Heal's core strategy is to offer healthcare services through tech-enabled digital products using four modalities.
A new kind of electronic health record for a new kind of healthcare.
Heal is a healthcare practice specializing in digital healthcare software products, enabling doctor house calls, telemedicine, remote patient monitoring and appointment scheduling.
Heal's practice focus is primary care for seniors with chronic diseases, delivered to the patient's home.
Why Build A New Electronic Health Record System?
Overview
Heal embarked on a new mission to provide a more comprehensive, less expensive and more convenient care model to the Senior patients that needed it most. This model of value-based healthcare is one in which healthcare providers are reimbursed based on the quality and outcomes of care they provide, rather than the quantity of services they deliver. This approach aims to improve patient outcomes and reduce costs by incentivizing providers to focus on preventive care and efficient treatment.
In contrast, the fee-for-service model pays providers for each service they perform, regardless of whether or not the service was actually needed or effective. This can lead to unnecessary treatments and higher costs.
Heal needed an electronic health record (EHR) system that was designed for implementing a model of value-based care, focused on Seniors with chronic conditions, utilizes mobile technology and could be used across all four modalities of care. There wasn't any existing products in the market that fit these needs.
The next 9 months would kick off an ambitious project to revolutionize electronic health records and create a product that was the flagship product that connects the entire Heal suite of health products.
The competitive landscape in EHRs
The Status Quo in EHRs
The typical EHRs in the market are up to 20 years old, and deeply ingrained in health systems. But there are several drawbacks:
• Bloated with too many features
• Complicated
• Not user friendly
• Web-based, and not touch-enabled
• Focused on billing features
• Expensive
• Don't offer an easy way to add new features
Evaluation of features, compared to needs
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It's not just Doctors that use EHR products. Several types of users including Medical Assistants, Nurses, Care Coordinators and Operations staff are all regular users of the product. To get a deeper understanding of their goals, needs, experiences, and behaviors, new personas were created new personas to represent everyone who comes in contact with the software.
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Specialist Provider
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Nurse Practioner
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Medical Assistant
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Primary Care Provider
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Patient Support Coordinator
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Operations Coordinator
In order to truly understand a day in the life of a Doctor conducting house call visits, I joined several doctors on their routes. I took notes during the visits, and interviewed them in between visits. I gained insights from talking with them about what they were doing, their goals and pain points during each process. I could also observed what they didn't say, but what I saw them experiencing as they picked up equipment, drove to visits and worked with patients. Some observations:
Doctors prepared for their visits the day before, reviewing patient charts and problems
Medical assistants drove the Doctors form visit to visit, allowing Doctors to work in the car between visits
Staff were frustrated with the number of context switching of different apps and tools they had to do during their day
Routes were complicated and not efficiently planned out by location.
Doctors were frequently backed up in the afternoon and late to appoints at the end of the day, frustrating patients
Study on trends influencing healthcare for Seniors
Initial ideation on the home screen
Ideation
Our goal for design was to create a product that had a robust feature set, yet was intuitive and aesthetically pleasing. The initial ideas explored several versions to show different navigation styles and content organization. The initial sketches were translated into low-fidelity wireframes using Figma. It was a fluid process. As product requirements were gathered though Provider insights, the wireframes were refined and improved.
As the designs matured, color and icons were added and rough prototypes were created in order to prepare for first round of user testing..
A fully-functional, high-fidelity prototype was created in order to show initial designs and core feature flows to Providers and C-Suite stakeholders. These designs captured all the core features needed to allow doctors to see their visit schedule, understand priorities, see details of visits and patients among many more use cases. Through this initial testing, we gathered critical feedback on the designs and were able to iterate several more times throughout the process to meet the user needs. Each screen was reviewed with clinical staff in order to capture as many details as possible.
Some findings:
• Providers wanted to see a map of all the locations of their visits so they can see their route maps and drive times
• Providers wanted to see patient details at-a-glance to understand chief complaints, and the nature of the visits
• Providers need to have contact information and entry instructions into patient homes
• Providers found it valuable to have high-priority reminders for the day
• Providers required the ability to access patient charts
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My Visits screen is the home base for providers and features their calendar of visits and route map
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Patient list that highlights analytics on the patients and the ability to filter in various ways
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Telehealth calls that can add participants such as translators or care givers
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Route map for the provider's map of house calls
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Patient profile that shows health data that is pulled from multiple sources
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Clinical entry sections that allows providers to record details of patients' lives at home that may affect their health
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A full-featured patient profile that includes medication records
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Providers have the ability to set risk levels that drive decisions on how often to see patients
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Touch friendly controls in order to record various aspects of social history
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Visit details allow providers to understand an overview of the visit reason, home entry instructions, and access to the patient profile
Mobile Web Version
In addition to the iPad iOS version, a web-based companion app was also created for other staff such as medical assistants and drivers, who need to have visit data, but don't have access to the EHR.
• Schedule
• Directions and home entry instructions
• Telemedicine
• Vitals entry
• Update insurance and demographic data
UI Design System
A new design system was developed to capture a cleaner, more modern aesthetic. The goal was to have a more consumer product appeal.
The system is able to grow with the product as more features are added. The result was a comprehensive new UI kit that accommodated all the needs of not only this product, but was the foundation of the design of subsequent follow on products.
In order to get the product in the hands of Providers as quick as possible, the product was planned for three main releases. Based on business goals and Provider needs, a feature strategy was developed that released the most impactful, must-have features first. Then subsequent releases were in follow up releases that filled out the feature set.
Final Thoughts
A beta version of the product was released in March of 2022, and the final product was released in January 2023.
Partnering with clinical staff was essential to the success of the product. The co-creation among clinical staff, design and engineering allowed for innovation opportunities in this very complex product. Close collaboration among the different disciplines allowed there to be a shared trust in what each of us brought to the team and our approaches. The working methods also helped shape our processes of discovery, user testing, iteration, and roll-out of releases. The learnings of this product will continue to influence my future processes product development.