Why Digital Health Systems Should Embrace Clinical Complexity

As digital clinical systems become more widely adopted, the debate around their complexity and usage persists. Some argue that clinical systems that require users to be trained shouldn’t be used, however, others argue that the complexity of the systems reflects the nature of their purpose in the healthcare sector. Perfect usability lessens the value of incremental progress and devalues any improvements made along the way. 

In his blog ‘Digital Health Needs to Embrace Clinical Complexity’, Jim Ritchie, Chief Clinical Information Officer at Northern Care Alliance NHS Foundation Trust explores the issues and opportunities relating to the complexity of the digital clinical systems and the healthcare sector. 

Challenges in achieving perfect usability in digital health systems  

1. Healthcare is delivered in a complex adaptive system 

A complex adaptive system has three main characteristics: 

• The people within the system can differ in their approach to decision making and these approaches can change over time 
• People working within the system interact with each other 
• Emergent properties of the system vary over time

This differs from the needs of the user during the adoption of consumer technology, such as an iPhone, as the product only needs to meet the needs of the single user and has the opportunity to define what outputs the user can achieve.  

2. Expert staff require autonomy 

Adopting a digital system that requires zero training is a system that removes all decision making ability from the user. This means that instead of supporting healthcare teams, it will become an implementation tool that tells them how to work. For the digital health tool to be successful, we need to be certain that all clinical and patient scenarios are mapped out so that it can correctly respond. This would be an impossible task, so systems that allow users to meet the needs of any given scenario in healthcare will need training. 

Furthermore, autonomy is one of the basic needs that form the self-determination theory so digital health systems need to allow for a feeling of autonomy and relatedness to support connections with others.  

3. Consumer technology products still offer training 

Many people argue that consumer technology products require zero training, however, how many people can pick up a new product and use it to its full potential? No matter how easy something is to use, people will have different experiences and may require some level of training. 

Opportunities to improve the usability of digital health tools 

Regardless of the issues highlighted above, there are many design opportunities and training opportunities that could be implemented to improve the usability of digital health tools: 

1. Usability does not just mean simplicity  

Simplifying digital health systems will not necessarily make them more usable. Usability has many different components such as navigation, consistency, visual clarity, familiarity, flexibility and efficiency. Achieving all of these different aspects will allow for usability to grow. 

2. Avoid implementing complex solutions 

Some external agencies may offer cutting edge solutions that promise to solve every problem but often fail due to their complex implementation requirements.  

Digital health teams need to be honest with how much complexity staff are capable of absorbing and should advocate for the right level of complexity at the right time, helping staff to evolve. Complex tools need to be as easy to use, accessible and as safe as possible, however, it won’t remove all complexity.  

3. Spend more time on user testing 

A greater level of testing should be done before the full implementation of digital systems to ensure all of the jobs people are doing within the system are considered. This means more initial engagement and post-go live feedback to better understand any problems staff experience with the tool. Understanding these problems, processes and outcomes before the system is fully integrated reduces the risk of these problems impacting people in the real world environment.  

Despite the ongoing debate, we should still work to improve the usability of digital health systems, but remember that achieving perfect usability is unlikely.  

Discover more about the usability of digital health systems at HETT North, 28th February 2024

HETT North is a new extension to the established HETT Show and is taking place on 28th February 2024 at Manchester Central Convention Complex. HETT North provides the opportunity for you to convene, connect and collaborate with fellow healthcare professionals at a flagship event that focuses on digital transformation in healthcare. 

HETT North is free-to-attend for NHS, charities, and the public sector. Register to enjoy: 

• 40 hours of CPD-certified sessions to support your professional development. 
• 100+ industry leading speakers covering crucial topics in the sector. 
• 100+ digital health innovators offering the latest digital health solutions.  
• The opportunity to connect with 1,400+ like-minded peers. 

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