A health application integrates medical records from different providers
This is a usability course project that focuses on evaluating the usability of a real-world product ─ Akute Health and gives recommendations to improve user experience.
Akute Health is a health application which designs for patients and medical providers. Users can record their medical data, connect with medical providers and share medical records with others in Akute Health.
3 members' team project
RESEARCH METHODS & TIMELINE
We had a video call with Sharud Agarwal who is the founder of AkuteHealth. From the conversation with Sharud, we’ve learned that the main goals of this product is to democratize access to medical data and make sense of medical data.
At the beginning of the project, we searched pieces of literatures to help us have more understanding in the health industry and the medical environment in the United States.
Findings in literature reviews
While patient harm is the primary risk posed by inaccurate records, cost is no small consideration. The Office of the National Coordinator for Health Information Technology reported that each instance of a misidentified record cost the Mayo Clinic roughly $1,200. (Source: How Smartphone Apps Could Help Keep Health Records Accurate, RAND Corporation.)
In a 2012 survey conducted by the College of Healthcare Information Management Executives (CHIME), 1 in 5 hospital chief information officers indicated that patients had been harmed in the previous year due to mismatches. (Source: Enhanced Patient Matching Is Critical to Achieving Full Promise of Digital Health Records, The PEW Charitable Trusts.)
Over the past decade, our patients have had increasing access to their own health data via electronic patient portals. Now, in an exciting transformation in health care, patients are shifting from simply accessing their health data to more directly managing and using it to improve their health and care. (Source: Chistpher Longhurst, CIO, UC San Diego Health.)
Only 10% of people are willing to share health data with tech companies, and they only have 24% of confidence in data security.
Findings in marketing analysis
In 2017, more than 75% of U.S. adults own the smartphone. (Source: Mobile Fact Sheet, Pew Research Center.)
Nearly a third of people who downloaded a health app did so because the app was recommended by their doctor. (Source: 50 things we now know about digital health consumers, Rock Health.)
Recommendation: Build relationships with medical providers and doctors.
In 2018, 45% of 65 and older own smartphone, compares to 29% in 2013. (Source: Mobile Fact Sheet, Pew Research Center.)
Recommendation: Focus more on elderly people since they may suffer from various chronic diseases and may have experience in visiting many medical providers.
Competetive Evaluation allow us assess if the design is better or worse than our competitors as well as discover the relative strengths and weaknesses of competing designs. They let us to take an in-depth look at how others solve the same design problems. The goal of any competitive evaluation is to see what competitors are doing, how they’re doing it, what’s working and what’s not.
We conducted heuristic Evaluation for finding the usability problems in a user interface design so the design can be iterated throughout the design process. Our team members worked as evaluators to examine the interface with Nielson Norman Group's usability principles.
SCREENER & RECRUITING
After finishing the secondary research about Akute Health, we already had basic knowledge about EHR system and medical environment in the United States. To have a deeper understanding of 1. What are the satisfaction, effectiveness, and efficiency of Akute Health? 2. Have users encountered difficulties with medical records? 3. Does Akute Health satisfy users’ needs? we chose to conduct a usability test and semi-structured interview to help us realize users’ behaviors and motivation. Before conducting these, we used screener and recruited the target users we wanted.
Must have experience with medical providers and the healthcare system in the United States.
Must be a native English speaker.
Must use iOS-based devices on a daily basis.
As a result, the questionnaire included questions as below:
Is English your first language?
Have you been to medical providers in the U.S.?
What kind of mobile operating system do you use every day?
Then, we announced an online survey on Qualtrics.
There are five tasks in our usability testing including a warm-up task at first. The tasks are:
Please browse the website of Akute Health, looking at the marketing description on the website and how do you feel?
Create a new account on Akute Health.
Add the new medical provider to Akute Health.
Show the allergies and previous lab results to the new medical providers.
Share medical records with a medical provider.
According to the problems we found in usability testing, we gave recommendations to improve the user experiences.
Findings in website
Findings in application
Akute Health's average SUS score is 71 which only a little bit higher than the average SUS score ─ 68. That means the usability in Akute Health still can be improved.
Our semi-structured interview consists of 18 questions, divided into three sections: warm-up, general overview, and further information. There are several examples in every session.
In the warm-up session:
How frequently do you visit your doctor?
Have you been to a hospital or clinic in the last year in the United States?
In the general overview session:
Do you usually keep your physical medical records? If Yes, what is your process of storing physical medical records?
Do you share your medical records with your family/ partner? Why?
In a further information session
How do you keep your medication schedule? ( Have you ever missed taking medicine in time?)
After finishing all the interviews, we used the affinity diagram to help us analyze the answers.
People do not keep their physical medical records.
None of them use EHR software.
People visit the medical records on hospital portals.
People do not tend to share their records except emergency.
No one has ever shared medical records with them.
There is an information gap between patient and doctors such as interpretation about lab results, but patients can just ask their doctors about this information.
Based on research results, here are four recommendations.
Perfect edit function.
Narrow down the target user.
Emphasis the importance of sharing function.
Deal with the trust problem.
What I learned?
Clear and specific recommendation.
It is important to present to the client with clear and specific recommendations. Show them the hierarchy of suggestions such as which can be improved immediately or which should do more studies.
Recruiting is a rigorous process.
Researchers should define what kinds of participants are needed firstly, then use the screener to filter. Meanwhile, researchers should pay attention to the diversity of participants as well.
Recorder and recording tool are helpful.
Interviewing with a recorder allows interviewer focuses on the conversation and interaction with interviewees. Furthermore, recording the whole processes helps to clarify the confusions and quotations.