The Disconnect between Doctors and Software Designers

Doctors are asking Silicon Valley engineers to spend more time in the hospital before building apps

• Richard Zane, an emergency room physician, developed a program so that engineers can understand the clinician's workflow before they build their products
• RxRevu is one start-up that shadows Zane on the job.
• In the Bay Area, it's become common for doctors to invite technologists from Google and elsewhere to follow them on the job

As an emergency room physician, Richard Zane often considers how software can help him with patients. The problem is that engineers and doctors are from different worlds.

Zane, who's also the chief innovation officer at UCHealth in Colorado, said that most technologists he's met have never seen the inner workings of a hospital and don't have a deep understanding of what doctors want and need.

"We found that tech companies more often than not had a preconceived notion of how health care worked," Zane told CNBC. They've "gone very far down the path of building a product" without that input, he said.

Zane decided one way to bridge the gap was by inviting in developers from companies to see how he works. For now, that involves monitoring how he uses computers and other software tools to document and make decisions, but keeping them out of the operating environment and away from patient information.

Start up developers are much more inclined toward working with doctors one on one, with their efforts to build better software by attending clinics and surgery to observe.  One possible barrier to this is HIPAA which requires additional permissions and a business associate agreement. Established companies such as EPIC,  CERNER and others have little to gain since they have a huge market share and little motivation to improve their product(s).

Epic Systems, the largest privately-held medical records company, reportedly sends its engineers along to open heart surgeries so they can see how important it is for their software to function in critical situations. Even so, many doctors see plenty of room for improvement when it comes to Epic's user experience.

Physicians need more from their software. In general, they're spending less time with patients, and more on so-called desktop medicine, which involves hours of documentation in front of a computer after a long day at the clinic. Studies find that so much time on administrative tasks related to things like billing is contributing to increased levels of physician burnout.

Zane wants better technology, built with an understanding of how doctors work.

'Your engineers, my clinicians'

Carm Huntress, the founder of a start-up called RxRevu, shadowed Zane and is applying what he learned.

RxRevu, based in Denver, worked with the hospital on a service to help physicians figure out how to prescribe better. The company's software aims to quickly figure out whether certain drugs will interact negatively with each other, if a patient is allergic to a medication or if insurance covers a specific drug. The goal is to help doctors have informed conversations with their patients about their options.

Huntress said one thing he noticed in observing doctors at their desks is that many automatically move their mouse to delete a notification before reading it. He could tell that clinicians were suffering from alert fatigue and might be missing out on important information amid all this noise. Doctors work extremely long shifts and see dozens of patients, so they need to avoid anything that's even more "taxing on their brain," Huntress said.

Despite more than ten years of criticism by users of their software systems, little has changed....

Burnout and satisfaction with work-life balance in US physicians worsened from 2011 to 2014. More than half of US physicians are now experiencing professional burnout.



Doctors are asking technologists to shadow them before they build apps: Doctors have had enough with software that's not useful, so they're inviting entrepreneurs to shadow them.