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A good user interface makes all the difference in apps - and in medical care
From 'Immersion,' an exhibit about gaming technology at Tel Aviv's Beit Ha'ir (photo credit: Neta Alonim)
From 'Immersion,' an exhibit about gaming technology at Tel Aviv's Beit Ha'ir (photo credit: Neta Alonim)

It never ceases to amaze me how much the interface design of a program can affect its use. When I was developing my own electronic medical record [EMR], which ended up being quite a large system with many modules geared towards different types of staff, it was sometimes the addition or removal of a single button that made all the difference. For example, allowing doctors to click a button to view all of the x-rays associated with the present case, dramatically increased their level of satisfaction with the software. In the previous version, the doctors would have to close the open window they were on and then click the button to view the x-rays. The extra requirement to close the immediate open window before viewing the x-rays greatly disturbed the physicians. They claimed that it confused them, and interfered with their train of thought.

This was a great advantage of having designed the entire system on my own, with an amazing colleague. The two of us could make minimal cosmetic changes that were perceived as dramatic enhancements. Allowing a doctor to click a button and send an SMS directly from a given window [such as the x-ray viewer], made the physicians work much simpler. They worked faster and felt less stressed.

For quite some time, I have been looking for a dropdead simple video chat tool that would allow two users [or more] to start a video chat. The idea is that the doctor on site could click a single button on the screen of their mobile phone and immediately be in the midst of a video chat with the off-site consultant. By switching the camera being used from front to back, the doctor on site could show the remote physician a rash, cut, the way a child is breathing and so on. This incredibly simplified interface would reduce the friction to making use of this critical and powerful technology.

I came across a new service called “”. I have absolutely no personal or financial connection to this service.. But I wish I did. Two people can go to this website and choose a common name for a meeting room. At that moment, the two people are in the midst of a high quality video chat. This process can be made even simpler. Let’s say that the two users decide to call their meeting room “mroom”. Now, each user can save a bookmark on their mobile phone which links to “”. Once this bookmark has been created, each user need only click the bookmark and they are immediately video chatting with each other.

This type of single click interface is clearly as simple as they come. Obviously, if the user could simply say “start video chat”, that would be easier, and this could be set up. The point is that no doctor now has an excuse for saying that it is too difficult to video-converse with a remote consultant, taking full advantage of the mobile device’s camera. There is no reason for a doctor to now argue that it was not possible to get a specific consultation on a complicated case because the remote physician could not see the patient. This company has really made it possible for doctors to communicate in an incredibly powerful and efficient way.

Of course, people will now ask, what about documentation, saving the video conversation for later review, being able to draw on the screen to point to a pathology and more. And all of this capability can be added. I came across another startup company with an excellent product called “Zoom”. Setting this up requires a little bit more work but you gain more functionality in return. Of course, Microsoft is now pushing a new version of Skype [which they recently purchased]. And there should be no doubt  that over time, Skype will become more and more capable of doing more and more advanced video chat related features. As simple as Skype is though, I never succeeded in getting remote physicians and on-site physicians to use it for discussing a patient. I have absolutely no idea why it was so difficult. Nevertheless, this new service might finally be straightforward enough to get everyone video chatting for medical needs.

It’s key to point out that a key feature of is that it works across Apple, android and Windows devices. In a previous blog post, I spoke about the critical need of having tools that completely shelter the user from the background details of the device [such as its operating system]. This video chat system is device agnostic. I suspect it would work on a blackberry as well. This kind of universality is exactly what the doctor ordered.

I am obviously praying for the success of such a company. And I am also hoping that they will continue to add features but in a very careful way so as not to make the interface complicated for the user. I am hoping that we will finally achieve the immediate and free flow of important medical information among physicians. Properly used, it is these kinds of technologies that will continue to improve quality of care across every medical institution.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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