EMX Systems

User Research

Uncovering the Facts on Medical Records

Without any knowledge about healthcare delivery, our team’s first steps in this project were learning electronic record systems, patient record exchange, and patient encounters.

User Interviews

We interviewed nine healthcare providers to learn about their experiences with EMRs and record exchange. Our findings showed that providers had similar concerns and experiences with EMR systems and patient record exchange.

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  Waiting for Mail

  Waiting for records to arrive often delays patient care.

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  Busy Work for staff

  Records from outside have to be scanned and manually entered into the system.

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  Hard to find what you want

  Outside records are often entered as images, making in-document search impossible.

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  Overly Complex Software

  Features unrelated to patient care clutter EMRs, making them harder to use.

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  Difficulty Searching

  Many EMRs have a search feature that requires too much precision to use correctly.

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  Too much time on the computer

  Providers felt that it took too long to find a specific record in their current record system.

Personas

Based on our interviews, our team created three personas representing segments of our audience.

Survey

We surveyed providers to get their opinions are current record exchange methods and what types of records exchanged most often. 22 providers responded to this survey.

User Journey

Our conversations with providers painted a clear image of how the record exchange process impacted care:

• Providers have long waits to get records.
• The systems to manage the data were confusing to use.
• The whole process created additional work for the practice.

Going into the redesign phase, a big question I had on my mind was: What features could we create/improve for EMX portal to improve this user journey?

Design Process

How the Experience was Made

To create a better provider experience for EMX’s web portal, I considered three main questions in my design strategy:

1. What are the most important things to a provider using this system?
2. How can the interface deal with differences in needs by different types of providers?
3. What contexts surrounding a record need to be considered in feature design?

During the design process, we followed an iterative design cycle where we worked on a prototype, user-tested features, and iterated based on the feedback received.

Putting patients first: Designing the dashboard

When I learned about providers’ dislike for their current record systems, I thought about how I could make EMX Systems the opposite — a system that viders liked using. To tackle this question, I focused on what providers cared about most: their patients.

To focus on patients, I designed a dashboard that displayed a list of patient records as the first screen after a provider selects a patient. This list was ordered by most recent first. Since more recent records are more often reviewed, this ordering increases the chance that the provider finds the record they need right away.

I initially showed all record types in a single list, but changed my design after the rest of the team reminded me that different kinds of records were more relevant to different types of providers. To address this problem, I split up different record types into different dashboard sections in my next design iteration.

Fitting EMX for All Provider Types

Our team took a design risk in the redesign allowing providers to customize the record types that appeared on their dashboard. This feature would add complexity, which providers viewed as a distraction from patient care.

After debating the pros and cons, we decided on adding record type personalization with an onboarding process. The time saved by having the most relevant record types upfront would be worth the extra complexity. We included the customization in the onboarding process so that the app could guide providers through the setup and not require them to worry about it later.

Presenting Medical Imaging Records

Providers we surveyed cited medical images as one of their most requested record types. As such, I was particularly interested in figuring out the best way to present them.

My initial strategy for imaging was to present them like any other type of record — click and view the document.

But after testing my design, I discovered a flaw in my approach. Medical images are not only used individually. Providers also compared images of the same patient to check their progress!

In response to this discovery, I added a compare feature to imaging records that lets users select multiple images and view them side by side.

Cutting down on typing: Search filters

From our research, we knew that our users preferred searching to find specific records, but did not like how precise they needed to be for most record systems. One interviewee noted about his EMR’s search, “You cannot find anything if you type in spine clinic instead of clinic spine.”

Search filters are our team’s solution for easier searching. Instead of memorizing and typing exact terms, EMX portal users can use broader keywords and drill down with filters. Every record type that appears the dashboard includes filter options, letting our users find records on the landing page, skipping the typing altogether.

A Sum of many parts: Save for later

During a user testing session, we saw users flipping between multiple record categories to learn about the patient. When we asked what they were doing, the users told us they needed to review several types of records to get a good impression of the patient. We had not considered this behavior up until this point. Our workflow required a lot of repetition to get through multiple categories.

To reduce the repetition, we introduced a feature called Save for Later. This feature allows users to bookmark records and review them from a single page later. Bookmarking can be done with one click next to the document and easily accessed through the “saved for later” shortcut on the bottom right of the dashboard.

Considering the Context

Cutting Back for Limitations

Our initial design for lab result records showed numbers from the lab right in the dashboard to save a step. But after review with EMX’s developer, we got feedback that it was unrealistic. Lab results are often scanned into record systems as images and contain too many different values -- our original idea was unfeasible. To make our design more feasible, we changed the lab report display to show a link to the report instead.

Patient Demographics Location

In our early prototypes, patient demographics were put on the main dashboard because we believed that this was important information for a provider. However, after user testing, this assumption did not hold up. While providers did want to see the patient’s demographics, they only reviewed it extensively the first time they met the patient. Afterward, it was only referred to as needed. With that in mind, I moved patient demographics to a different part of the page. This choice decluttered the interface and gave more room for useful patient information.

Conclusions

Client Feedback

At the end of the project, our team presented the new EMX Systems portal to our client. Our final deliverables included a hi-fi interactive prototype, a set of UI design guidelines, and a workflow map. Our client was happy with the outcome and had the following to say:

"I've finally had a chance to review your work thoroughly, and I'm thrilled. You took a very difficult problem, one that we couldn't define very well for you, and came up with an elegant, simple UI design: exactly what we needed. It was a pleasure working with all of you, and you have our enthusiastic thanks for all your hard work." Alan
Co-founder, EMX System

What I learned

• Validate your assumptions about the product and the users

  Designers often make assumptions about the product and the users. Some of those assumptions may be wrong, so it is vital to get user feedback to check that the features align with the user's goals. In this project, user testing helped us catch mistakes and inspired the creation of features like bookmarking with Save for Later.

• Get the Client Involved

  Getting our client's healthcare expertise was vital to understanding the healthcare context of this project. Our client, a doctor, helped us answer any questions we had about the healthcare process. Our team also shared prototypes for feedback to ensure that we based our designs on a correct understanding of the record exchange.

• Be a Proactive Teammate

  As our prototype grew, so did the number of inconsistent UI elements. To keep our team working efficiently, I turned our UI components into a shared Sketch library. This library helped us work faster — during our meetings, we spent less time syncing mockups and had more to discuss UX improvements.