PCMEDICS: Redesigning the Peace Corps’ Electronic Medical Records System

Description

The Peace Corps Office of Health Services needs a web-based user interface framework for an electronic medical record application that includes look and feel, general navigation, patient data presentation and clinical form layouts. The existing application, PCMEDICS, is a sub-par interface that lacks coherent navigation and design and, since launching last October, has led to errors and requires extensive training for the staff. Initially, our focus was on redesigning the landing page, patient summary page and patient encounter form.

THE SOLUTION

After conducting interviews with users in Costa Rica, Africa and in the Peace Corps’ Washington, D.C., headquarters, we redesigned three sections to reduce the number of clicks, and the time required to enter and access information within PCMEDICS.

PROJECT CONSTRAINTS

  • Time. The project had a three-week timeframe for completion and delivery.
  • Access. Due to security and privacy issues, we had limited access to the PCMEDICS system.
  • User interviews. PCMEDICS is a closed website intended for Peace Corps personnel, which limited the number of users available for interviews. Medical staff in the field serve worldwide and manage busy posts, creating logistical challenges of time zone differences and access to staff.
  • Technology. The electronic medical records system needs to be cloud-based, but light enough to work efficiently in areas where access to broadband is often limited.

ADDRESSING THE CONSTRAINTS

  • We redesigned the landing page, the patient summary page and the patient encounter form and developed deliverables (prototypes, wireframes and a case study) to the Peace Corps on a three-week deadline.
  • To overcome access issues the team used screenshots provided by the Peace Corps of the system and interviewed staff members at Peace Corps headquarters. Overseas medical staff were interviewed using Skype.
  • We intentionally maintained a light redesign of PCMEDICS to avoid large images or videos that would impact load times for users.

THE initial PROCESS

Given the inherent complexity of medical records and the lack of hierarchy on the current site, affinity mapping helped put an early focus on what needed highlighting and what could be condensed or removed.

affinity mapping

 


DIGGING INTO THE LANDING PAGE

landing

The current PCMEDICS landing page is dominated by the calendar and a message  center and reminders area. Users said these features were little used, if at all. One area that is widely used though is the search bar, which is buried at the bottom left of the page.

Early wireframes tested some new ideas like more visualization of patient data and a revised message center.

The team’s early wireframes tested some new ideas like more visualization of patient data, geolocation of the Peace Corps volunteers in-country,  and a revised message center.

The redesigned landing page.

The landing page redesign removes the focus on the calendar, messaging and reminders that dominate the current page. The new design includes an in progress bar for tracking unfinished work, a universal search bar and options that allow the user to customize the size and content of the dashboard.


RETOOLING THE SUMMARY AND ENCOUNTER FORMS

Screen Shot 2016-04-26 at 4.23.34 PM

The current patient summary page lacks hierarchy and focuses most of the page on demographic information, which users said was of little use.

PEF_final_1

The patient summary page redesign removes the demographic information that dominates the current page. The new patient summary page includes consistent information at the top and left of the page that displays critical information needed by Peace Corps staff. A medical timeline was added to quickly view upcoming events and visits as well as past visit information.

The current patient encounter form is a long, dense, scrollable form with no visual cues or hierarchy to help users determine what needs to be filled out each time from what might not.

The current patient encounter form is a long, dense, scrollable form with no visual cues or hierarchy to help users determine what needs to be filled out each time from what might not.

PEF_final_1

The redesigned form is condensed and tabs have been added for easier navigation. Highlights of the final design that tested well included a consistent in progress bar and highlighting crucial patient information like allergies and patient headshot highlight throughout the encounter and profile forms. The redesign also solved an often-voiced criticism of the current system that closing a form required scrolling around to different sections of the form. The redesign includes a signing-off function placed in a single location.


TAKEAWAYS

  • Given the three-week timeframe of the project, more time should have been spent narrowing the scope further earlier on in the process.
  • The process became much more efficient and useful for the client when the scope of the redesign was narrowed and the team was able to meet with all of the stakeholders and get everyone onboard with the process.
  • The team learned that while a website can appear to be filled with features and information that seems to have little use, in this case many of the items are still required to be there. But, by straightening up navigation and organization this would not be as distracting as it is now.
  • This particular website is used by a narrow, clearly defined audience and not for the general public. The design needed to reflect the complexities of the medical practice and not factor in what a general user’s experience would be.

TOOLS

  • User research
  • Prototyping/wireframing (Sketch, InVision)
  • Competitive analysis
  • User interviews
  • Information architecture
  • Personas

Dr. Thomas Wilkinson

Chief, Health Informatics Unit

"Ben brings academic training in psychology and an impressive professional background in journalism to UX design. He is a copious note-taker and has an affable personality, both of which are clear assets, but his true strength lies in his ability to elicit information and to synthesize it and then apply it."