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Archive for December, 2010

How Standardized UI Conventions for Healthcare IT Can Improve Patient Care

The notion of standardized user interface (UI) elements for healthcare IT applications seems vastly warranted.  As discussed in an earlier blog post, clinicians are often juggling several tasks at once and as such need applications that require a minimal expenditure of mental energy.  A consistent experience across applications can help clinicians reliably and quickly find information that they need to care for patients.

The Microsoft Health Common User Interface (MSCUI) project is to my knowledge the most advanced publicly available set of user interface (UI) design conventions for healthcare IT applications.   The MSCUI resulted from a collaboration between Microsoft and the UK’s National Health Service (NHS) and was initially released in 2007.  Fortunately, Microsoft has continued maintaining the MSCUI and released a major revision in May 2010. It now includes some useful guidelines on a lot of UI elements common to healthcare IT application, including patient banners, medication timelines, and many more.

A great example of a design convention that can simplify life for clinicians is the the format called for by the MSCUI for displaying a patient banner, which is shown in the following image.

The format for a patient banner called for by the MSCUI

By having a standard patient banner, clinicians can learn to find certain information in the same location, regardless of the application.  A patient’s address will always be in the first column of the table, while their phone number will always be in the second column.  Even more importantly, a patient’s allergies (which if not noticed could as a worst-case scenario lead to patient death) will always be in the rightmost column.

Such conventions are important to standardize because they have to be learned.  After all, there’s nothing inherent about allergy information that would lead users to expect it to be in the rightmost column of a table.  So by standardizing conventions, the amount of different conventions that clinicians must learn can be minimized.  Not only does this reduce the risk of clinicians overlooking an important bit of information, it also saves clinicians time and mental energy.  All this adds up to less time on the computer and more time working with patients.

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Disseminating Health Information Through Twitter

Last week my co-blogger Liza Sisler (@lizasisler) shared a great story about the power of Twitter in connecting people and ideas.  As a straightforward one-to-many messaging service, Twitter offers a lot of different ways to disseminate knowledge. I think one of the most compelling use cases is in helping experts share information with non-experts—on Twitter, by following an expert in a given field, non-experts can learn about news, videos, and articles that a subject matter expert finds useful and informative.  And unlike more traditional forms of online information, the 140 character limit of each Tweet helps ensure that each blast of information is concise and [usually] easy for users to decide whether to click through on a link or ignore it.  As such, it’s possible to follow dozens (maybe even hundreds, if you’re really good) of different people and gain exposure to just as many ideas.

When it comes to healthcare, I think there’s an enormous opportunity for Twitter to serve as a way for physicians (experts) to guide patients (non-experts) toward credible online resources. As Dr. Sean Khozin states in this New York Times article:

Platforms like Twitter can be powerful if doctors are a lot more active in disseminating their expertise. Patients are being bombarded with information online, but I don’t think all that information necessarily empowers them. You also need expertise.

The potential usefulness of Twitter in spreading health-related information is particularly striking when considering a recent study by the Pew Internet & American Life Project. The November 2010 study found that while 8% of all online Americans use Twitter (a number that’s sure to grow), 13% of African Americans that are online and 18% of Hispanic Americans that are online use Twitter.  As such, the presence of health-related information on Twitter may have a disproportionately positive impact on these communities, communities which have historically been underserved by healthcare. Obviously, Twitter won’t erase disparities in healthcare delivery, but it does offer the potential to help empower patients with information from credible, authoritative sources.

The best part is that any Twitter user can follow and in some cases interact with any physician with a public Twitter account, regardless of insurance (or lack thereof), geography, or other constraints that historically limited a patient’s information to whatever brochures were in their local physician’s office.  Some of the physicians I follow on Twitter include @Doc4Heart, @kevinmd, @davisliumd, and @seankhozin.  There’s even this list of physicians on Twitter.

Who are some of the physicians you follow on Twitter?

You can follow Perficient at @Perficient and me at @ChrisMonnier.

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Posted in News

The Power of Twitter: Connecting People and Information, Fast!

I’m a big fan of Twitter.  I use it to find & share information & to connect with people that share my interests.  As such I’m an active participant in several Twitter communities including the Healthcare, Health IT, Health Social Media, SharePoint & Microsoft Partner Communities.

Yesterday Dux Raymond Sy (@MeetDux) posted a link to an excellent analogy on what Twitter is all about.

…and a little later I had my own real life example of the power of Twitter to connect people & usable information real time that mirrored Dux’s analogy.  You see Dux is someone I know from the SharePoint community & Dr Kent Bottles (@KentBottles) is part of the Healthcare community… Read the rest of this post »

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Posted in News

Healthcare User Experience and the Importance of Reimbursement

As a user experience designer, my goal is to help design products and software that are as easy, efficient, and enjoyable to use as possible.  A critical part of this design process involves understanding the needs of the various stakeholders—everything from the need for end users to be able to use the product without hassle on up to the need for the product to provide sustainable revenue for the business.  And when it comes to healthcare, there are several unique factors that are important to stakeholders.  In this post I’d like to focus on one specific and often overlooked factor: reimbursement.

First, some quick background.  “Reimbursement” is an industry term for the payments made by either private insurance or Medicare to healthcare providers in exchange for specific healthcare services rendered.  In the US, most such payments follow the ICD-9-CM (soon to be ICD-10-CM) guidelines published by the Centers for Medicare and Medicaid Services (CMS), a division of the Department of Health and Human Services. In simple terms, providers use these codes to characterize each patient interaction and, assuming everything goes smoothly, receive corresponding payments.

Along with a variety of other factors, reimbursement helps shape and constrain clinician workflows, so by gaining an understanding of how reimbursement affects workflow a user experience can be designed to help optimize clinician workflow.  For example, a common feature in a number of healthcare applications is a list of patients that needs to be reviewed by a physician.  The following image shows a simplified version of such a list:

Table showing one row per patient

At first blush, it may seem that the best way to meet the needs of the clinicians who will be using the list is to organize the list on a “per patient” basis, with only the most recent patient listings shown.  That is, if a patient has multiple procedures that need to be reviewed, the procedures would be grouped together into a single row for that patient.  Such an arrangement is shown above.

However, if we consider the nature of the relevant reimbursement codes, we may find a slightly different table arrangement to be preferable.  If, for instance, the reimbursement code is structured such that each time a patient receives a given procedure the provider is entitled to receive a payment, then it may be advantageous to structure the list on a “per-procedure” basis in chronological order, as this may be the order in which clinicians must enter the reimbursement codes in the Hospital Information System (HIS).  This modified arrangement is shown below; the highlighted row shows where the difference is.

Table with one row per procedure

This difference may seem small from a development standpoint but could make a fairly large difference to the end user, especially if it saves them time.  Moreover, there may be even larger gains from aligning the design of a healthcare application with the end user’s workflow if such consistency helps reduce medical errors.

The bottom line: when understanding how clinic workflows work, be sure to consider the impact that reimbursement has on that workflow.