Interviews

My main user research method was semi-structured interviews (Martin & Hanington, 2012).

Wherever possible, I interviewed face to face. However, due to location, some interviews were via Skype or phone call - whatever was convenient for them.

All of my interviews have been confidential - all of their names have been changed, and any information that could identify them has been removed. This was to ensure they could be completely honest, without concern of our discussion impacting their lives.

The interviews were semi-structured, I had a list of questions which were designed just to be talking points - my main interest was to find out as much about them as I could, particularly things I would've never thought to consider. For each person, I did background research and tailored the talking points to fit.

I was willing to interview anybody who had experience or knowledge about medical software in NZ. This ended up being a fascinating interesting mix of people, from daily users such as GP's and Nurses, founders of healthcare software companies, to the highest level of healthcare management in the NZ Defence Force. My goal with these interviews was to find topics and points I wouldn't have found otherwise, and I certainly succeeded.

I had the pleasure of interviewing some very interesting people, and I would like to thank them again for their time.

Olivia arrow_forward

Managing nurse at large community clinic

Key takeaways

Paul arrow_forward

Possibly the remote GP in New Zealand

Key takeaways

Michael arrow_forward

Founder of healthcare software company, with a background in psychology.

Key takeaways

John arrow_forward

John is in charge of the entire New Zealand Defense Force's healthcare.

Key takeaways

Will arrow_forward

AI powered EHR systems

Key takeaways

Bryan arrow_forward

The process-obsessed GP

Key takeaways

Survey

As additional user research, I had the opportunity to send an email survey to a GP ICT research group, run by The Royal New Zealand College of General Practitioners. This group was around 85 NZ GPs who had self-selected that they had an interest in Health IT, and out of that, I had 19 responses.

The survey was a short five questions, as I was advised that GP's get many emails. I focused on open-ended questions, about their likes, dislikes, wants, and other thoughts. As I knew the individuals were all GP's, the survey was anonymous (Martin & Hanington, 2012).

Below is a thematic analysis (Guest, MacQueen, & Namey, 2011), or you can view all the responses here

Common Themes

The single largest theme evident was a latent dissatisfaction with MedTech32, which was used by the large majority of respondents. There are two sub-themes within this.

Slow Performance

Slow performance was a major complaint, and the effect it has on patient outcomes. Web-based plugins and integrations were specifically mentioned.

"1. I work in a large practice (30 gp's) and it takes a long time no less than 6-8 seconds per item to prescribe a medicine when I press the F10 button
2. Web enabled forms are great but in practice slow down our workflow..."
"Today for instance, I had the plug-in web based applications non functioning. This results in a few minutes of wasted time per time of use. Sometimes more than one incident per consultation. These were ACC forms and lab request forms. Yesterdays problem was the prescribing assistance for Pradaxa hanging for 5 minutes. Many of my colleagues are not prepared to wait this long, crashing out of the patient medical record system and writing prescriptions by hand. Hence the drug with high risk of adverse effect if not properly monitored does not appear on the electronic medical record at all."
"Often...when it runs too slowly or its association with other systems (eg Best Practise, healthpac) make the system run even slower / don't work at all."
"Lots of add ons which slows software"
"it runs too slowly or its association with other systems (eg Best Practise, healthpac) make the system run even slower / don't work at all."

Poor Customer Support

Many were dissatisfied with how the company responds to customer requests.

"When we changed hardware Medtech threw up a lot of error messages; it took a long time with escalation of enquiries at the support desk to realise that there was a very quick fix. The error messages and numbers were of no use to identify this problem"
"I basically hate Medtech their support is appalling..."
"There were drug transcription errors in GP2GP notes transfers which could have had serious consequences for the patient and Medtech were very slow to sort (them) out"
"It is a dinosaur system and the developers have been sitting on their backsides because of a lack of decent comptitions"

Simplicity and Familiarity

However, MedTech's simplicity and familiarity was appreciated

"Medtech is slow and old but it is familiar and very reliable."
"Relatively intuitive - not complicated to use."
"It works most of the time. Easy to use basic functionality. However, there is no advance functionality beyond that. The system has not changed significantly since introduction 15 to 20 years ago"
"I know it, and used it for years, it is all simple. Other than hiccups on a single PC the system is stable. Locums and all new doctors and nurses have used it before. But I wouldn't say there is anything really useful about it."

Features to save time

I asked GP's what features they would want to add to their software - a common theme was time-saving features.

"I would love to able to tick a combination of typically used medicines to facilitate easier / faster prescribing."
"Have the ability to add "auto complete" PDFs by the practice its self"
"More electronic forms rather than having to print out paper ones, integrated best practice guidelines to assist with management"
"speed, format of consultations "
"Make it all one sign on and password, not several. Make it one tab/drop down not multiple entry points."

Features to improve patient outcomes

In addition to that, many suggestions revolved around patient outcomes.

"Addition of learning or evidence topics in the workflow of the EHR and gantt chart of medication use"
"Have a field to show when patient demographics were last updated and a prompt to check if not up to date. Similar prompts would be helpful for long-term medications and "classifications" (problem lists)"
"...there is scope for a lot more automation with incorporation of clinical guidelines into a PMR to ensure patients' results are appropriately actioned and that treatment plans meet current gold standards (I believe our PMRs should even out variability in practice between GPs so that every patient can achieve the same clinical outcomes)."

Modernisation

There was a strong call to modernise MedTech - both aesthetically and internally.

"Aesthetically MedTech as a system looks old and outdated - even MedTech Evolution doesn't look like a modern system."
"Make it more modern rather than working on a 1990 frame with things being added on "
"Medtech - I would change it so that it was less Dos and more Windows"
(In response to If you could make an update to your software, what would you change?) "Almost everything."