UX Research:: Electronic Medical Record Systems
My role in this project was the UX researcher. I collaborated closely with a research mentor, the Director of User Experience, and the Senior Product Manager. I planned the research protocol, recruited all participants, and executed the research. After collecting and analyzing quantitative and qualitative data, I presented my results to development, business strategy and management teams across the nation.
CHALLENGE
This was a major research effort to guide strategy and direction for developing a new EMR platform that incorporated the needs of 3 separate EMR systems.
The re-branded logos for the 4 different legacy EMR systems. Only the first 3 were compared in this study.
Because each system had their own vernacular, their own user base, their own mental model (site structure) and user interface paradigms, I was faced with the challenge of:
1) Determining the usability and UI issues of each system
2) Compare workflow, data needs and interface paradigms
3) Uncovering customer's attitudes towards different EMR products, the obstacles of migrating from one EMR to another and the learning curve for each of these systems
METHOD
We recruited 16 physician users - aiming for equal distribution of system knowledge. Physicians all met the following criteria: intermediate skill with EMR, articulate and expressive, from either a large clinic, mid-size clinic or solo practice.
We established a research session agenda which included (1) Usability walk-through and (2) Participatory design.
The image below shows an artifact of the Participatory design session. It was a card-sorting matrix to categorize tasks into frequency of use and clinical value.
For full details on the research design and agenda, please send me an email and I'd be happy to discuss. Email: jennifer.g.kong [at] gmail [dot] com
OBSERVATIONS: USABILITY WALK-THROUGH
The following is a snippet of my results. It is a table of surface user interface issues as well as long-standing pain points across all 3 EMR systems. These were presented to developers along with an actionable design suggestion.
QUALITATIVE ANALYSIS: SUMMARY OF SYSTEM COMPARISON
The following is a journey map of a common user workflow. User pain points and areas of uncertainty are highlighted. Data needs and specific variations of user workflow are documented at each step.
We found that EMR users have similarities in terms of their workflow and data needs. However, the display and focus of the information (mental model) is very different from each EMR system.
QUANTITATIVE ANALYSIS: ATTITUDES AND INFLUENCES
We asked physician users to rate their own EMR satisfaction at a general level, and then specifically, their satisfaction around the “Encounter” feature. The infographic below shows the overall satisfaction rating scores among users grouped in 3 different ways: (1) by EMR experience; (2) by technical comfort; and (3) by cross EMR experience.
We consistently found that the factors with the greatest influence on attitude was their experience level, technical comfort and cross EMR exposure.
CONCLUSION OF STUDY
This research study was successful because it uncovered surface UI issues as well as long-standing pain points in all 3 EMR systems. We were able to identify similarities between workflow, data needs, UI conventions, common interactions and challenges among the 3 EMR interfaces. We found that users attitudes' were influenced by 3 main factors which helps us approach our client facing interactions with more empathy.
Results of this study were presented across a nation-wide company to directors, client services, development, and marketing. The product manager was able to employ these findings to road-map a next generation EMR project. The development teams were able to use the surface level UI issues to make short-term design fixes.
All clients who participated in this study rated each session (Usability walk-through and Participatory design) as 4/5 and 4.3/5 respectively.
