If you see something, say something.

This post is a manifesto on reporting bad health information technology (HIT) problems.

If you’re having HIT problems complain about ‘em! I know everyone in medicine is conditioned not to complain and to deal with the crappiness of the “system”. But HIT is an area of healthcare where you can make a difference just by complaining.

While a lot of the problems in HIT run pretty deep (cough usability cough) there are many things that can be fixed if attention is brought to them. These are things like: changing the order of columns on the team patient sign-off/hand-off report, stopping a best practice alert that no longer matches your clinical practice, or improving the loading time of a patient’s chart. None of these are big changes that involve redesigning user-interfaces or re-factoring server-side code. They are simple changes that will make the task of using HIT less arduous. If you put in a help-desk ticket with your hospital’s HIT team its very likely that they can fix the issue quickly and slightly improve your experience.


You might say “well I don’t do that with any of the other software I use” and that’s true. I don’t think I’ve ever reached out to tech support for Microsoft Word, iOS, or Instagram. There’s a couple reasons for this, but the one most relevant to our discussion is feedback. The developers of most consumer software may actually USE their software on a daily basis. So there’s a very tight feedback loop. With healthcare IT this feedback loop is long and leaky. Let’s take the electronic health records (EHRs). Most EHR systems are sold to health systems as enterprise software. That is software that one company sells (or licenses) to another company (the health system). The health system then has their clinicians use the EHR. This setup means that there are several tiers of support for the software. Additionally the software company specializes in making software, not using it, so their developers may not have a good sense of how the software works “in the wild”. Contrast this with a developer at Slack, who may use Slack to interact with their coworkers. User feedback doesn’t naturally occur in the EHR development space. So what do we do?

We use the system! There’s a feedback loop built in for us, but its not widely known. That feedback loop is initiated by reporting issues. When a doctor or nurse reports an issue to their health system’s HIT team that should kick-off the feedback process. Your issue ticket will be triaged and then sent to the people who can fix it, either the HIT team or the software vendor. Neither of those teams are going to do anything for you if you don’t tell them what’s wrong.

So report your issues. Your HIT team might fix them. Your software vendor might make an improvement in the future. Your work tech life might get an iota better and your colleagues might thank you. Sure there’s a lot of “mights”. But these things won’t happen if you don’t say something first.

Go ÖN Home

P.S. while writing this I found myself mulling over the bad tech support experiences I’ve had in the past. As someone who was essentially in tech support I’ve developed some techniques that I can share in another post if people are interest. Additionally, tech support for HIT should not be a blackhole, if it is that’s a red flag and should be rectified. Stifling this feedback loop is a surefire way to miss critical safety issues.