
Healthcare
MANAGING HEART FAILURE
research - prototyping
WHAT
Partnered with the College of Pharmacy to perform qualitative and quantitative research to produce an initial user interface design for an electronic health record (EHR) application to facilitate the management of heart failure.
WHEN
January - April 2019
ROLE
I was part of the UX research team and I conducted observations, interviews, and made a prototype.
TEAM
Kelly Murdoch-Kitt, MGD
Denise Anthony, PhD
Juan Arzac, Developer
Adrian Choi, Researcher
METHODS
Observations, contextual inquiries, interviews,

Prototype
RESEARCH
Heart failure (HF) is the most common hospital discharge diagnosis among older adults in the United States.
The management of HF patients is evolving from the traditional model of face-to-face follow-up visits toward a proactive real-time technological model of assisting providers to more efficiently care for patients in the community.
40%
Nationally, over
of patients are readmitted to the hospital within 1 year following their first admission for heart failure
The proposed project will establish a user-centered electronic health record clinical decision support application for HF that can improve patient care by optimizing evidence-based medical therapy and allowing quick response to clinical worsening.
Qualitative Study
15h
of observations focusing on the providers use of the EHR for taking care of HF patients
4 nurses
1 physician
1 resident
Michigan Medicine
VA Hospital Ann Arbor
Henry Ford Hospital, Detroit
VA Hospital Ann Arbor
What we observed:
-
The tools inside and outside the EHR they use to take care for patients
-
Tools they use to streamline their workflow taking care of a patient
-
The pain points in using their EHR system to take care of HF patients
-
The time it takes to review a patient in the EHR
journey map + Pain points
Affinity Mapping: We synthesized our observations, creating
categories to understand relationships and major concerns. We identified three primary areas of opportunities:
SYNTHESIS
affinity mapping
KEY FINDINGS
Notes
-
Extensive use of the “notes” and subjective information about the patient;
-
A lot of information to find/fill while talking to a patient;
System
-
Information from other systems are hard to get;
-
Nurses/Pharmacists/Physicians each focus on different information;
-
The system does not remind when to follow up with a patient;
Patients
-
Patients forget recommendations.
Specific goals for the application
-
Less scrolling to use and find information on “Notes”;
-
Less clicks to find results from exams;
-
Make it easier to compare exams results and notes while talking to the patient.
IDEATION
Sketching: bla bla bla
affinity mapping
Wireframing: low fidelity wireframes based on the initial sketches that accomplished the goals for the application better.

Card-based design, rearrangeable according to provider needs, which may vary for each patient. Easy access to objective and subjective information.

On the left side, a similar structure of the current notes, but with bookmarks. Card-based design on the right, for the objective information.
I decided to go forward with this one because its structure is more familiar to the providers.
PROTOTYPING
Style guide
Better way of showing the colors


Explain each icon
Prototype: high fidelity clickable prototype, created with Adobe Xd
Interaction flow


The prototype focus in the opportunity areas by having the objective (graphics, test results) and subjective (notes) data in the same space.

Last visit selected, exams to be updated

Social history selected


Last visit selected, exams to be updated
Most relevants aspects to consider:
To deepen our understanding of the pain-points experienced by staff, we analyzed the current screen and identified the four aspects most relevant to ED hallway bed challenges:

Analysis of current ED screen:
The current screen has three panels and two hinges and can be used in either a straight line or “Z” configuration, as shown. Although it is mobile and easy to store, its poor stability and Z form does not provide consistent or adequate coverage.


Alternative screens available in the market:

Analysis of alternative screens:
We chose four of the most appropriate available screens and ranked their coverage, mobility, storage and stability.

Existing screen recommendation:
Our short-term privacy solution recommendation would be to buy two models of screens — a single and double panel — that could be used separately or in combination. Both screens offer good mobility, stability and ease of storage.
The panel width is similar to that of the hallway bed.
The single panel could be used easily by patients and the use of two in combination provides a good balance of coverage and accessibility for staff to perform exams.


Developing a custom privacy solution:
Our long-term privacy solution recommendation
would be to develop a new screen specific to the needs of a hallway bed.
From observing and talking to patients, as well as understanding staff needs, these are the important features that all the screens should have:
-
Non combustible materials
-
Material that reduces noise
-
Blocks light
-
Easy access for staff to perform exams
-
Ease of use for patient to control level of privacy
-
Ease of storage


Free standing enclosure
Type
3 panels, 2 hinges that close as an “U”
Features
Patient can control amount of visual privacy
Ok for fire code (same size as current screens)

Suspended enclosure
Type
Lower curtains that do not block exit signs
Features
Patient can control amount of visual privacy
Easier access for staff to perform exams
Easy storage

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Fold down enclosure
Type
Curtain that folds down from wall
Features
Patient can control amount of visual privacy
Easier access for staff to perform exams
Easy storage


Patient canopy
Type
Canopy that attaches to bed
Features
Patient can control level of privacy
around the upper body
Blocks light
Can be attached to any bed/area in ED
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Bed attachment enclosure
Type
Screen that attaches to bed and rolls out + canopy

Features
Patient can control level of visual privacy
Blocks light
Can be attached to any bed/area in ED
Easier access for staff to perform exams
Easy storage
We recognize that the challenges for both patients and staff
in the hallway bed context are many, but hope that some
of the ideas we have proposed can contribute to improving
the care experience. We are grateful for the opportunity to work
and learn in the ED.
MDes in Integrative Design, cohort 3, 2017