Are EHRs dehumanizing
patient-doctor interactions?

There is nothing more frustrating to a patient than talking to their doctor, wanting advice, and that provider is typing away and looking at a computer screen instead of the patient. That most fundamental aspect of human communication, which is eye contact, now is being robbed from the medical encounter because of the electronic health record.

Dr. Lloyd Minor

Dean, Stanford University School of Medicine

Physicians see EHRs as a storage – not clinical – tool;
about half say it detracts from their clinical
effectiveness

IMPLICATIONS

For Doctors

Rather than focusing on the interaction with the patient, healthcare providers are involuntarily thinking of what needs to be documented or navigating the complex EHR.

For Patients

Doctors are instead distracted by the technical complexities of the documentation, rather than the indications of the patient’s symptoms.

There lies a pressing need to upgrade the existing system for healthcare providers and practices to improve their relationships with patients and deliver top-notch services.

Our Client

A global leader in healthcare IT, helping over 130,000 doctors and
nurses and 850,000 medical professionals worldwide to deliver
quality care and industry-leading Practice Management solutions.

THE BRIEF

Create an EHR snapshot of the patient’s clinical details to enable the provider (user) to view the most important aspects of the patient’s health history in order to make a current diagnosis, prep for surgery, or write prescriptions.

CHALLENGES

Slot Patient Data as per Relevance

Accurately slot the patient’s data in terms of relevance for the doctor to make his present diagnosis. This way, the doctor gets to focus completely on the patient interaction without being bogged down by navigating the complex EHR and documentation procedure.

Mission Statement

Enhance the EHR to provide all the vital and relevant
information to the primary user (doctor) in a single glance so
as to help him make an informed diagnosis.

DESIGN PROCESS

At Koru, our design process is focused on improving the usability, accessibility, and delight provided in the product interaction. Keeping the user in the center of the creative process leads us to create designs that are clutter-free, easy, intuitive, scalable, engaging and provide a fabulous experience to the users.

RESEARCH

  • Understand and review data that a provider would refer to for a patient during the visit
  • Review the visit process from the provider’s perspective
  • Review and study documentation generated post appointments

SYNTHESIS

  • Journey map for office/virtual visits
  • Clinical information referred to by the physician
  • Actions that a provider could take
    • Prescribe medication
    • Prescribe lab/diagnosis
    • Refer to another doctor
    • Set a follow up appointment
    • Change the parent diagnosis

User Journey For Office Visits

KEY FINDINGS

  • Information randomly distributed across the EHR
  • Information is not displayed as per the context
  • Providers preoccupied with navigating the complex interface
  • Multiple keystrokes and screens to fulfill a basic search query
  • Long scroll to navigate and arrive at the necessary information
  • Documentation is a tedious process
  • Quality of documentation suffers as doctors are hard-pressed for time
  • Doctors are prone to skip certain details while documenting at the end of an appointment
  • Unawares, doctors tend to feed incomplete or vague details/instructions for their support staff

Building the Design Brief

FOCUS AREAS

UX Approach

The objective was to create a simplified snapshot of the patient’s vital details so as to enable the provider to process it in a short time and complete his intended action. We had to ensure that the provider be more focused on the interaction with the patient, rather than be distracted by the overwhelming EHR usage.

The idea was to create an EHR tool that’s actually a source of assistance instead of being a source of intimidation.

All the while, we had to ensure that patient safety and compliance
standards were fulfilled.

IDEATION

We made multiple variations that were tested with the users.
We wanted to evaluate the prototypes on the following.

Direction A

Direction B

The findings were compiled in the Usability Testing report, and the final design direction was based on those results.

The findings were compiled in the
Usability Testing report, and the final design
direction was based on those results.

DESIGN

The process of validating the solution begins with transforming
the wireframes and prototypes into actual images with themes,
components, and styles applied to them.

Highlights

Floating toolbar is visible
through the scroll, gives for
continued access to editing

Easy visibility of context of
the patient’s current visit

All the important and relevant
details are available at
a glance

Patient History is visible as
a timeline

Dictation tool records the
conversation and lets the
doctor proceed with the
discussion without having to
worry about documenting

Suggested codes during documentation speeds up data entry and reduces erroneous entries

CONCLUSION

The EHR system was implemented to create efficiencies in workflow, providing accurate, updated, and complete information about patients at the point of care. Quick access to patient records was enabled for more coordinated, efficient care and improved clinical decision-making.

“An intelligent EHR system is a crucial tool that helps us be proactive and attentive during a patient interaction. With a simple and easy-to-navigate EHR such as this, I am better able to inform patients about trends in their personal data, and provide evidence-based medical care.”

Dr. Harry Nguyen

Highlights


Floating toolbar is visible through the scroll,
gives for continued access to editing

Easy visibility of context of
the patient’s current visit

All the important and relevant
details are available at a glance

Patient History is visible as
a timeline

Dictation tool records the conversation and
lets the doctor proceed with the discussion
without having to worry about documenting


Suggested codes during documentation
speeds up data entry and reduces
erroneous entries

CONCLUSION

The EHR system was implemented to create efficiencies in workflow, providing accurate, updated, and complete information about patients at the point of care. Quick access to patient records was enabled for more coordinated, efficient care and improved clinical decision-making.


“An intelligent EHR system is a crucial tool that helps us be proactive and attentive during a patient interaction. With a simple and easy-to-navigate EHR such as this, I am better able to inform patients about trends in their personal data, and provide evidence-based medical care.”

Dr. Harry Nguyen