Case studies / Telemedicine for EHR System

Urgent design for Telemedicine add-on in response to COVID-19

Healthcare

File management

Communication

SaaS

B2C

Duration 3 months

Following the EHR design system guidelines influenced the creation of an accessible interface that speeds up scheduling a consultation with a doctor

Project Roadmap

Research

Personal

Information Architecture

Project Roadmap

Research

Requirement’s management

User flow

Informational Architecture

Wireframes

General layout

Navigation

Basic interaction Principles

Screens

UI design

Design Language

First screens

Delivery

Changes

Development and testing

Stage 1

Stage 2

Design Review

Research

Telemedicine is a part of Telehealth. Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies.

It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is remote clinical services, such as diagnosis and monitoring.

Project Challenge

Our team has been working on the EHR system for almost 2 years. We received a request to create an interface for telemedicine products, which would be integrated to the EHR system but still remain independent.

World Changes

In recent years, we have seen a transition to online areas that were difficult to guess. Skeptics of the rapid development of online services said that medicine and the entertainment industry will forever remain offline.

But today we see that a lot of medical consultations can be done online. Even an initial examination of the patient. You can also monitor the condition of a patient who is at home online.

COVID-19

With the outbreak of the global pandemic, we realized that now more than ever telemedicine will be relevant. After all, this technology solves many problems at the same time. It helps solve the problem of congestion in the hospital. Solves the problem with an initial examination, initial consultation at home.

And also this is a great opportunity to monitor the condition of the patient at home. Indeed, many patients were treated for the virus at home.

Project Goals

Develop intuitive interface

Create a quick and easy way for the patient how to look for a doctor, how to schedule a consultation etc.

Cover diverse user flows

Envisage ways for patients: from those who have already been to the hospital and are going for a second consultation online,

Integrate to EHR system

Integrate a new product into the existing EHR system following the design system guidelines.

Personas

We started by exploring health care. This is a complex topic. We studied the healthcare system in the market and gradually got acquainted with the structure of the existing product. We had also created Personas to understand user needs.

Mateo Fernández, Doctor

I want to feel good about the care I deliver.

My work makes it hard to have a life. It’s hard for me to be a great parent if I also want to be a great physicion and meet all the demands placed on me by my organization due to the amount of time it takes for me to meet them.

Why can’t my EHR work like my iPhone?

When I can be a doctor and not a clerk, I enjoy what I do. I am overwhelmed by administrative burdens from all sides. I have less and less time to spend with my patients.

Tasks

Continue the interview
Exam the patient
Record assessment
Diagnose
Request additional analysis
Prescribe medication

Goals

Be able to elficiently and easily share information about my patients with other providers.
Be able to spend less fime completing administrative or duplicalive tasks that get in the way of patient care, including delegating some of these tasks to practice staff.
Be able to communicate effectively with patients by providing information and directions that they con understand.
Identify and participate in an advanced care team solution so that the practice can improve its management of patients with multiple chronic conditions.
Identify more ways that technology can be used in the practice to save time or improve processes, workflows and tasks.
Become a totally paperless medical practice in the next two years.

Tasks
Goals
Painpoints

Continue the interview
Exam the patient
Record assessment
Diagnose
Request additional analysis
Prescribe medication

Be able to elficiently and easily share information about my patients with other providers.
Be able to spend less fime completing administrative or duplicalive tasks that get in the way of patient care, including delegating some of these tasks to practice staff.
Be able to communicate effectively with patients by providing information and directions that they con understand.
Identify and participate in an advanced care team solution so that the practice can improve its management of patients with multiple chronic conditions.
Identify more ways that technology can be used in the practice to save time or improve processes, workflows and tasks.
Become a totally paperless medical practice in the next two years.

Spend 2-4 hours every day offer work completing EHR tasks, which results in less time for continuing education, family and other non-work-related activities.
The practice cannot keep exam rooms full, because medical assistants must take fime after each visit to complete the post-visit quality reporting tasks required for each patient.
Daily frustrations when interacting with the EHR system, because there are so many clicks required for frequently used workflows, navigation is difficult, and the systems does not organize the data in an efficient way. Examples include:
Incoming CCDA core summaries that contain 30 pages of information and only one paragraph of clinically relevant data that the EHR cannot find.
Alerts are helpful... until they are rot. Alert fatigue is real!
Trying to document information in the EHR during the patient visit, while struggling to find the correct place in the EHR to document the information for quality reporting, distracts from interacting and communicating with patients effectively.
Prior authorization and other payer-imposed roadblocks contribute to inefficient care delivery for both clinicians and patients.

Painpoints

Spend 2-4 hours every day offer work completing EHR tasks, which results in less time for continuing education, family and other non-work-related activities.
The practice cannot keep exam rooms full, because medical assistants must take fime after each visit to complete the post-visit quality reporting tasks required for each patient.
Daily frustrations when interacting with the EHR system, because there are so many clicks required for frequently used workflows, navigation is difficult, and the systems does not organize the data in an efficient way. Examples include:
Incoming CCDA core summaries that contain 30 pages of information and only one paragraph of clinically relevant data that the EHR cannot find.
Alerts are helpful... until they are rot. Alert fatigue is real!
Trying to document information in the EHR during the patient visit, while struggling to find the correct place in the EHR to document the information for quality reporting, distracts from interacting and communicating with patients effectively.
Prior authorization and other payer-imposed roadblocks contribute to inefficient care delivery for both clinicians and patients.

Marisol Martínez, Nurse

“l am always on, thinking and working. And it’s not just that I am always on when I am there… l am on when I get home. It takes hours, sometimes days, to relax after a particularly bad day”.

“It’s like waiting tables when you have five to six patients, going from room to room all day, everyone always needing something. There’s a lot of repetition in tasks I perform”.

“My medication won’t scan… again!”

“What was I doing before I got interrupted? Did I finish all my notes? I regularly end up staying 30 minutes late to finish my charting, but is anyone even reading my documentation?”

Tasks

Modify Legend
Have an inferview with patient: reasons to come, what's wrong, what pains?
Check patients history: laboratory results, etc.
Check vital signs (temperature, etc.)
Send to doctor

Goals

Ensure that all patients receive their medications and other treatments on time.
Educate patients on a healthy lifestyle (medications, nutrition, exercise, durable medical equipment), and observe the patient putting the education into action.
Make sure each patient and family feels like they are getting the core and attention they need.
Organize the day to finish shift on time.
Complete all tasks. Don't leave a lot of extra work for the next shift.
Ensure patients are discharged in a timely manner so that waiting patients can use the beds.
Be able to easily see and communicate each patient's plan of care.

Tasks
Goals
Painpoints

Modify Legend
Have an inferview with patient: reasons to come, what's wrong, what pains?
Check patients history: laboratory results, etc.
Check vital signs (temperature, etc.)
Send to doctor

Ensure that all patients receive their medications and other treatments on time.
Educate patients on a healthy lifestyle (medications, nutrition, exercise, durable medical equipment), and observe the patient putting the education into action.
Make sure each patient and family feels like they are getting the core and attention they need.
Organize the day to finish shift on time.
Complete all tasks. Don't leave a lot of extra work for the next shift.
Ensure patients are discharged in a timely manner so that waiting patients can use the beds.
Be able to easily see and communicate each patient's plan of care.

Staffing shortages can put nurses at greater risk for patient safety issues.
Unable to locate patient records in one place.
High percentage of nursing burnout, with nurses leaving the patient care workferce in favor of non-direct patient care types of nursing.
Unable to speak to some patients without interpreter due to language barrier.
Difficulty communicating with healthcere team efficiently so that all primary team members ate kept informed.
Spend a lot of time recording large amounts of information and completing documentation.
Common tasks can be laborious (too much clicking).
The doctor keeps reconciling the meds incorrectly, further lengthening the time required to discharge patients.
Rarely doing one task at a time and constantly interrupted.
Nursing staff comes up with workarounds to keep everything and everyone straight.
Often feel the pressure and fatigue from the constant long shifts and don't see an end in sight.
There is no consistency. Other nurses are documenting same information in different areas of the EHR.
Complex tasks are not reflected in workflow, and it feels nurses are an afterthought when using the software/EHR. Tasks done all the time are so hard - so many steps becal.
Can't easily see what is missing or what hasn't been done particularly around documentation.

Painpoints

Staffing shortages can put nurses at greater risk for patient safety issues.
Unable to locate patient records in one place.
High percentage of nursing burnout, with nurses leaving the patient care workferce in favor of non-direct patient care types of nursing.
Unable to speak to some patients without interpreter due to language barrier.
Difficulty communicating with healthcere team efficiently so that all primary team members ate kept informed.
Spend a lot of time recording large amounts of information and completing documentation.
Common tasks can be laborious (too much clicking).
The doctor keeps reconciling the meds incorrectly, further lengthening the time required to discharge patients.
Rarely doing one task at a time and constantly interrupted.
Nursing staff comes up with workarounds to keep everything and everyone straight.
Often feel the pressure and fatigue from the constant long shifts and don't see an end in sight.
There is no consistency. Other nurses are documenting same information in different areas of the EHR.
Complex tasks are not reflected in workflow, and it feels nurses are an afterthought when using the software/EHR. Tasks done all the time are so hard - so many steps becal.
Can't easily see what is missing or what hasn't been done particularly around documentation.

Cia Rodriguez, Front Desk

“I am sorry you feel that way. Let me check with the doctor and see what we can do”.

“How can I help you?”

Tasks

Create new patients
Collect documents
Put to waiting list (nurse)
Scan documents, put to the next step (nurse)
Scheduling appointments
Patient communication (complaints)
Working with insurance companies and other industry contacts
Overseeing the supply situation and physical state of the

Goals

Not have patients get upset with or yell at me today.
Return patient calls.
Don't let the incoming faxes pile up.
Get billing notices out.
Call copier repair person (need to keep the equipment up and running).
Follow up on denied claims.
Leave office on time.

Needs

Earn a certificate in an additional set of skills to potentially advance career.
Save enough money to retire at age 68 without too much worry.
Keep the practice running smoothly through transitions of clinical staff.

Tasks
Goals
Needs
Painpoints

Create new patients
Collect documents
Put to waiting list (nurse)
Scan documents, put to the next step (nurse)
Scheduling appointments
Patient communication (complaints)
Working with insurance companies and other industry contacts
Overseeing the supply situation and physical state of the

Not have patients get upset with or yell at me today.
Return patient calls.
Don't let the incoming faxes pile up.
Get billing notices out.
Call copier repair person (need to keep the equipment up and running).
Follow up on denied claims.
Leave office on time.

Earn a certificate in an additional set of skills to potentially advance career.
Save enough money to retire at age 68 without too much worry.
Keep the practice running smoothly through transitions of clinical staff.

Low pay - need a raise.
Patients don't pay their bills on time and expect me to be able to reduce their bill.
The physicians do net listen to my ideas or treat me as a skilled team member.
System is slow; I have to keep telling people on the phone to pause.
I am asked to do things that other team members should bedoing. Doctors ask me to look up diagnosis codes; but I am neither a doctor nor a coder.
Insurance companies always deny claims in September and October.
The fonts on my screens are extremely hard to read.
I don't know how to get useful information and have to rely on others to get it for me.

Painpoints

Low pay - need a raise.
Patients don't pay their bills on time and expect me to be able to reduce their bill.
The physicians do net listen to my ideas or treat me as a skilled team member.
System is slow; I have to keep telling people on the phone to pause.
I am asked to do things that other team members should bedoing. Doctors ask me to look up diagnosis codes; but I am neither a doctor nor a coder.
Insurance companies always deny claims in September and October.
The fonts on my screens are extremely hard to read.
I don't know how to get useful information and have to rely on others to get it for me.

Product Map

After that, we made the first attempt to create a product map. This attempt crashed. The product was too complex and we decided to work on the product map step by step

Wireframes

We have created prototypes in very close collaboration with our client: we gathered necessary information, asked questions, listened to their ideas.

The interface had to be simple, intuitive, and follow the design rules we have established in our design system.

We were able to quickly prototype new product flows both for patients and doctors. With rigid timelines, we actually had time to test the product with the existing users and lister to their feedback.

UI Design

When creating the UI, we relied on Fuse - Angular 8+ Material Design since this style was most suitable for the task that we faced with, namely, an understandable, unloaded style.

Full Design System Case

UI Language

We chose a font Rubik for this project because this font goes is a sans serif with slightly rounded corners and this font is well readable both large size and small size.

Fonts

Colors

Primary

@RedBrand

#cf152d

rgb(207, 21, 45)

@Cyan

#00a1de

rgb(0, 161, 222)

Shades of Gray

As a result

Functional interface implemented

We have created a quick and easy flow for the patient.

Optimized user flows

We have covered cases for different patients: who have already been to the hospital, who are going for a second consultation online, or who do not know which doctor they are looking for.

Successful EHR intergration

We have integrated a new product into the existing EHR system.

Project Team

https://angle2.agency/wp-content/uploads/1-2.jpg

Yevheniia Klysha

Lead UX Designer

https://angle2.agency/wp-content/uploads/2-6.jpg

Olesya Vdovenko

Senior UX Designer

https://angle2.agency/wp-content/uploads/4-1.jpg

Igor Alexandroff

UI designer

https://angle2.agency/wp-content/uploads/7.jpg

Kristina Manzhaliy

Project Manager

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Urgent design for Telemedicine add-on in response to COVID-19

Table of Contents

Project Roadmap

Research

Telemedicine is a part of Telehealth. Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies.

Project Challenge

World Changes

COVID-19

Project Goals

Personas

Product Map

Wireframes

UI Design

UI Language

As a result

Project Team

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