Design for Practice Management System Success – An overview 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, as patient perception of teamwork is one of two key factors in generating referrals (the other factor being your expertise). Therefore, the user interface for medical office management systems should be designed for teamwork.

This article builds on and concludes my previous reviews of two books on 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 a conceptual model, consistency and responsiveness. As it turns out, understanding the conceptual model doesn’t necessarily mean control, and both Norman’s and Johnson’s books go no further than designing complex software products that allow for teamwork or competition.

Think back to how you learned to play chess. Someone explained to you “a pawn goes like this and a knight goes like this. Your goal is to checkmate the king.” So, did you know how to play the game? Can you assess your situation, opportunities and risks? Can you draw up an improvement strategy? Chess requires years of practice to learn how to play well.

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

Tharon Howard – “Design to Thrive”

Tharon Howard is a professor at Clemson University and director of the usability testing facility. His book “Design to Thrive” focuses on what motivates people to join, stay and grow within an online community or social network, and articulates four strategic design principles for building successful online communities:

  1. Compensation – individuals do not join a social network without clear benefit. The most important reward you have to offer is the experience.
  2. Influence exists in a community when its members believe they can control or shape policies, procedures, topics and standards. Different membership types—visitors, newbies, regulars, leaders, and seniors—have different influence needs.
  3. Belonging are the techniques and mechanisms to help community members develop a sense of ‘social presence’, a sense of belonging to that community, identifying with it and sharing a bond with its members. Shared mythologies, the origin story, initiation rituals, symbols, codes, rituals and brand identity all contribute to connection.
  4. Meaning – to be considered significant, your community must be well recognized, established as a “go-to place” for achieving your users’ goals, valued by people who respect your users, populated by people who are serious and passionate are in their field, distinctive as a reputable brand for your users. The importance of your community lies in the story you tell when you invite individuals to join, in the achievements of the members, in the videos shared and contests won.
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Like chess, complex software products designed for teamwork, e.g. social networks, require at least two levels of conceptual models:

  1. tactical – how you 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 reward, influence, connection and meaning (or how to plan defense or attack on the chessboard)

Howard’s book focuses solely on the strategic level, leaving the success and failures of user interface design in popular and failed social networking products to other authors.

Practice Management

Practice management includes multiple types of activities (patient scheduling, visit documentation, billing) that can be broadly broken down into a six-step loop below:

  1. Collect data
  2. Quantify
  3. Interpret
  4. Formulate goals, plans and tasks
  5. Assign tasks
  6. Check job execution – go back to stage 1.

Steps 4, 5 and 6 above are related to teamwork. Teamwork also means working together to discover mistakes, prevent future mistakes and reduce their impact.

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