In the past, we have discussed in the newsletters and blogs about Electronic Medical/Health Records (EMR/EHR) especially in the US, where the trend has accelerated under the Affordable Care Act, aka ObamaCare.
Government programs such as Medicare (elder and disabled) and Medicaid (low income) require digital records in order to reduce the paperwork burden and improve analyses of diagnoses and outcomes.
We had an opportunity to discuss this issue with one of the physicians in a major research hospital. She and some of her colleagues have been devoting part of their professional time to converting their health system to EMR.
We asked about the "3rd person" that the computer has become in the exam room, and the potential for physician-computer time to reduce the physician-patient time. While she acknowledged the problem, she offered that the real problem is that doctor's offices were not laid out for computers activities; they're all-too-often just plopped on a desk. Truly integrating computers into the medical process is proceeding slowly.
Well, an article in the January 12, 2014 New York Times by Katie Hafner, "A Busy Doctor's Right Hand, Ever Ready to Type," adds insight into how some doctors are coping with the change to computers. It's not what we would call 'high tech', either. The article points out that often a medical scribe nearby types the doctor's notes into a computer. Either sitting at a desktop or cradling a notebook, the scribe enters the information into the patient's electronic record. One relieved physician summed it up perfectly, now "I can think medically instead of clerically."
Disregarding for the moment the relative merits of EMRs or the improved work satisfaction physicians using scribes report, there is a profound QFD issue that merits our attention:
"If the move towards high tech solutions requires a retreat to manual labor to enable the technology, something is amiss." [Glenn Mazur 2014]
Decades ago, Dr. Yoji Akao, the founder of QFD, cautioned about "product-out" thinking vs. "market-in" thinking. What this means is that engineers often "push" technological capabilities onto the customer with insufficient understanding of the importance of the customer problem being addressed by the new technology. Without understanding the customer's work flow, operating environment, customer's customer, and other influencing factors, the high tech solution could make things worse.
QFD helps us do better by designing-in customer satisfaction from the start, rather then forcing customers to adapt to unsatisfying products. The modern Blitz QFD® approach that we teach at the QFD Institute has several new tools to help both customer-facing (sales/marketing) and technology facing (R&D/engineers) staff better align. Here is how the public QFD Green Belt® course instructs these new tools.
Introduction to the QFD Methodology - why and how it works.
Workshop 1: Defining project goals and outcomes. (Project Goals Table)
Workshop 2: Defining key customers and stakeholders, and their applications/scenarios. (Customer Segments Table)
Workshop 3: Planning customer visits (gemba) to see for ourselves, and model what they say and do. (Customer Process Model)
Workshop 4: Documenting what goes right (and is to be protected) and wrong (and is to be improved) based on voice of customer and observational study. (Gemba Visit Table)
Workshop 5: Translate voice of customer into true customer needs, both spoken and unspoken. (Customer Voice Table)
Workshop 6: Structure customers needs to find missing ones. (Affinity Diagram and Hierarchy Diagram).
Workshop 7: Prioritize customer needs. (Analytic Hierarchy Process).
Workshop 8: Deploy high priority needs into solution requirements and concepts. Assure quality in delivery. (Maximum Value Table).
Discussion on advanced QFD tools for competitive assessment (Quality Planning Table), complex projects (House of Quality), Emotional Quality (Kansei Engineering), etc. Implementing QFD in your organization.
Course includes: workbook, Excel templates for exercises, and related case studies.
Teams can work on their own projects in the workshops.