(sim-plis-i-tee), noun - simplicity. The quality or condition of being easy to understand, deal with or use.

Simplicity relates to the burden which a thing puts on someone trying to explain or understand it. We hear again and again from health care workers that the information systems they are asked to use are not simple and present them with a great burden. For example, according to a recent Johns Hopkins study that closely followed first-year residents at Baltimore’s two large academic medical centers, medical interns spend just 12 percent of their time examining and talking with patients, and more than 40 percent of their time behind a computer.¹

We hear the phrase KISS (keep it simple stupid) as a worthy goal. One of my favorite books on effective messaging is from the Heath brothers entitled “Made to Stick”.² They propose the acronym SUCCESS and the first S stands for “Simple”. In order for messages to stick they must be simple.

So why is simplicity in health IT so hard to achieve? The simple answer is lots of reasons.

The healthcare domain is complex and rapidly changing, and many IT vendors try to solve many healthcare problems for many users at the same time. Committees that make purchase decisions tend to judge IT vendors on laundry lists of functionality and pretty colors rather than focusing on apps that solve common problems for specific groups of end users in a simple and elegant way. Health care is not unique, I’m writing this blog with the word processor application, Microsoft Word, that dominates the market. It contains tons of functionality that neither I (nor probably 99% of end users) take advantage of in our day to day use.

The concept of simplicity is one of our value statements at Caradigm. It underlies our commitment to an open platform plus applications approach. Ingest data from multiple source systems once, then allow that data to be used by multiple apps for multiple purposes. So apps can simply and elegantly solve problems for specific end user groups that are not well served by generic monolithic systems.

Simplicity in design allows apps to shield end users from complexity and enables providers to focus on what’s important. Specific examples? A surveillance app that automatically calculates a MEWS risk score in near real time on patients throughout a hospital, so that a simple numeric score triggers activation of the rapid response team. Another application that uses machine learning to generate a simple score to reflect likelihood of readmission, so a specific group of end users, in this case discharge planners, can prioritize the assignment of resources. An app that includes a rules engine to help guide care managers to focus on the most important of many tasks that need attention in a given day. The bottom line is health IT applications that are not a burden but instead make it simple for users to do their jobs well.

As our value statement explains, a simple solution is a beautiful thing. In a world of increasing complexity, we take joy in striving for and achieving simple excellence. This is a value we will continue to pursue with vigor.

1. http://www.hopkinsmedicine.org/news/media/releases/doctors_in_training_spend_very_little_time_at_patient_bedside_study_finds
2. Heath, Chip and Heath, Dan: Made to Stick: Why Some Ideas Survive and Others Die. Random House, 2007.