EHR Airport Control Towers, Automobile Engines, And Aviation Cockpits: Analogies & Metaphors

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We’re going to talk about visibility. Before we talk about the relationship between customizable workflow, workflow engines and task visibility, we need to lay a little bit of groundwork. 15 years ago, at HIMSS in Atlanta. HIMSS00 at AT., this was one of my presentations and was called Workflow enabled CPRs. This is even before people called systems electronic health records or electronic medical records, these were computerized patient records. In the middle, you have that engine that I’m talking about, the engine that consumes instructions. Over on the right, you have the aviation cockpit. I spent a year in aviation human factors at the University of [inaudible 00:08:54] and I graduate a degree in Industrial Engineering, one of the top programs in the world.

I learned about Fitts’ law and Hick’s law. Fitts’ law is the larger the target is, the larger a button is, the easier it is to hit accurately and quickly. Hick’s law is the number of options on the screen. The fewer there are, the more likely you can select the right one. It’s the job of the workflow engine consulting the workflow model to put the right buttons on the right screens and to filter out all of the extraneous, irrelevant content. If you don’t have that workflow engine, you get an explosion of the space you have to search in order to figure out what to do next.

Even if you have a workflow engine and you have a user customizable and improvable workflow model that’s being executed, sometimes tasks still fall between the cracks. Over on the left is the control tower of an airport. In that tower, you have what the usability engineer calls a ‘radar view’. You can see all of the patients and all of the planes, how long has they been waiting in their exam rooms on the runways or stacked up. You know how many minutes of fuel they have left. You can note exceptional circumstances and jump in there and fix them so that maximized throughput, while preserving safety. That’s actually called BAM or business activity monitoring in the business process management world, which I’ll go talk about briefly at the end.

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