I grew up during the era when PC video gaming was gaining popularity. It was an exciting time when trail-blazing designers and developers created masterpieces like the Oregon Trail, forcing school children everywhere to decide whether to ford the river, or caulk and float their wagons across it—and, most importantly, learn what those phrases meant. It also taught the importance of anticipating and preparing for the unexpected: dialog boxes seemed to constantly interrupt game play and announce a drought or another bout of dysentery. The game was an endless maze of unknowns, which was scary when you were just trying to get your family and animals safely, and healthily, to new land.
It turns out that designing good health IT isn’t that far off from the lessons we all learned from playing the Oregon Trail. The path to an integrated healthcare ecosystem has proven challenging: some pioneers have been lost along the way, while others have persevered, making inroads despite the dense regulatory fog. Here are four basic lessons I learned from playing the Oregon Trail and how they map to the challenges we face when it comes to good health IT design:
- Expect the unexpected. Every student traveling down that Oregon Trail knew their good fortune would not last. In health IT, the same is true: without a doubt, there will be changes, so creating agile systems that are flexible and can accommodate inevitable shifts in clinician and administrative needs is important. Technology that has the capacity to extend functionality within the existing system (with as little impact to the clinical teams as possible), enables healthcare partners to easily integrate with and make any modifications needed to enhance workflows.
- Think about those around you. It’s important to remember you’re not in your covered wagon alone, and when designing health IT technology, it is important to remember the different care team members, patients, and IT support staff who need to access information or who will be involved in implementing, updating, and supporting the system. Enabling these individuals to customize workflows or simplify existing ones is important.
- Know your terrain. Thankfully, the eponymously titled game was a good indicator of the path we were going down, but that didn’t make the many twists and turns any less frustrating. Similarly, in healthcare, we have seen our fair share of bumps along the way, some that we have learned to anticipate (ICD-10 delays), and others that catch us off guard. Looking at regulatory roadmaps and designing technology that anticipates and prepares users for future milestones, like Meaningful Use, will help alleviate the pressure placed on existing health IT infrastructures, now and further down the road.
- Anticipate what is downstream. Rushing rapids were never a good sign if you were attempting to cross a river with your caravan. The same holds true now. We have all learned that even noblest policies can have unintended consequences. As pressure for interoperability continues to mount, health IT designers should create and test solutions to ensure the systems are user-friendly, accessible, and meaningful for clinicians and patients alike. Additionally, we know that schedules will become increasingly busier, which means that finding time to learn new technology will be nearly impossible and will pose challenges to clinician adoption. Platforms and solutions should be flexible and allow them a phased transition or to enable care teams to use a hybrid approach depending on their setting.
While the specific conditions and circumstances of the Oregon Trail game may have been different for each pioneer, the guiding principles were steadfast: travelers needed to eat and rest, they needed to determine the best route, and they needed to have transportation. Good health IT design has a similar paradigm: users need technology that is easy to use and efficient, it needs to provide meaningful insights that help prepare them for the future (whether they are physicians, care teams, patients, or healthcare administrators), and technology needs to be mobile, accommodating different situations and workflows.
It’s a long journey, but a rewarding one that will change the way we think and experience healthcare.