eCare

Practitioner and Patient Apps

Brand/Project:

EMI Advisors, NIH Multiple Chronic Conditions, Healthcare IT

Role:

UX Researcher

Date:

Q4 2023

Context:

As part of a federal health contract, we collaborated with a team at Oregon Health and Sciences University to conduct focus groups in order to get feedback from practitioners on our practitioner facing app. This app allows practitioners to access patient created goals and health information from external institutions, information that has historically not been accessible in one place.

The Problem

How do we help doctors manage patient goals? How do we make information from many sources easy for doctors to understand?

* Additional Considerations:

  • Health practitioners are already overburdened and overwhelmed with information. How do we ensure information easy to understand?

  • The client is especially interested in how practitioners create goals with patients.

The Solution

A three step process of question building, implementing focus groups, and analyzing results

Diagram of the flow of electronic health record data

Core App Features

Health Practitioners would have access to:
  1. Patient entered goals and data from our patient app
  2. Feed of patient health data from other institutions
*Note: wireframe of this app had been completed at this stage, the development of the wireframes can be found another case study.
eCare Design

Research Goals

  1. How do practitioners currently work with patients to create health related goals
  2. How practitioners collaborate across different institutions
  3. Practitioner feedback of our app wireframes
  4. What needs are their current tools not meeting?

Based on our apps core functionality, we wanted to understand how practitioners relate to patients, particularly in the creation of health goals. We also wanted to understand how practitioners collaborate with other practitioners across institutions for a given patient and how they might leverage improved access to patient data across silos.

Question Building

I facilitated brainstorming sessions with the PM and our subject matter expert where we ideated questions to ask during our focus group. Based on our apps architecture, we wrote questions based on the following subjects:

  • General/Intro
  • Goals and Target Values
  • Diagnosis and Health Concerns
  • Active Medications and Active Orders
  • Vital Signs Measures and Tests
  • Care Team

Example: Goals

Here’s an example of some of the questions brainstormed, our goals was to obtain qualitative data about the practitioner’s existing processes for managing goals with patients. because of time constraints we had to limit our questions to three per subject.

Goals and Target Outcomes
Digital whiteboard with sorted sticky notes of questions
Goals + Target Outcome Questions
  • What types of goals have patients expressed to you? Can you share some examples?
  • How do you keep track on progress against a goal? How do you know if a patient needs help with a goal?
  • How do you currently document these goals? Does someone else on your clinical team document these?

Conducting the Focus Group

The Broad Stokes
  • Two one hour sessions
  • 4-6 practitioner participants per session
  • All participants were affiliated with Oregon Health and Sciences University
  • Conducted virtually over Zoom
  • Audio was recorded and transcribed fro analysis
The Details
  • Project requirements specified that the focus group be facilitated by a personnel from OHSU
  • This research was facilitated by an academic institution and subject to IRB protocol. Human subjects research certification I received during my graduate studies allowed me to attend the sessions.

Transcript Analysis

Audio of the focus groups were transcribed and analyzed from reoccurring themes

Diagram of the transcript analysis process
  1. Raw interview transcript
  2. Highlight for insights
  3. Identify themes and code insight by theme
  4. Diagnosis Data Trust
Theme Outline

Based on the focus group transcripts, these are the major themes that arose:

  1. Data Trust
    1. General Data Trust
    2. Medication Data Trust
    3. Diagnosis Data Trust

  2. List Item Sorting
    1. Group by Problem (diagnosis)
    2. Duplication of List Items
    3. Cognitive Load
    4. Sorting List Items Alphabetically

  3. Goals
    1. More Goal Context
    2. Patient Reported Information
    3. Goal Prioritization
    4. Social Goals Over Vital Goals
    5. Patient Goal Conception
    6. Achieved Goals
  1. Practitioner to Practitioner Functionality
    1. Additional Practitioner Attribution
    2. Practitioner Collaboration Functionality

  2. Diagnosis
    1. Prioritization of Diagnosis by Severity

  3. Medication
    1. Tracking Medication Adherence
    2. Medications List Needs more Detail

  4. Curation
    1. Custom Information Display
    2. Incorporation of A.I.

  5. Miscellaneous Positive Feedback
  6. Miscellaneous Negative Feedback

Feature Brainstorming

I took the themes and sorted them by the number of time they arose in the transcripts. The team then got together and brainstormed ideas for features that addressed the themes, focusing on the themes that came up the most

Digital whiteboard with sticky notes sorted into themes
Digital whiteboard with sticky notes with goal specific insights
Example: More Goal Context
Practitioners noted that they wanted more information about a patient’s goal than was provided in the wireframes

As a team we came up with the following feature recommendations to address that feedback:

  • Add more room for information about goals, prompt patients for more detailed info
  • Allow patients to submit progress and track subjective progress and attitude toward goal

The Results

I created high level documents for the client summarizing the findings and which features recommended to be slotted for the next design and development cycle

Example Feature Recommendations

Feedback: A patient’s medication and diagnosis lists are often long and disorganized

Recommended Features:

  • Allow the medication list to be grouped by “reason”
  • Revise medications list to allow more space in dose field, get realistic data and check wrapping behavior

Feedback: I want to see more context about a goal that a patient created

Recommended Features:

  • Add more room for information about goals, prompt patients for more detailed info
  • Allow patients to submit progress and track subjective progress and attitude toward goal

Simplify med and diagnosis lists

Based on the practitioners’ feedback their in current experience with electronic health record software medication and diagnosis lists are overwhelming and cluttered.

  • Allow the medication list to be grouped by “reason” as well as chronologically
  • Revise medications list to allow more space in dose field, get realistic data and check wrapping behavior
  • Consolidate duplicate items where a dose was changed
Initial Design
Original medications wireframe
Updated Design
Updated medications wireframe

Additional Goal Context

Based on the practitioners’ feedback that they wanted to see more context related to a patients’ goal, I implemented the following features

  • Add more room for information about goals, prompt patients for more detailed info
  • Allow patients to submit progress and track subjective progress and attitude toward goal
Initial Design
Original goal wireframe
Updated Design
Updated goal wireframe
Theme Summary

High level summary of the themes that occurred in the focus group.

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Feature Recs

A recommendation of features based on feedback from the focus groups.

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