Design for Practice Management System Success - A Review of Tharon Howard's "Design to Thrive"

Teamwork is considered the weakest link in most medical practices. Teamwork is important not only to get the job done but also to grow your practice because patient's perception of teamwork is one of the two key factors for referral generation (the other factor is your expertise). Therefore, user interface for medical office management systems must be designed for teamwork.

This article expands on and concludes my earlier reviews of two books about design - Donald Norman's "The Design of Everyday Things" and Jeff Johnson's "Designing with the Mind in Mind." Both books emphasized the importance of conceptual model, consistency, and responsiveness. It turns out that understanding the conceptual model does not necessarily mean control and both Norman's and Johnson's books stop short of addressing the design of complex software products that enable teamwork or competition.

Think back about how you learned to play chess. Somebody explained to you "a pawn goes like this and a knight goes like that. Your goal is to checkmate the king." So, did you know how to play the game? Could you assess your situation, opportunities, and risks? Could you create an improvement strategy? Chess require years of practice to learn to play well.

Turning to social networks and online communities, the concepts of walls, comments, sharing, and liking are almost self-explanatory and millions of people at different ages and cultures have no trouble understanding the basic conceptual model. Yet only a few networks work and grow while most - have not survived their first six months.

Tharon Howard - "Design to Thrive"
Tharon Howard is a Professor at Clemson University and Director of its Usability Testing Facility. His book "Design to Thrive" focuses on what motivates people to join, remain, and grow within an online community or social network, and formulates four strategic design principles for building successful online communities:

1. Remuneration - individuals will not become members of a social network without a clear benefit. The most important remuneration you have to offer is the experience.
2. Influence exists in a community when its members believe that they can control or shape policies, procedures, topics, and standards. Different membership types, visitors, novices, regulars, leaders, and elders, have different influence needs.
3. Belonging is the techniques and mechanisms to help community members develop a sense of "social presence," a sense that they belong to that community, that they identify with it, and share a bond with its members. Shared mythologies, story of origin, initiation rituals, symbols, codes, rituals, and brand identity all contribute to belonging.
4. Significance - to be considered significant, your community needs to be well recognized, established as a "go-to place" for accomplishing your users' goals, valued by people your users respect, populated by people who are serious and passionate in their field, distinguished as a reputable brand to your users. The significance of your community is in the story you tell when you invite individuals to join, in the members' accomplishments, in the videos shared, and contests won.

Like chess, complex software products designed for teamwork, e.g., social networks, need at least two levels of conceptual models:

1. tactical - how to manage your wall and share comments (or how the pieces move on the chessboard)
2. strategic - how to design a thriving social network where users can experience remuneration, influence, belonging, and significance (or how to plan defense or offense on the chessboard)

Howard's book focuses exclusively on the strategic level, leaving the user interface design success and failures in popular and failed social networking products to other authors.
Practice Management
Practice Management involves multiple kinds of activities (patient scheduling, visit documentation, billing) that can be roughly divided in a six-step loop below:

1. Collect data
2. Quantify
3. Interpret
4. Formulate Goals, Plans, and Tasks
5. Assign Tasks
6. Verify task execution - go back to stage 1.

Steps 4, 5, and 6 above have to do with teamwork. Teamwork also means working together to discover errors, prevent future errors, and reduce their impact.

It seems there is a growing body of research and literature at each design level. I look forward to reading a book that bridges the tactical-strategic system design gap.

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