Inspired EHRs: Designing for Clinicians

inspiredEHRs.org

Jeff Belden MDUniversity of MissouriFamily physicianUsability Geek

Learning Objectives• Describe the process of creating Inspired

EHRs: Designing for Clinicians with HIT vendors, clinicians, and human factors researchers.

• List human factors principles often overlooked in modern EHR designs.

• List visual pre-attentive attributes that reduce cognitive load for healthcare providers.

Clinical Informatics Grand Rounds

Disclosure Summary

Jeffery L. Belden, MD has nothing to disclose.

Clinical Informatics Grand Rounds

Disclosure SummaryPlanning committee members who have nothing to disclose:• Vitaly Herasevich, MD, PhD, Director• Kim Jones, Program Coordinator

Disclosure Summary (the fine print)As a provider accredited by ACCME, Mayo Clinic College of Medicine (Mayo School of CPD) must ensure balance, independence, objectivity and scientific rigor in its educational activities. Course Director(s), Planning Committee Members, Faculty, and all others who are in a position to control the content of this educational activity are required to disclose all relevant financial relationships with any commercial interest related to the subject matter of the educational activity. Safeguards against commercial bias have been put in place. Faculty also will disclose any off label and/or investigational use of pharmaceuticals or instruments discussed in their presentation. Disclosure of this information will be published in course materials so those participants in the activity may formulate their own judgments regarding the presentation.

desirablefeasible

desirablefeasible

viable

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…free, online…

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…interactive eBook…

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…vendor developer teams…

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…who want to improve UX…

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…clinically inspired…

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…generously illustrated…

Inspired EHRs: Designing for Clinicians is a free, online, interactive e-book for vendor developer teams wanting to improve their user experience. It offers clinically inspired, generously illustrated, inspirational examples to work from.

…inspirational examples…

Quick Overview

on the web at inspiredEHRs.or

g

ChaptersMedication List

Medication Reconciliation

Allergy List

e-Prescribing

Drug Alerts

Human FactorsDesign Principles

Health IT Usability

Peek inside a chapter

Medication List

Clinical ScenariosEmpathize with the clinician’s thinking

ImagesBefore & After Comparisons

Links to HF Principles

Jump to HF Chapter

… with examplesgeneral example

… specific to EHRHIT specific example

…and prototypesto practice and explore

The Making ofInspired EHRs

Brought to you by

ONCSHARP-C Project

andCalifornia HealthCare

Foundation

Cast of Characters

Vendor participationincluding EHRA support & encouragement

2-Day Workshops

1 2 3

Health IT vendor

Core

Advisory Panel

Vendor Workshop Guests & Reviewers

Health IT vendorVendor

Core

Advisory Panel

Vendor Workshop Guests & Reviewers

Clinically inspiredPhysician Nurse PharmD

Core

Advisory Panel

Vendor Workshop Guests & Reviewers

Designer & HF guidedDesigner Human Factors

* Vendors will still need to do user testing

Iterating ideas

Failed medication timeline sketches

inspirationFinding

inspiration?

Where have you found

Timeline inspirationHipmunk

Timeline inspirationHipmunk

How can you useInspired EHRs?

Start at the topMedication ListMedication ReconciliationAllergy ListDrug Alerts (and CDS)e-Prescribing (and CPOE)Human FactorsDesign PrinciplesHealth IT Usability

or

Jump to a topicMedication ListMedication ReconciliationAllergy ListDrug Alerts (and CDS)e-Prescribing (and CPOE)Human FactorsDesign PrinciplesHealth IT Usability

or

Use like Wikipedia

A few examplesfrom

Inspired EHRs: Designing for Clinicians

Clinical ScenariosWalking through the tasks from clinician

perspective

Clinical ScenariosEmpathize with the clinician’s thinking

Before & After RedesignsShowing simple ways to improve the User

Experience

Before & After Redesigns

We explain our rationale in the text.

Before

After

Next mental taskin the larger clinic visit workflow

What thinking looks likeWhere the eye goes, the mental math, memory load…

What relief looks like

The Interactive Medication TableSort, filter, search

Sort by DiagnosisThe condition(s) for which the medication was

prescribed

Filter by “provider”or filter by “condition (diagnosis)”

Mini-TimelinesSee at a glance the history of the medication

Search for adverse effects

…filtering to show only those meds with that effect

Expand row to see Adverse Effects

Expand row to see Adverse Effects

…and find the term, with all other adverse effects

Medication TimelinePrototype

‘Challenge’ featureHandling issues that lack a clear answer

Want to learn more?Linking out to the Human Factors Chapter, for more depth.

pre-attentive attributes

Collecting Feedback

Confirming Impactfrom the Health IT community

What’s next?

Spread it around

Show your team.Show your leaders.

Take your pick

Web | PDF | Print

For printed copy, go to lulu.com

orbit.ly/print-inspired-EHRs

Participatemake it better

Inject code

Will there be more chapters?

Contact me at feedback@inspiredEHRs.org

…if there’s funding.

Current projects

BP graphsMaking home BP primary, BP trends, annotations,

medication timeline

Give back my dashboardSingle view.

Printable “second screen”.

Starting over - CCDAsBack to basics with horrible usability

Starting over - CCDAsBack to basics with horrible usability

Questions

Questions

Contact us

University of Missouri-Columbia Jeff Belden

Richelle Koopman

Joi Moore

Nathan Lowrance

Involution Studios Juhan Sonin

Jen Patel

Shreeya Gangwal

University of Maryland Catherine Plaisant

University of Texas-Houston Todd Johnson

feedback@inspiredEHRs.org toomanyclicks.com