks, theories and practices of those disciplines that design EHR interfaces. This knowledge is not easy to elicit by conventional means—it can be at the same time explicit, tacit, experiential and even haptic.
The overarching ambition of this research is to re-frame EHR interface design as less of a 'wicked problem' (Rittel and Webber, 1973)—defying any standard attempt to find a solution because of multiple, contingent and conflicting issues—and more as a talented design collective waiting for meaningful and informed collaboration with clinician users. It is an effort to demystify how clinicians think, and a declaration that this clinician community—like so many others—would like to be part of a truly trans-disciplinary community.
Rittel, H. W. J. and Webber, M. M. (1973). Dilemmas in a general theory of planning. Policy Sciences, 4 (2), pp.155–169.
Stokes, D. E. (2011). Pasteur’s quadrant: Basic science and technological innovation. Washington D.C., USA: Brookings Institution Press.
Whyte, D. (1997). 'Start Close In'. In: The house of belonging. Langley, WA, USA: Many Rivers Press.
