Part One: Immediate Adaptability (IA)

This is Part One of the 4-part series, Immediate Adaptability.

Part One: Immediate Adaptability
Part Two: Objections to Immediate Adaptability
Part Three: Functional Specifications of IA Clinical Information Systems
Part Four: A Generic Architecture for IA-CIS – Refactoring the EMR Model

One of the major themes on the AMIA Implementation List is the need for better user interfaces, often couched in calls for more Usability research. There is much reference to the academic usability research and its failure to impact delivered products rolled out by the vendors. The vendors themselves are variously reported as claiming it is not needed, too subjective, too theoretic, already achieved by customer feedback, or they are doing it anyway.

A major debate at ACMI focused on academic research in usability. It was agreed that academic usability research has paltry penetration into vendor products. Furthermore usability research at one point in time can become moribund or irrelevant because technology itself moves on or the context of use of the vendor product changes while it is in situ, e.g. work practice changes due to new medical practices, government legislation, new medications, changing populations and disease profiles …. The Implementation List is replete with examples of complaints from physicians that they cannot get requested/required changes to their user interfaces because the vendor will not accept the changes or it will take inordinate amounts of time to make the change (IV excepted, because he has control of his interfaces since he works with the VA system).

We all understand that vendors are reluctant to make changes because it increases their cost of maintenance, potentially increases the complexity of their product, and the financial reward to them is insufficient to motivate them.

Complaints about the usability of interfaces on the Implementation List don’t address the functional behaviour required of the software needed to resolve these complaints, that is, the software isn’t:

1. Adaptable, and,
2. that adaptations can’t be made immediately, that is within the next few hours, days or weeks, but not months or years.

In its most simple and direct incarnation they are asking for “Immediate Adaptability” of the software.

Part One: Immediate Adaptability
Part Two: Objections to Immediate Adaptability
Part Three: Functional Specifications of IA Clinical Information Systems
Part Four: A Generic Architecture for IA-CIS – Refactoring the EMR Model