Utilitarian Redesign of Electronic Medical Record Systems

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Electronic Medical Record (EMR) systems are the computers used inside healthcare clinics. EMR systems have multiple stakeholders whose needs continuously evolve. The traditional EMR design approach focuses on designing systems that perfectly fit the requirements of some stakeholders as they are understood in the initial design stages. This results in EMR systems that do not answer all the stakeholder’s needs and quickly become outdated. To address the limitations of the traditional EMR design approach, we propose a utilitarian redesign approach for EMR systems. By “utilitarian redesign”, we mean that the designers continuously redesign the EMR system with the aim of maximizing the satisfaction of all the stakeholders. Our approach allows the designers to (i) identify the features to redesign and (ii) to know which features would bring the largest good to the largest number of stakeholders. We showcase the approach using a case study of redesigning an EMR system in Japanese antenatal care settings. We also evaluate our approach with 21 participants split over 7 workshops. Our results showed that the approach provides useful information to help the designers make utilitarian redesign choices. Even though our approach was applied to EMR systems, it may also be applied to redesign other complex socio-technical systems and potentially maximize the good for the largest number of stakeholders.

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