When Design Ideas Come to Life
We’re more than halfway through our design phase and recently shared with you how our design sprints were organized. This week, we’ll reveal the output of these sprints as well as initial user reactions.
For design to yield impact, it must be based on something grounded, something real…otherwise known as user research. Before we share with you the specifics of our prototype, let’s recall how we got here.
EMR implementations are painful
When a hospital purchases EMR software, there are many stakeholders involved in the process. Project teams are formed to gather technical and logistical requirements and then plan implementation strategy. Typically, these teams are made up of implementation consultants, IT staff, and subject matter experts (medical directors, information directors, and lead clinical providers).
Implementation consultants (IC’s) are process and project managers who control and lead the transition or optimization of a given EMR. They work alongside IT staff to understand the organization’s existing system as well as the strategic goals of medical and information directors and practical needs of physicians. One of the main tasks of IC’s, within the greater goals, is to gather, document, and refine a clinic’s processes. These are known as workflows, a sequence of events with multiple actors that are visible representations of clinic operations.
A lack of transparency on workflow design leads to weak training
Prior to the beginning of our design phase, our team set out with the intention to understand the pains of training physicians on how to use electronic medical records (EMRs). Buried within the troubles and pains of training is that the inability of ICs to collaborate, receive feedback, and iterate on workflows with clinical providers. A workflow with no direction, in turn, leads to weak training.
When workflow validation — the state in which all parties on the EMR project team discuss, refine, and agree on a given workflow — is left to the last minute, training gets shortchanged and pushed to the side, becoming a quick afterthought. That was when our team realized that to improve training, we must bring in design to solve not training just yet. The root of the problem was actually workflow design.
Introducing…WorkVision
Given that ICs have difficulty getting feedback and validating workflows from subject matter experts (SMEs), the team set out on resolving this pain point. We reasoned that imprecise, inefficient workflows result in physician burnout. When a workflow doesn’t reflect a physician’s mental model and real-time documentation process, it often results in physicians lingering around work for an hour or two to finish documentation.
The purpose of WorkVision
At present, ICs get feedback from SMEs by sending flowcharts via email, calling them and sending along PDFs, or working together in a workflow validation meeting. Any decisions are often documented on the IC’s side and never made visible to the greater project team. In addition, the burden of giving feedback is on the SME. They have to schedule separate time on top of their existing work, distracting them from their main focus — their patients.
With WorkVision, we wanted to make workflow validation smoother by enabling SMEs to comprehend the existing EMR’s state and then give feedback on an IC’s proposed optimization suggestions. In the long run, a smoother, more accurate workflow that incorporates physician perspective can reduce physician burnout and thereby improve patient outcomes.
Our Prototype
WorkVision, at a high level, is a web-based workflow visualization tool that enables ICs to create and receive feedback on workflows in a single space.
Features of WorkVision
Import notes to automatically generate workflow components: We learned that an IC generally documents workflow requirements in Excel and Word Documents. Much of this information has to be translated into flowcharts.
Drag and drop components: To further reduce the strain of creating workflows, ICs can use the component library to drag and drop content into the main work area.
Commenting: Currently, feedback on workflows are presented to the greater project team, let alone others who might play a role in the EMR implementation process. We wanted a historical view of the collaboration and ideas that feeds into workflow design.
Documentation of versioning: Similar to the feature above, we found that there are no methods for ICs and SMEs to view versions of a workflow. We wanted to make versioning and access more transparent to foster a greater sense of accountability.
Workflow Estimator: With current technology, it is possible to capture EMR usage data. Our intention is to provide relevant information captured by this data and highlight optimal paths clinical providers can take to reduce time spent in the EMR.
Sharing at scale: It is hard to get feedback in person or remotely. This feature allows ICs to easily share workflows to anyone quickly and easily.
Targeted commenting: Stakeholders can give feedback easily by creating hotspots anywhere on the screen.
EMR previews: SMEs at present cannot mentally process workflows by just looking at a flowchart. This allows SMEs to better engage and comprehend workflows.
Validating Concepts through User Testing
Thus far, we’ve tested with 9 people. We were keen on targeting implementation consultants as well as doctors and medical directors because we need individuals who have had direct experience with EMRs and are fluent with the concept of workflows.
We’ve had a handful of reactions, all of which we’re transposing into a spreadsheets and user stories for the sake of quantifying qualitative reactions.
“This would help me do my job faster.” Implementation consultants were obviously the most excited few since WorkVision was made for them. Though we learned that Visio was standard for most ICs, we also learned that many revert to Powerpoint or still heavily rely on PDFs due to the inability to share and document feedback within Visio itself.
“Flowchart diagrams probably won’t resonate with clinicians.” Our client and doctors both cautioned our team to consider the clinicians even more. WorkVision works in favor of the project manager or the IC; however, the end goal is to work more closely with clinical providers.
“Tracking versions and comments is by far the best thing I see here.” Regardless of user interests, almost every session appreciated and thought versioning and tracking feedback would strengthen workflow validation processes.
What’s up ahead
Following user testing, we realized that WorkVision may not be the solution that can provide a better space for collaboration between physicians and implementation consultants to improve workflow validation.
Sketching and ideating are still team priorities as we’ve already gone through two additional design sprints parallel to our user testing sessions. User testing has made clear to us that ideas and designs are always imperfect, and that there’s always room to continue experimenting and creating.
Designing away at 300 S. Craig,
Jeong Min + daphne
