Chorus

Allscripts Healthcare Solutions

A web application to efficiently manage the implementation timeline, make better configuration decisions, and engage more stakeholders in the design and configuration of electronic health records.

Description

Allscripts is an electronic health records (EHR) vendor with Sunrise EHR as their core product. Allscripts contracted with us to assist their client hospitals in improving clinical satisfaction and mastery with Sunrise EHR.

Problem

Through research, we found issues in their on-premise delivery process, and identified the EHR configuration step as an opportunity to make an impact. Due to over customizations without definite standards, Sunrise implementations go over-time and over-budget.

Insight

Tracking decisions were difficult due to key decision makers miss the decision making meetings. Also, even the decisions are made, there is no standards in recording the decisions; therefore, the decisions are recorded in personal notes, emails, and text messages, which get lost time to time.

Outcome

We designed a web platform for Allscripts implementation consultants to engage end users early on, guide clients to best practices and facilitate data collection.  

Timeline : Jan 2018 - Aug 2018
Team : Jia Liu, Daphne Tan,                   Ishaan Kolluri, Selin Insel
My Role : Product Designer
  • Led design process, including storyboarding, developing screen maps and wireframes.
  • Generated the overall design system

Product Overview

How does Chorus Work?

Enable progress tracking at a glance across multiple projects in one platform

Implementations are very costly when they go over-time. Chorus allows to track the status of each decision and allows to assign owners on both the client and the Allscripts side to make sure that all decisions are made within the given time frame.

Provide standardized templates and summaries to ensure efficient decision recording

Currently, each implementation process is vastly different for each client site due to having to start the configuration process from scratch. Standardized templates allow implementation consultants to record decisions and notes fast and efficiently without misinterpretation.

Provide recommendation to guide best practise

Every client site has different needs for Sunrise. However, different sites still share up to 60-80% of similar needs. Using the power of analytics, Allscripts recommendations can guide decision making with past examples and resources to make better choices.

Collect inputs and approvals from stakeholders with a click

Chorus is designed to make key decision makers to make informed decisions efficiently. Physicians are already very busy with their own work. Chorus allows physicians to make decisions for only the ones that matter to them.

Provide Scenarios and overviews to understand more context

Physicians can really understand how their decisions will affect their day-to-day lives when they are in that shoes. Chorus helps physicians by providing clinical situation to see how their decisions are so that the physician is able to finish the question set and have more context for what’s going on

Feedback Results and Discussion History to provide more context

Chorus enables implementation consultants to get more informed decisions in an efficient way. Implementation consultants now can better understand what happened in the meeting and clearly see who made what decisions.

Audience of Chorus

Justin
Implementation Consultant at Allscripts

He needs to guide and record decisions about Sunrise configuration. He wants to finish the project without going over-time and over-budget.

Michelle
Head of Pediatrics
at North Hills Clinic

She is very busy with her work. She wants the implementation process to go as smoothly and as quickly as possible while Sunrise includes what she needs.

Why is Chorus needed?

Better collaboration
lead to better result

Currently, decision makers are not engaged in the implementation process because they don't have spare time. So implementation consultants have to rework many things in order to get the decisions.

With Chorus, both implementation consultants and decision makers can work efficiently and get the right decision at the right time.

Our Process

Understanding the Healthcare IT Space

Electronic health records are complex

EHRs end up really complex and are difficult to use because EHRs are required to support clinical, financial and regulatory needs.

Physicians are burned out using EHRs

Physicians spend approximately 50% of their work times on using EHRs. Physicians feel overworked because they have to spend more time on documenting patients' visits than interacting
with patients.

Pain points of Sunrise EHR

Sunrise EHR is highly customizable, but over-customized EHR is difficult to manage.

Over-customized EHR makes it difficult for Allscripts to provide continuous support, such as providing solutions for usability problems, providing training for new employees, causing client dissatisfaction.

Insightful data isn't collected and used to its full potential to inform better decisions for future implementation process.

EHR usage data can inform valuable information for providing supports to clients. However, data is underutilized and not fully surfaced in the Allscripts management system.

Key stakeholders are not engaged and often miss crucial decision-making meetings.

It is difficult to gather all stakeholders in the same place to make decisions. Lack of communication between the physicians and IT technicians causes poor decisions to be made.

Decisions and insights are not captured in repeatable manners and often get lost.

Decisions, conversations, and insights are not captured in standardized method. Each implementation consultants have different ways of collecting data using phone calls, email chains, personal notes, and excel sheets. The insights vary depending on the implementation consultant's skill levels.

Physicians do not know the long-term implications of the decisions they make.

Physicians are not experts in designing EHRs. They do usually don’t understand the long-term usability implications of the decisions they make when.

Synthesizing our research

We used affinity mapping and service blueprints tools synthesize the data we collected.

Click here to view our digital affinity diagram

Identifying opportunity areas

From our research insights, we identified 5 opportunity areas

We found 5 opportunity areas and decided to focus on Workflow Design because workflow design balances feasibility with long-term impact

Identifying design goals

Increase Engagement

Engage end users early in the implementation process in a physician-friendly way

Provide Guidance

Guide clients to standardized best-practices to minimize dissatisfaction.

Achieve Consensus

Enable a shared understanding and expectations among different stakeholders.

Mapping insights to product features

How might we get input in a physician friendly way?

Provide the right type of physician input to increase engagement and get more informed responses efficiently.
“I don't have time to answer questions for hours. I want to give feedback for only the ones that matter to me.”
                                                                 - Physician
Interactive comments to understand physician's insights without misinterpretation
“I like that I’ll be able to see specifically
what a physician is thinking directly in
the interface.”
                            - Implementation Consultant

How might we guide clients toward standardized best practice?

Recommendation to guide and steer clients towards best practice.
“[Customers] really do look to us to provide the guidance and be the lead. They get exhausted when we put it all in their lap.”
                    - Client Delivery Service Manager
“I’d want the software vendor to point to past examples or resources that help me make better choices.”
                                                   - Medical Director
Scenarios & Overviews to help physicians to make better informed decisions.
“Help me understand where this is going -
and whether it’s a good use of my time.”
                                                   - Medical Director
Discussion history to keep insights from the meeting without losing.
“I like that I can keep up with the tiny things
that happened during a meeting.”
                                                                 - Physician

How might we enable visibility and shared understanding?

Track progress that provides overview to let implementation consultants to efficiently manage different projects.
“I want more of an overview, but the Build
team needs to see each decision item.”
                                                   - Project Manager
Provide Feedback results to give physicians better context of decisions that were made during the meeting.
“I like how the notes provide context into what happened during the meeting.”
                            - Implementation Consultant

Ideation

Here are some concepts we explored

Workflow Visualizer

A tool to document, analyze and get feedback

Micro Feedback

Get quick feedback on mock-ups and demos

MockVision

Shows live preview of how it will be configured

Progress Dashboard

A tool to check the implementation process

Finalizing our concept

After our last round of user testing, we conceptualized a prototype composed of a platform for consultants to create mockups for physicians to react to, and a feedback platform to gauge the responses from care providers. The key, in our minds, was for a narrative scenario to accompany the visual aid in mockup creation, and for the feedback platform to ask the right questions of providers.

Refining usability with high-fi prototypes

We created hi-fi wireframes and interactive prototypes to test the usability

Design Decisions for Chorus

Getting the right type of physician input

Chorus has two different types of input for cases that decisions need to be approved and for cases that decisions need to be made. Having two input types allows both implementation consultants and physicians to get the right types of inputs at the right time efficiently.

Questionnaire

Questionnaire allows physicians to freely
express their opinions. We wanted physicians to express their honest opinions to collect more insights

Approval

Approval allows physicians to efficiently agree or disagree with the already made decisions. We wanted physicians to make decisions quickly

Asking for the physician friendly input

Physicians are already really busy with their work. Being able to make a quick judgements with few clicks only when in situation when needed can save them time so they can focus more time on treating patients.

Commenting directly on the interface

Without having physicians to talk about what they thought about the interface, which can cause misinterpretation, we wanted physicians to directly comment on specific components of the interface

“I like that I’ll be able to see specifically
what a physician is thinking directly in
the interface.”
                            - Implementation Consultant

Asking for the right amount of input

If initial decisions were already made, we did not want physicians to go through every choices and select/deselect individual choices

“I don't have time to answer questions for hours. I want to give feedback for only the ones that matter to me.”
                                                                 - Physician

Guiding standardized best practice

Even though each site has uniquely configured Sunrise EHR, we found that they still share 60% to 80% similar components with similar organizations.

Show how similar organizations decided

Using the previous data from other organizations, physicians can make better informed decisions

“I’d want the software vendor to point to past examples or resources that help me make better choices.”
                                                   - Medical Director

Providing specific scenarios and visuals to give more context

Having a clinical scenario can show physicians how their day to day workflow will be affected. Every EHR is different and some features are completely new. Having an overview of the feature with visuals can better inform physicians to make decisions.

Having more context can help physicians to make better decisions

We wanted physicians to really know how their decisions will affect their long-term usability. Sunrise users often report a mismatch between what happens in the clinical workflow and how it is required to be documented in the EHR.

“Help me understand where this is going -
and whether it’s a good use of my time.”
                                                   - Medical Director

Showing feedback results for both questionnaire and approval

Some decision makers' decisions weigh more than others. It is important to know who made what decision and what the majority decided for those who make the final call.

Show the results of approval

Implementation consultants can better understand of what happened during the meeting quickly just by glancing at the results

“I like how the notes provide context into what happened during the meeting.”                           
                                      - Implementation Consultant

One click sharing to the build team

Even when all the decisions are made, implementation consultants have to tie everything up and send appropriate documents to the build team to get Sunrise configured. Now, they can click one button to send details to the build team.

Send result to the build team directly

Implementation consultants currently have to gather all necessary documents and decisions separately and send them to the build team. We wanted this process to be faster and prevent any kinds of misinterpretation

“I want more of an overview, but the Build
team needs to see each decision item.”
                                                   - Project Manager

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