This is where user-friendliness is a requirement, not a luxury.
Anyone who has ever looked at an EHR/EPIC screen, can tell you that the 1990s Web called, and wants its tables and frames back.
In fact, one doctor I went to, still ran Windows 95 (in 2009), because they didn't want to deal with new interfaces.
Engineers are notoriously unsympathetic to usability and simple GUIs, but I have found them to be an absolute gold mine, if you want people to actually use your product. Apple and Google are trillion-dollar companies, now, mainly because of their simple, usable UX.
Simplicity and usability are not the same thing.
On one hand you have massive GUIs spanning the whole screen containing hundreds of controls. On the other you have airy GUIs with more empty space than actual content and every time you want something you have to open 3 layers of menus to find it.
Both are wrong. The correct thing is to find a balance. The balance depends on the usecase as well as the users.
This is what makes it hard. You can't just code up an app and throw is over the fence. You have to actually engage with the users, watch them perform their work, even try it yourself. You have to understand what is important and what is a distraction. You have to understand when these things chance. And you have to understand that beginner users evolve into experts all the while you have new beginner users coming in.
The principal-agent problem means usability isn't actually a deciding factor. Business users might prioritize that but the buyers (C suite) choose on ROI and metric
This is actually not unique to healthcare (see others above posting about Learning Management Systems and Workday). As a result, most enterprise software across verticals is similarly dated. Some research here: https://open.substack.com/pub/healthapiguy/p/there-will-be-b...
I can't quite tell if you are saying the tables and frames are a better UX than Apple and Google. Personally I find frames and tables far more user friendly than the constantly shifting and indecipherable UX that Apple forces on us with updates.
Well, it doesn't matter what you or I think of it. It does matter, however, what a doctor thinks of it.
As the other comment pointed out, it's a balance. Simple is not the same as user-friendly, but they live on the same street.
Doctors routinely deal with concepts that would confound me, but they are often quite technophobic, when it comes to computers. I have a friend that's a really skilled anesthesiologist, and is constantly asking me the most basic questions about his iPhone.
Complex interfaces can be trained, but the magic is to have an interface that can be explored. If you train someone on rote, then they go to pieces, when anything changes.
However, if you give them an interface that doesn't penalize them for exploring, and has clear, unambiguous affordances, they can easily adapt to things like updates, and they won't force you to have to maintain an ancient UX.
But designing that kind of UX is quite difficult, which is why so few people do it.
How do you know I'm not a doctor?
HTML forms are a metaphor for literal paper forms. They don't have to be complex. One of the forms in the EHR system I am familiar with uses a stick figure layout. So if you are making notes on the left leg you just type it in next to the left leg. I don't see how this is difficult.
Meanwhile I can't figure out how to get my iPhone to show me what photos I took in the park by my house and every setting change involves consulting a web search or LLM.
nah
I maintain my emacs config
the problem is if someone changes something, that immediately impacts my efficiency which slows me down, then the patient's are pissed, and the administrators are too (which is ironic since they're the ones who signed off on the change)
It has to be rote, no time for exploring
Eh. Whatevs. We look at things differently.
No big deal.
TBH, yes it's a big deal. You correctly identified that docs are especially good at rote memorization. I always thought that this calls for a drastic revamp of accepted UI principles. You would usually design to group things logically, conform to an assumed user story and design around it. Well, docs have exactly one single UI priority: speed. They'll adapt easily to having a thousand infos on the same screen, given time to learn the location of each of those. They'll never adapt to deep menus requiring 10 clicks to reach a form.
I was just saying I won't argue about it. I haven't done UI for medical records software (but some for imaging).
Not really my wheelhouse.
The problem is a bit more complex than just UX from my experience. It's not as if the people designing these portals are going out for their way to make it user unfriendly, it's that the underlying data model all these hospitals use for their EHR is usually completely insane.
Hospitals were among the first to get "computers", I'm talking the big mainframes and such that used to be popular in big institutions & universities. On these systems many hospitals each individually hired programmers to construct custom databases for their record keeping. While most have by now have transitioned into a more standardized structure, like HL7, the original sin has carried forward enormously bizarre data structures that make you wonder if the designers were deliberately trying to sabotage the possibility of good software in the industry. I can't think of a better example of why you should never design by committee.
Yet in parallel to all this, capturing medical data is already hard. Doctors are most comfortable just writing notes freehand, recording the patients current state, notable observations, treatments and so on. When modeling this it becomes very tricky because you basically need a proper medical background and be a good at data modeling / programming. This kind of person is basically a unicorn in the industry everyone wants but can never get.
Consider, just for a moment, all the complexities that come with dealing with the thousands of different units and their conversions within the industry. Some doctors don't even use the same units for certain measurements, entirely out of personal preference. Then remember that measurements are the easiest part of the system to model, even what should be the simplest part of the entire thing is hard. Also yes, you will have to re-write all this from scratch, there is no special library or open source software to help. Everytime someone makes tools for this they keep it proprietary.
But that's just the tip of the iceberg, to really get an idea of what I mean, just look at HL7. It's basically a data format that is like a cursed csv with about 5 layers of deliminators for nested entries, since all hospitals like to be super special, the specification tries to be "flexible", so what exactly these characters are is not actually standardized! It wasn't enough for HL7 to just be a data model, they needed to violate a few OSI layers and interlace it with the transport protocol too!
So in essence you must establish a bizarre handshake on top of tcp to learn what the hospitals super special configuration of the standard is, the very syntax itself! Worse, 90% of it is the same for all hospitals but the 10% that isn't is entirely unpredictable!
Then you have the actual data model itself, like demographics, lab records and so on. They change the specification every few years! You need to support it all since this committee of monsters don't seem to care much about the migration path! All the changes they make seem pretty arbitrary to me but what do I know?
I'm still only scraping the surface here but my exposure has been limited to what I do, which was processing all this from the perspective of a medical device that only needed to deal with a subset. When I imagine the struggle one would have with actually dealing with the entire thing holistically I feel empathy and a desire to never have their job.
It's like building a house on top of an active volcano. Any illusion I had that my medical records could be used for anything other than basic notes for another doctor to read have long since shattered, because clearly that's how all of this mess is actually being used in practice.
Oh and don't forget HIPPA! Even when you roll up your sleeves and try to fix the problem, you learn you aren't even allowed to thanks to the governments overbearing regulations against using medical data for things that could help society. Wish they just made it a crime for insurance companies to use instead of whatever this is.
The fact any of this works at all is a fucking miracle honestly.
Like I said, it's not easy. I've made some big screwups in "easy" UX. I have the scars to prove it.
Interoperability is also one of those "holy grail" things that is really hard.