A few years ago, we worked with a clinic; the goal was to develop a design concept for a patient's medical record. Using this project as an example, we’d like to tell you how we approach the interface development process.
When you switch your business online, it is not enough just to go online. It’s a mistake to try and reproduce offline features online “as is” , with all the artifacts and inconveniences that come with the physical process.
In fact, at first we need to change the structure of the activity, design processes in a different way, and find new management methods. Let’s analyze how to do this using the example of the concept creation of the digital medical record.
Where to begin?
When designing a professional interface, UI designers often stop after designing a dashboard with impressive graphics inspired by some beautiful infographics.
It doesn’t really work like that. Before working on the design, you need to understand what your clients typically require in the interface, what they use less often, and what is unnecessary and should be excluded.
How can we determine what really needs to be changed? What algorithms in medical processes can we improve? How can we create a meaningful concept?
To answer these questions, we’ll analyze:
- How to move from an abstract setting to focusing on the main problems and their solutions.
- A sequence of actions for defining a change vector, a general hypothesis, specific ideas, and a way of prioritizing them.
- The concept we created based on the proposed scenario.
Part 1. How to move from an abstract setting to focusing on the main problems and their solutions.
Step 1. Highlight the work area
Our workflow is based on the “double diamond” model. The process phases tend to converge and diverge. These amplitude peaks illustrate the extent of our focus on elements at different stages of the development process.
When we develop a complex ecosystem of products, we often return to the very beginning of the plan, because it provides us with the primary definition of the future product. The only difference is that each new return includes knowledge about previously implemented services. This is the only way to keep the system consistent and structurally prepared for delegating to various work teams.
For our example, we defined possible links between the main participants of medical processes: patients, doctors, clinics, and the state. Then we visualized the interface architecture as a module of an abstract structure.
To highlight a particular area of work, we need to understand which of the communication links has the biggest amount of problems and make it the focus of the interface solution.
What problems are the most critical and common for users? Why so? It could be because the process is not yet automated. Or maybe, the existing interfaces are cluttered and require a lot of time and cognitive resources. Maybe, because there are unnecessary loops in the process.
For our study, we chose a doctor/patient relationship and focused our attention only on these participants. However, this level of detail is still not enough — we covered a too large area of interaction scenarios, so we continued to clarify the role and context of relationships.
This is the context for which we developed the interface:
Doctor/Patient → Doctor → General practitioner → Context/Appointment
Step 2: Setting up goals and tasks
In a way, designers are like doctors , as they also determine where it hurts; except for the fact that doctors see their patients, and designers examine a process in detail.
Our goal was to build a new model for an interactive experience with a medical record that is better than the previous approach. The model should be based on solid knowledge and should provide proof that it meets the user’s needs. Therefore, at first we created a complete overview of a doctor’s workday. For this purpose, we chose methods and conducted research, then filtered and combined the information obtained into a Customer Journey Map.
The following is a comparison of methods with their pros and cons.
In our case, we used the methods that provided a more reliable result with less effort: interviews, quantitative studies, benchmarking, and expert commentary.
Then we defined the tasks. In real life, we need to:
- Analyze people’s actual experiences as soon as possible
- Test the interaction scenario on rough prototypes
- Gradually improve the quality of analysis by incorporating finer and more time-consuming tools as you proceed (analytics that show results on a running interface).
Step 3: Interviews with users
At this stage, it was important:
1. To understand the daily algorithm of the general practitioner’s actions
2. To identify the insights and nuances of the doctor-patient relationship: how trust is established between them
3. To identify the doctor’s personal KPI
4. Also, to find out:
- Patients’ and doctors’ desires and motivations
- Beliefs, goals, values, and norms
- Perception of the process
- Hidden needs
You can check out (and later use for yourself) our tailor-made interview plan with the general practitioner.
Based on the results of the interviews with the doctors, we gained a number of insights for the process of medical record concept development. Here are some of them:
- In private clinics, the most important thing for the doctor is to get complete information on the patient to understand whether the case corresponds to the doctor’s specialization or not within the first three minutes. It is also important for the doctor to manage the schedule — to understand who is scheduled to see them today, and, if possible, to divide them into groups according to the types of requests.
- State clinics have printed registered forms for reporting to the Ministry of Health. These logs are used to determine the efficiency of the clinic. Filling out the forms is an important part of the doctor’s work and a task they need to perform manually if the clinic is not automated.
- One particularity of the work of a doctor at a rural clinic is that there are many house calls. The primary filter before an appointment with a doctor is a paramedic. In most cases, an appointment at the clinic is scheduled through a call made by a doctor.
- When diagnosing a child, the results of the child’s tests (compared to those of an adult) are not as important to the doctor, because children have fewer chronic diseases.
- Video conferences are held with relevant specialists for clarification and to make complex diagnoses; they can be held during the appointment.
- 10–15% of a doctor’s time is taken with healthy patients who need to visit the doctor to get documents for their employers, for example.
- In order to clarify drug dosages and minimize the risk of errors, doctors regularly refer to medical reference books and databases.
Step 4: Quantitative studies
We have used existing research results as part of the conceptual design.
The advantage of this is that they allow us not only to see the survey results at once, but also to reveal the changes in the dynamics. The main drawback is the impossibility to find a correlation between the answers and the main characteristics of respondents.
For example, we referred to the annual study of doctors’ behavior on the Internet Doctor Index. With its help, we found that medical professionals are actively using electronic devices, including smartphones, at work and even during appointments. From the same source, we learned about communication between patients and doctors outside the clinic.
Step 5: Benchmarking
In our search for existing solutions for our topic, we referred to the European experience. The healthcare system in Europe is primarily focused on providing quality services and a personalized approach to health and patient needs. In a number of countries, the digitization of the medical field began at the beginning of the 2000s and continues to this day.
The processes are integrated into the general communication between citizens and the state through official portals . Depending on the country, data centers — the processors of a large array of patient data — are operated by the state or private structures with shared access or access on demand.
The startup products that provide telemedicine services are used on an ongoing basis. With the help of these companies, doctors conduct remote appointments with patients from any location and maintain communication with them. This effectively transforms relationships, because a medical professional becomes an indispensable attribute of a healthy lifestyle, not a consequence of diseases.
Telemedicine itself is not new to Northern Europe. Back in the 20th century, sailors communicated with doctors by radio, if it was not possible to dock in a location.
Medical records, along with visit histories and medical prescriptions, are available to patients via smartphone applications. The current level of visualization of such services leaves much to be desired, but the benefits of their implementation are undeniable.
A single access point for all process participants and the absence of bureaucratic paperwork saves money for more important programs in the budgets of health ministries.
Denmark was one of the first countries in Europe where the medical industry was digitized.
More than half of the doctors in the Czech Republic use electronic medical records. There is also a separate application for patients with information about visits, appointments, and the opportunity to communicate with doctors.
In Sweden, medical professionals can use a free web platform for secure remote video consultations with patients.
In many ways, this gap in the development of the digitization of medicine compared to our country is due to a well-developed health insurance system.
Step 6: Expert commentary
When we design a working interface, we don’t always have time for a sufficient number of surveys and studies. In this case, we need to rely on our own experience to solve such problems.
For example, for several years, we have been developing the ecosystem of the products of a major private clinic. As part of our collaboration, we have developed a website, a user profile with the integration of data on visits and appointments, a mobile application, and a record form with an automatically updated schedule of more than a hundred doctors and the ability to select a branch without the involvement of the reception crew.
We have also created a website for distance learning for doctors and CRM for dentists.
The main advantage of such experience is obtaining and processing of the medical information, as well as experience in integrating third-party databases and connecting services. In addition, we are in constant communication with medical professionals and gather their feedback throughout the entire project cycle.
Hypotheses, which we formulate based on personal experience, may refer to individual features as well as the service’s architecture. For example, we have modernized the familiar concept of the clinic’s presentation website into a medical e-commerce site, offering the services of both doctors and diagnostics. This change has affected the entire ecosystem of products: using common rules of layout and display of blocks, we have established this arrangement and made network interactions with the clinic intuitive for all users.
Part 2. How to set up a change vector, a general hypothesis, specific ideas, and a way of prioritizing them
As a result of the research, we knew the details of a doctor’s working day. Then, to develop the interface concept, we divided it into seven phases. Each phase was written out, and we proposed ideas for implementation in the interface. Finally we came up with a general hypothesis. We put together the CJM of the doctor’s working day in table format.
1. A general hypothesis
By reducing the time required to manage documents and introducing new tools, doctors will be able to:
1. Treat their patients with greater attention. In the future, this will increase patients’ confidence and help remove psychological barriers in the course of treatment.
2. Achieve KPI without compromising the quality of appointments and examinations.
3. Improve the speed and accuracy of diagnosis by providing a more relevant and visible context in the patient’s clinical picture.
2. Focus on specific ideas
We think that changes in the interface should contribute to a paradigm shift in the doctor-patient relationship from “I only need the doctor when it hurts” to “the doctor helps me maintain a healthy lifestyle.”
It is important that the medical record provides opportunities for prevention without a doctor: giving recommendations on what the patient can do on their own.
3. Validation and prioritization of ideas
When drafting concepts, designers often have a tendency to let the imagination run wild and do all the work. On the one hand, this is good: this approach allows you to find unconventional and creative solutions. On the other hand, such solutions often differ from the technical capabilities on the market, require disproportionate costs, are aimed at visual presentation and not the user’s experience, or do not coincide with their actual need.
How do we understand what features to include in your solution?
We have adopted the RICE prioritization technique where each concept or feature is evaluated based on four parameters and eventually receives a certain number of points:
- Reach
- Impact
- Confidence
- Effort
At the beginning of the implementation, the concept must be flexible to change — we will get a lot of feedback from real users and, subsequently, something will work completely differently than originally designed by the team. Therefore, some aspects will have to be reworked or removed.
Clearly, we can’t discuss reach at the start. Therefore, we have added another more important parameter at this stage — the degree of influence on the other features (Network Effect).
First, we need to offer a feature that will be used in more interaction scenarios and could potentially become the basis for minor but useful features in the future.
In practice, this usually means:
1. Choose a sufficiently flexible general form.
2. Develop a dictionary of basic “interface words,” so that a small number of entities can cover the variety of cases we need.
3. Define the basic work of the interface and compare the results with the hypothesis.
Features with a high level of Network Effect (NE) should form the basis of the concept. They can be called the ‘backbone.’ With the development of the service and its scale-up, the NE level will become less significant for defining the priorities of the features, but still meaningful among other RICE indicators.
For example, in our concept, we have abandoned the usual entry forms in favor of free input with context hints depending on the type of document and the doctor’s specialty.
In addition to the obvious advantages — convenience and speed — this solution prepares the basis for the possible introduction of voice input and automatic text recognition in the treatment. It also allows doctors to customize or refine diagnoses with examination results using integrated blocks.
There are also disadvantages. First, expensive machine training may be needed to implement this idea. Secondly, older doctors may face difficulties when switching to the new interface.
Read more about RICE and the Network Effect in this article by Anton Iokov from Targetprocess: “Enhancing prioritization with networks.”
Part 3. Creating a medical card concept
In this part, based on the research carried out, we will consider the peculiarities of some stages of concept creation.
Layout
The patient’s medical record, accessed by the doctor, is divided into two areas, based on the initial problem — to quickly read all the information necessary for the visit.
On the right is a block with information about the patient. It reflects their physiological data, as well as diseases that strongly affect the possible treatment or limit contact with the patient, including allergies. This area, if necessary, can be supplemented with any relevant information and does not prevent navigation in the main area on the left.
On the left, there are several navigation options. The first is navigation through the main sections of the patient’s medical record: profile, diseases, tests, etc. It also has an additional indication of the presence of types of diseases according to the international classification of diseases.
Open dashboard with snippets
The second option is a special dashboard with a treatment history and widgets. With this tool, the doctor quickly identifies the patient’s latest interactions with medical structures and has access to all relevant data — from test results to assessment reports. At the same time, documents are also linked to prescriptions, so they can be found easily.
Doctors’ approaches may vary greatly, so we have thought about creating a custom dashboard with the necessary information for a particular doctor. For example, whether the patient is taking antibiotics or what the dynamics of a particular substance are in the tests. The variants of such events for the records are customized separately.
Open form for filling out documents
In order to reduce the time required to fill out medical records, we have abandoned the standard paper forms on the patient’s visit in favor of easier information input and interaction with databases of diagnostics and lab tests.
All the doctor has to do on this page is start typing (or press the voice input button). The system itself will offer the necessary options for document design: select frequently used headings or attach test results.
Hints on the process of document filling are contextual, depending on the specialization of the doctor.
Examples of interaction mechanics
In the interface, the doctor can:
1. Attach a document to a certain disease or problem.
2. Click the “add test results” button, open the adaptive, filtered data dashboard, and drag the test results into the document so they can be printed.
3. Get all the necessary information from the system to describe the drug treatment, make a diagnosis, and fill in complex data types.
4. Work in remote mode.
Remote work with the patient
Communication with the patient is not limited to chat or video communication. For example, the patient can check their test results in the chart using the snippet mechanics — data cards that are inserted into the body of the document or in the chat dialog box. And the doctor, using special forms, can form requests for measurements of health parameters, such as temperature, and record them in the system.
In summary
A consistent approach to solutions allows you to work successfully on tasks whose problem is expressed in abstract or implicit form. Communicating with users helps to rethink existing solutions and identify the places that need fundamental changes.
It is possible to invent your own methods of defining users’ needs or modernize the existing ones — everything depends on the context not only inside the task, but also in the area it originated from.
The concept that is developed must contain the prerequisites of a form used at different levels of interface interaction. It is necessary to highlight the basic scenarios and be able to execute them in a flexible way with a small set of interface primitives.
Visit our website to learn more about our approach to design of user interfaces.
