This article hits home for me. I work on an EHR, a system very similar to Epic. We talk about this stuff all the time. There are a lot of breakdowns that can result in a situation like the one described in the article.

Simply redesigning the UI can be a fool's errand when you don't know the system architecture and business goals. A lot of these systems (including the one I work on) are legacy systems with layers and layers of different code stacks, APIs, databases, etc. that results in a house of cards. Or you have a tech stack that's so old, all the people who worked on it are gone and newer engineers don't even want to touch it in fear of breaking everything.

For enterprise healthcare systems, like Epic, the UI can become an amalgam of shit because competing functional teams at the hospital vie for competing needs. And then the people who actually use it (i.e., nurses and doctors) are stuck trying to use a broken UI.

For ambulatory systems, like the one I work on, the perception from customers and companies is that the product must bundle with 100+ functions and features that no one will use. The more features, the better. This makes sense intuitively but it usually results in common usability problems with navigation and discoverability.

Health systems are starting to wake up though. I'm inspired by ListRunner which helps doctors track their patients. It's a focused, single-purpose mobile app that doctors actually like using. I'm hoping we start to see more of these unbundled style healthcare apps. There's clarity and power in a focused experience that's separate from the main EMR system.

Very timely read as I just began a project in the medical field.

Anyone know of other good web / app designs for this industry? Please share.

I must start by saying that the title feels a bit sensationalist. I know you probably didn't mean it that way, so I'd rather focus on the topic you're talking about, which is of prime importance.

I find it very frustrating that the most critical systems are usually the ones with the poorest design: health, air & space, online banks and ATMs, cars are all areas where the UX seems to be traditionally in hands of engineers. I'm not going to blame engineers for situations like the one you describe, but I've had some experience trying to be the UX guy in teams and big organizations that are led by engineers and could say that in most cases the main concern for them is to make the things work.

Things like CapitalOne acquiring Adaptive Path seems to be a good first step to change this paradigm, but of course, that's only one case.

Jonathan, thanks for sharing. Agreed with how heartbreaking the UI is for mission-critical systems.

I admit I have a hard time with your conclusions, though: as far as unsolicited redesigns go, we need fewer of those in the world, not more. I can't condone spec work and as bad as those UIs are, without an intimate understanding or appreciation of both the user needs and business objectives, we can't possibly claim to know which insights should inform our design decisions.

Stated differently: without data, we're talking decoration, not design, no matter how pretty it looks.

Theres a lot UX problems need to be solve in healthcare industry. I'm currrently working for a startup that builds app for doctors to use.

Bad UX permeates even the most basic functions that nurses perform every day. Here's a piece of anecdotal evidence:

Just last week I was talking to two RN's, from two different large and busy hospitals, who both shared very similar experiences of nearly losing a patient in the same way.

The problem was, when a patient was sitting up, and suddenly they needed CPR (for two different reasons), neither of them could find the button to flatten the bed out quickly, both had to resort to the slow and steady motorized lowering of the bed whilst their patients were suffocating. This button is rarely needed, but in those moments, seconds spent missing the right button and waiting for the wrong button can mean the difference between life and death.

It's the difference between this potentially bad interface and this slightly better interface.

It's a very simple example of potentially dangerous UX, but the idea is the same. When lives are on the line, somebody should be caring more about the end user (doctors, nurses, pilots, refinery operators) and making their job easier.