LEAD UX UI DESIGNER
Avoiding Physician Burnout in Healthcare
Amazed by the number of studies about bad usability in Electronic Health Records, I decided to research and design ideas to improve it.
THE CHALLENGE
Understand the problem through in-depth UX research with physicians and present possible improvements.
MY ROLE
Product Designer, User Research, Interaction & Visual Design, Prototyping & Testing (6 weeks)
Usability Challenges in Electronic Health Records
Impact on Physicians and Patient Care
Numerous usability studies have identified critical Electronic Health Records (EHRs) issues that affect healthcare delivery, leading physicians to burnout.
These include alert fatigue due to excessive notifications, information overload complicating patient care, inflexible workflows unsuitable for varied medical practices, burdensome manual data entry, and complex user interfaces that elevate cognitive strain and frustration.
It is an undeniable fact that certain issues can put immense pressure on physicians, leading to stress and ultimately affecting the quality of patient care.
My goal was to research, analyze, and propose usability solutions that improve patient appointments in an Electronic Health Record (EHR) system, addressing the issues highlighted by physicians.
Insights from Discovery
This research was conducted with family physicians, a specialty active in the public health service of some countries like Brazil. However, the proposed solutions aim to improve care in EHRs for any medical specialty.
Understanding the Context
Broad-scope
The central idea of this specialty is to know and accompany the patient for their entire life, reminiscent of the figure of the trusted physician.Trained to care for patients from birth, family physicians, in a structured system, can deal with up to 90% of health problems.
Patients of family physicians who provided a more comprehensive range of services experienced fewer hospitalizations and lower healthcare costs.
A study of family physicians in the United States showed savings of $46,183.968,060 per year.
Saving Money
The Situation in Brazil
Public Health
Positive
The Family Health Strategy of Brazil’s Unified Health System (SUS) is one of the world’s largest community-based primary health care programs. It is free of charge and serves about 60% of Brazil’s population.
Negative
The management of this project by the government requires improvement due to inadequate funding.
Private Health
Positive
Private healthcare hires many family physicians to improve patient care and reduce costs.
Negative
In certain private healthcare companies, doctors may receive payment based on the number of patients they treat. This payment structure can result in hurried medical attention, lower-quality examinations, and increased medical errors.
The Influence of Electronic Health
Record Use on Physician Burnout
Numerous usability studies, ranging from physician surveys to heuristic analyses of popular software, indicate that these systems cause burnout among physicians.
Complex User Interfaces
EHR interfaces are often complex, leading to inefficiencies in patient care.
Alert Fatigue
Excessive alerts in EHR systems can cause desensitization among healthcare providers, leading to the risk of overlooking critical notifications and compromising patient safety.
Information Overload
EHRs can overload providers with patient data, hindering quick access to crucial information for effective decision-making and patient care.
After-hours Data Entry
Doctors often update patient information in EHRs outside of work hours, leading to burnout.
Poor Information Architecture
Poorly organized EHRs make it hard for healthcare providers to locate and interpret patient data, reducing efficiency and care quality.
Interference with Practice Workflow
EHR systems can disrupt medical practices’ natural workflow, which can cause inefficiencies and frustration among healthcare providers.
User Interviews: Insights from the Field
To ensure the highest accuracy and precision, I conducted thorough interviews with fourfamily doctors, each with their unique workplace experience.
Through these interviews, I sought to confirm, without any doubt, the scenario depicted in the studies.
In one of my interviews, I visited a public hospital and observed their daily operations and software usage.
- Why become a family physician, and what makes them different from specialists
- Public healthcare vs. private healthcare
- The daily routine of work
- The appointment’s workflow
- The importance to look at general data from a patient population
At a public hospital (SUS) in Ribeirão Preto, in the interior of São Paulo, where I interviewed Dra. Fernanda Andreotti.
“Sometimes, we still use paper to make medical records. There is a risk of losing information in the process.”
“The physician’s appointment takes an average of 15 minutes, of which I spend half the time filling out the form.”
“Traditional medical records are not appropriate for family physicians.”
“I must go through 6 to 10 screens in today’s app to complete the doctor’s appointment.
Mapping the Findings
Personas
Based on the physicians’ opinions, I have compiled one persona to create understanding and empathy with the end-users.
Though the focus of this solution is to improve the doctor’s appointment daily routines, a persona with the profile of a manager was also identified in my research and interviews.
The Physicians Journey and Flows
I mapped out a typical day in the medical routine to identify challenges and opportunities for improvement at each stage.
I worked on some user flows to have a clear direction of the user steps before prototyping the solution.
Designing the Look-and-Feel with Purpose
I aimed to enhance readability and create a sense of calmness in the design. I chose pastel blues and greens for the design and selected the easy-to-read Lato font.
Key Features
Flexibility
Displaying information side by side enables faster access and reduces the chance of memory overload.
Workflow like a Shopping Cart
One of the significant burdens of physicians with EHRs is that they force a workflow that does not match what would be ideal. The idea here is to accumulate all prescriptions, orders, and referrals in a place like a shopping cart to be checked at the end, which is one idea to unlock the system.
Avoiding Alert Fatigue
Alerts should inform users of issues and provide potential solutions to those issues. The drug interaction alert is designed to give users immediate action choices on the screen.
Improved SOAP Notes
The Brazilian protocol recommends the use of SOAP Notes. The service is performed in 4 stages, each with its peculiarities.
In the Subjective stage, the patient freely describes their questions while the physician only registers the topics to be addressed later.
In the Objective stage, the physician can access the day’s vitals, add protocols for physical attendance, and upload test results brought in by patients.
The physician adds diagnoses and hypotheses based on the ICD and ICPC in the Assessment stage.
In the Plan stage, the doctor determines his strategy for the patient, from recommendations, prescriptions, referrals to other specialists, or test requests.
Final Prototypes
Conclusion
Tackling the usability issues of Electronic Health Records (EHRs) was more than a design challenge; it was a personal journey that validated the importance of UX and a good design is needed to improve the daily lives of physicians.
The research and design process showed that sometimes, even small changes in the interface and workflow of EHR systems could significantly reduce physician burnout and enhance patient care.
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