My role
Sr. Product Designer
- Lead product strategy & design for the full feature
- Lead planner and facilitator for presentations and working sessions for all features
- Lead design researcher for interviews, and usability tests to solution workshops.
Timeframe
04/2023- 08/2023
(Research, design & implementation)
Tools
- Figma
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Miro
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Illustrator
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UserTesting.com
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Looker
BACKGROUND
About Cerebral
Cerebral is a digital mental health company launched in January 2020 with strong growth. They mainly offer therapy and psychiatric video or phone visits for patients who are searching for accessible and convenient ways to access mental health care.
Project overview
Cerebral has a homegrown EMR that serves as the central hub for all clinical and admin operations. All patient records, messages, notes and prescriptions are housed and managed from the EMR. Unfortunately, as we’ve scaled, there are areas in the EMR that are not meeting the usability needs of our clinician and support teams.
A key area of concern is the clinical notes section. To address this, we’ve launched a project aimed at enhancing the usability and efficiency of clinical notes, ensuring a smoother experience for our users.
DISCOVER - RESEARCH
Why was it taking clinicians 1 hour 17 minutes to finish a note?
Prescriber appointments at Cerebral are usually 15 or 30 mins, and therapy appointments are 45 mins. However, completing notes during these appointments takes clinicians an average of 1 hour 17 mins. This is highly problematic since clinicians are only paid for appointment durations and not additional admin time.
Research Goals
🎯
Define the major pain points for all user groups using the clinical notes system.
🎯
Identify why note completion after visits was so time-consuming.
Research methodology
Understanding the problem
Interviews
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Prescribers (n=5)
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Therapists (n=3)
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Clinical managers (n=2)
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Support staff (n=2)
So many interviews...
Contextual inquiry
We sat in on mock appointments and observed how the clinicians are using the notes feature today during and after appointments.
Synthesis
Abstraction ladder to determine themes
We collected all interview notes in miro stickies and used abstraction laddering to determine the main areas of improvement for patients, as well as internal staff members.
Here's what we found...
Our core users consist of: 1. Clinicians, 2. Support members & 3. Clinical managers
Core user pain points ❌
“I’m currently taking notes on a Google doc, and copy and pasting in the EMR notes template. I have created a template for myself and it’s faster than trying to type everything during a session.”
“The messaging system is absolutely terrible. I keep getting lost, it's glitchy as all get out and I keep having someone who isn't assigned to my care team answer my questions and frequently feel as though they didn't read the message before responding.”
Soooo much scrolling. Patient’s skip around a lot when they get on a roll talking about what is going on with them. I can’t interrupt them, so I try to grab as much as I can. The current note makes this very difficult. I have to ferociously type and can’t even look at my patient. The notes open on a new screen, so I have to manually split my screen to take notes and look at the patient video camera
DEFINE
Objectives
Given all these pain points, we knew our job was challenging. We narrowed it down to the three main areas of focus below.
How might we deliver an efficient note feature that...
Challenges
🧐
The EMR was built with function in mind and not usability and delight. We had many technical constraints when it came to interaction and visual design implementation
🧐
The EMR was not built using the desing system. This meant new feautres and the UI facelift led to visual inconsistencies as we slowly but surely updated the EMR
🧐
Non-technical stakeholders meant having to be creative to ensure that there is a shared vision of what the solution would be
How did we overcome these challenges?
Solution o'clock
1. Brainstorming workshop
I conducted a brainstorming workshop including members of the engineering, clinical, operational and compliance teams.
2. Used an effort vs impact matrix to prioritize features
We prioritized all the feature ideas using an impact vs. effort matrix
3. Competitive analysis
We reviewed the notes features of other EMRs to discover methods they are using to improve clinician efficiency and happiness
Including clinical stakeholders early and often, created a feeling of collaboration and create a shared understanding between all parties involved.
DEVELOP
Notes before the updates...
Issues
All copy is freeform
No way to pull in data from other sources automatically
Not a lot of guidance on what to enter and how to enter it
No structured data
Updated features
Slider
1. Added a slider overlay, instead of opening the notes template on a new tab. Clinicians are looking at the patient directly and can review other parts of the chart, without having to tab away.
Prefill, copy and quick nav
2. Prefilled data fields if we have the information available in the client chart or from onboarding. Clinicians can review and edit as appropriate.
3. I added the ability to copy notes forward. If your session notes for the follow-up is unchanged, you can copy a previous note forward and edit as appropriate
4. Quick view navigation, made it easier for clinicians to skip around the note as the patients answer questions, so they could easily find the appropriate sections
Click through functionality
5. Click through note taking - the clinician could just click the sections and answers they wanted and we’d prefill the notes section with the appropriate context. All info could be reviewed and edited at the clinician's discretion
Pull data in
6. Pull data from other areas of the app, instead of having to do double entry ex. Prescription information
Coaching
7. Added dynamic guidelines and coaching for clinicians to ensure clinical safety and continuous education for more junior clinicians
Table format
8.Variable viewing options based on users preference to improve note reviews and improve findability
Patient summary
9. Added the option for clinicians to send a summary and additional messages from the note itself
DELIVER
Outcomes: How did we do?
Future iterations opportunities?
🤖
Smart text, predictive phrases, dot phrases (short hand used in the medical community)
🔮
Note data can be used to automatically send patients resources based on data captured
📋
Automatic transcription and note completion