5 ms·

Disclaimer: My Epic experience is around a decade old. I never saw a riot, but I definitely saw providers who hated Epic when it was installed. As in people li

Disclaimer: My Epic experience is around a decade old. I never saw a riot, but I definitely saw providers who hated Epic when it was installed. As in people literally screaming at the top of their lungs at IT nerds. I saw a few contributing factors: 1. Epic supports making all the technically-mandatory-but-not-mandatory-if-you're-in-a-hurry data actually mandatory, so providers have more typing and less ability to just get stuff done when needed (which minimizes agency). 2. Related to above, Epic will make the updates for any new regulation, which increases the amount of data providers need to collect. 3. The customizability of the Epic UI and workflows for each type of visit was completely insane; many permutations of steps in a visit had to be supported which meant a huge maintenance surface with ok coverage rather than an opinionated workflow for each visit that could be optimized and improved over time.

PubliusMI 4y ago
>technically-mandatory-but-not-mandatory-if-you're-in-a-hurry :/
- meandthewallaby 4y ago
  In my experience, the software development profession could spend a long, long time doing some self-reflection about this one. It's eloquently stated, and something a lot of developers could learn. Too many times, I've seen overly restrictive inputs cause users to hate and distrust the software. Ironically, overly restrictive inputs cause users to think that the software doesn't properly understand the domain, which is the root of mistrust. We should be very liberal with accepted inputs. I call them "Fuck It Buttons." There are lots of cases where you want a "Fuck It" button to just go around all the data entry and get an answer or move on with minimum info. Warn that the data isn't complete and we're using defaults, and don't just make output look the same as a complete workflow, but let them go through, nonetheless. Health care is just one example, but "Fuck It" comes up in every industry. This is the UI/UX equivalent of knowing which hills to die on.
  - emmelaich 4y ago
    I agree! But what would you put in the database? A NULL? A special fuck-it value?
    - npongratz 4y ago
      A trigger on a timer that notifies the fuck-it-provider (email, calendar entry, text message, whatever) that they need to go back and enter a value.
      - hunter2_ 4y ago
        Honestly this sort of deferred validation exists as a standard feature of certain modes of data intake that are often criticized for same, for example paper forms (the "required" fields can be left blank), or creating support tickets via email (required fields stay null until an agent updates the ticket via web UI). At some point additional round trips may occur to pay back this debt, but debt is a powerful tool for that person in the field who needs to move onto other things until the dust settles and they can pay it back.
        pmontra 4y ago
        Paper forms can be filled in by different people with different roles at different times. Customers can fill in their personal data and possibly leave blank something they don't understand. A clerk can review the form, ask the right question and fill in the missing field plus the remaining ones. "Fill in what you know and leave the rest to us" is a simple and cheap to implement GUI compared to a full fledged workflow. It could bootstrap a process quickly at the cost of some extra labor in the customer facing department. Maybe they have that extra bandwidth and the sw developers don't.
    - meandthewallaby 4y ago
      Like with most things, it depends! Maybe it's a default value; maybe it's a null; maybe it's a special value that triggers a workflow on insert. I'm an evangelist for RDBMSes, and they can do so much, so let them help you! Maybe you have a state column that's derived that you cannot move to another step in the workflow until all nulls are filled in, but you've let the UI save what data it knows about and move on. It totally depends on what the user is doing and why we're skipping steps/data.
- wccrawford 4y ago
  Right? When aren't medical professionals "in a hurry"? They've always got a ton of things to do and not enough time for all of it.
- devilbunny 4y ago
  It happens in hospitals. Treat the human first, treat the chart once they're stable. Speedbumps in the process are fine, because we shouldn't be bypassing protocol all the time, but flat-out roadblocks aren't, because sometimes we really don't have time to worry about all that.
emmelaich 4y ago
Interesting, because I think enforcing an opinionated workflow would be a similar mistake to enforcing mandatory requirements. There should be some flexibility in both.
rsynnott 4y ago
> The customizability of the Epic UI and workflows for each type of visit was completely insane Ah, Lotus Notes Syndrome.

PubliusMI 4y ago

>technically-mandatory-but-not-mandatory-if-you're-in-a-hurry :/

meandthewallaby 4y ago
In my experience, the software development profession could spend a long, long time doing some self-reflection about this one. It's eloquently stated, and something a lot of developers could learn. Too many times, I've seen overly restrictive inputs cause users to hate and distrust the software. Ironically, overly restrictive inputs cause users to think that the software doesn't properly understand the domain, which is the root of mistrust. We should be very liberal with accepted inputs. I call them "Fuck It Buttons." There are lots of cases where you want a "Fuck It" button to just go around all the data entry and get an answer or move on with minimum info. Warn that the data isn't complete and we're using defaults, and don't just make output look the same as a complete workflow, but let them go through, nonetheless. Health care is just one example, but "Fuck It" comes up in every industry. This is the UI/UX equivalent of knowing which hills to die on.
- emmelaich 4y ago
  I agree! But what would you put in the database? A NULL? A special fuck-it value?
  - npongratz 4y ago
    A trigger on a timer that notifies the fuck-it-provider (email, calendar entry, text message, whatever) that they need to go back and enter a value.
    - hunter2_ 4y ago
      Honestly this sort of deferred validation exists as a standard feature of certain modes of data intake that are often criticized for same, for example paper forms (the "required" fields can be left blank), or creating support tickets via email (required fields stay null until an agent updates the ticket via web UI). At some point additional round trips may occur to pay back this debt, but debt is a powerful tool for that person in the field who needs to move onto other things until the dust settles and they can pay it back.
      - pmontra 4y ago
        Paper forms can be filled in by different people with different roles at different times. Customers can fill in their personal data and possibly leave blank something they don't understand. A clerk can review the form, ask the right question and fill in the missing field plus the remaining ones. "Fill in what you know and leave the rest to us" is a simple and cheap to implement GUI compared to a full fledged workflow. It could bootstrap a process quickly at the cost of some extra labor in the customer facing department. Maybe they have that extra bandwidth and the sw developers don't.
  - meandthewallaby 4y ago
    Like with most things, it depends! Maybe it's a default value; maybe it's a null; maybe it's a special value that triggers a workflow on insert. I'm an evangelist for RDBMSes, and they can do so much, so let them help you! Maybe you have a state column that's derived that you cannot move to another step in the workflow until all nulls are filled in, but you've let the UI save what data it knows about and move on. It totally depends on what the user is doing and why we're skipping steps/data.
wccrawford 4y ago
Right? When aren't medical professionals "in a hurry"? They've always got a ton of things to do and not enough time for all of it.
devilbunny 4y ago
It happens in hospitals. Treat the human first, treat the chart once they're stable. Speedbumps in the process are fine, because we shouldn't be bypassing protocol all the time, but flat-out roadblocks aren't, because sometimes we really don't have time to worry about all that.

emmelaich 4y ago

Interesting, because I think enforcing an opinionated workflow would be a similar mistake to enforcing mandatory requirements. There should be some flexibility in both.

rsynnott 4y ago

> The customizability of the Epic UI and workflows for each type of visit was completely insane Ah, Lotus Notes Syndrome.