In 2015, I was asked to reimagine how the next generation of Electronic Health Records should be.

My Roles:
UX Manager and Principal UX Designer

Problems to solve:

Inefficiency - The legacy software is hard to use and it consists of multiple window software applications.

Immobility - It was designed for desktop experience.

User Roles & Activities

The Team

I managed and directed 10 team members, as well as worked along with product managers.

I divided my team into several groups:
NonClinical (Patient Management, Scheduling, Tasking, EDI) & Clinical (EHR, charting and ordering): 6 UX Designers, 2 UX Researchers, 2 UI Designers.

Understanding Business

As a UX, we think ourselves as user advocate, but understanding the business is equally important. Understanding business starts with stakeholder interviews. I talked with lead product manager, marketing and sales, and engineering to understand their vision, goals and concerns.

Understanding Product Ecosystem

The User Experience Vision

The next generation of EHR is designed as a single, robust, and integrated application that consists of Practice Management (Patient Financial Services, Scheduling and EDI) and Clinical (EHR, charting, ordering) functions. The experience is customized by user roles to provision the appropriate workflow.

The user experience is built on these design principles:
Intelligent & real-time
Display order summaries and conflicts as they are being built

Baked-in best practices
Module clinical content updates

Collaborative clinical content and data
Multi-edit and live clinical note workflow

Thinks like me
Allows user to have multiple items open at one time without having
to cancel/finish a workflow when they’re interrupted

Adaptive to my practice
Prepopulated fields with user’s default

Simplify my life
Minimize management and operational costs
Inheritable configuration (Smart Files)

Engaging user experience
Modern look and feel
Mobile application

Designed for cloud-enabled connected care
Connectivity to CDR & Analytics services

Target users
Physician, Physician Assistant, Medical Assistant, Nurse, Biller, Front Desk, Lab Technician, IT

Platform technology
SaaS
Responsive HTML 5 with Angular.JS

Team Management Schedule

With a big UX team I had, I created a team assignment chart. It displayed the progress and who worked on which features. With this method, I was able to monitor team individual progress with 1 - 1 meeting every week.

Core Features

Patient Tracker, Scheduling, Intake, Charting, E-Prescribe, Billing

~ UX Challenges ~

Charting Functionality

We used Wolters Kluwer (WK) Content incorporated into the EHR to help provide consistent quality of care. Inconsistent care practices adversely affect outcomes, patient safety, performance measures and cost.

A physician will be able to document the patient charts either during the consultation or after the consultation much faster than before. The research studies found out that many physicians complete patient charts after work. Physicians end up they need to do their homework after work or during the weekends.

Overall challenges:
The WK Content is not easy to customize based on the physician's speciality.
The WK Content is comprehensive but it is almost too much to display them all at once.

Preload content with default values was desired but creates patient safety risk. If the physician misses one value, it will cause negative outcomes.

Below is the earlier prototype concept on how we used WK Content.

~ The Usability Results on the Prototype ~

Participants:
4 male, 3 female participants representing physician user role
5 current EHR vendors represented, 1 participant is not using an EHR

~ Participant Demographic~

67% of providers spend >10 minutes with a patient per visit

58% of providers spend >10 minutes interacting with the EHR per patient visit

Providers interact with the EHR constantly throughout the day, typically documenting the visit during or directly after interaction with the patient.

Med refills, prescription requests, and patient emails are reviewed between patients and at the end of the day.

83% of participants have been using an EHR for > 7 years
67% of practices have been using an EHR for > 4 years

~ Affinity Diagrams in Trello ~

~ The Summary of the Findings ~

100% of participants were able to interact relatively easy.
Long content is perceived as overwhelming and intimidating.
Scrolling and clicking are perceived as more time consuming than typing in!
High preference towards being able to add notes contextually.
Preload content with default values is highly preferred as it allows physicians to document only the exceptions.

~ The Modification ~

From the usability results, we have to make some modifications to the functionality.

Search Functionality

This app provides an embedded Search capability that is a "one click" entry point into ALL of the practice's data: financial, clinical, as well as cloud-based data repositories.

Upon searching, the user is presented with categorized results, such as:
People- a category that contains both person and patient names
Appointments- lists appointment information for both persons and patients
Allergies- lists allergy details for patients
Reports- lists any saved reports

Activity Center
Functionality

Activities are a productivity management system to coordinate Tasks & Messages. Tasks and Messages can be configured in Activity Smart Files to customize Activity items. Combined with Rules Engine, Activities can be automated to create and complete Tasks/Messages.

The goal of this feature
Users use this as communication tool to access all Task and Messages assigned to them, or to a specific Patient, Account or Person records.

Design Framework

Maintaining consistency was our challenge as well as a team. I created a high level content map and navigation schema for the team to use. We also created a component library so the team could have consistent usage of the functionalities.