Guest Blog: Designing with the patient in mind

This week we are proud to publish a short synopsis of the Masters thesis project of Alyssa Costino. Alyssa conducted and reported on the use of EHR systems from the patient perspective -- something that isn't being done often enough.

The Electronic Medical Record: Designing with the Patient in Mind
A thesis project designed by Alyssa Costino
MFA Computer Graphics Design ‘12
Rochester Institute of Technology

My thesis explores how technology is making an impact in the field of health care at the current time. There are many changes being implemented in hospital settings and medical facilities and one of the major changes is the transition from paper charts to electronic medical records (EMR/EHR). Currently, hospitals and other facilities are focused on solving technical issues with the implementation of their EMRs and getting comfortable with how patient information is entered and accessed in this new environment. Because of this, it has not been decided how the patient will interact with his or her health information.

As someone who is a cancer survivor and has spent a lot of time in a large variety of health care settings, I believe my personal experience as a patient with a chronic illness was an advantage to solving the problem of how to design an EMR that is patient friendly and easy to use and understand. I have learned that people in health care do not make things easy for themselves. My design background combined with my knowledge of health care allowed me to create an EMR that is convenient for patients to store large amounts of health information, as well as being able to visually understand that health information.

I wanted this EMR to be specifically for patients only and to feel that they are in control of their health. When patients are involved with their health care decisions and can visually see how certain things are affecting their bodies, it leads to better outcomes and healthier lifestyles. They are better prepared for how to deal with possible health issues that may come up in the future and can learn how to prevent these issues. It is a learning tool just as much as it is an organizational tool.

The usability testing phase was critical in achieving a successful patient centered design.

I created a very thorough and detailed questionnaire for participants to evaluate this patient

EMR. I was worried this would result in a lack of feedback due to the time it would take for participants to answer the questions. However, I was pleasantly surprised when I received a large selection of willing participants who provided helpful and positive feedback about the project.

The questionnaire was designed in a specific way because asking questions about a person’s health issues is a very private matter. I wanted my participants who were evaluating the project to know that they only had to provide information they felt comfortable with and they could stop the questionnaire at any time. I chose two specific groups of participants to fill out the questionnaire- those who are currently suffering from at least one chronic illness and those who consider themselves to be healthy, but do not require tracking health information closely. My reason for choosing to ask those without a chronic illness to participate was to see if the average healthy person would consider using this EMR.

Before I sent the questionnaire out to participants, I had some suspicions and was expecting to receive certain answers. The feedback I received led me to one final conclusion. Not only is there a need for a patient focused EMR, but there is more of a want than I thought by those who are suffering from chronic illnesses. Many said that they have been looking for something like this for quite some time to keep track of health information instead of collecting papers in binders and folders. As for the group that considered themselves healthy, a few said they would not use this EMR because they felt they had nothing important to track at the current time. However, as any doctor would tell you, it is important to keep track of all parts of your health as a preventative measure to stay healthy.

I also received some excellent feedback to improve the design and content of the EMR. One of the most important suggestions came from a participant who is currently suffering from a chronic illness. The patient wanted abnormal numbers to show up in red when entering numbers in the “Medical Testing History” section. This is a necessary addition because it is easier for the patient to go back and see where numbers are abnormal to report back to their doctor.

At the conclusion of my thesis, I learned that it is crucial to seek patient feedback on products and services that are specifically designed for patient use. There was a point where I sat with willing participants of all ages to watch them interact with the EMR and I was pleased that the neutral color palette, simple layout and design pattern, and ease of use worked well with all ages, including the elderly. Usability in health care has become an important issue we need to be aware of with all of the changes happening in the industry. I think designers are going to play a key role in helping to shape what the future of health care will look like.
Read more about this thesis and interact with the project here:

The Usability People would welcome the opportunity to work with you on improving the Usability of Healthcare IT.

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