Focused Visit

The Focused Visit: Creating a workflow for fast-paced physicians

Company: athenahealth

The problem: How do we create an efficient, tailored workflow for specialty physicians to document their patient visits?

My role: discovery research, design strategy, UX design, validative research, project management, stakeholder management

The team: product manager, scrum team developers

Research methods: desk research, shadowing, contextual inquiry, interviews, surveys, resonance testing

Design methods: collaborative design workshop with users, ideation workshop, whiteboarding, low fidelity concepting, prototyping

The Opportunity

Athenahealth’s electronic medical record (EMR) software caters primarily to small/medium size primary care providers (PCPs) across the US. Athenahealth leadership set the strategic goal to broaden product offerings to specialists and to other sites of care. I had the opportunity to lead research and design to increase market share and customer satisfaction by introducing tailored documentation workflows for specialists.

The Solution

A new office visit workflow for shorter, variable visit types common among specialty providers. Primary care providers can also benefit from this workflow if they prefer a more abridged documentation style. Research from this project informed the product roadmap for two more years to introduce configurability to athena’s PCP-focused product.

Discovery Research

Quotes from our client feedback message board

Client feedback threads revealed the top pain point for specialist clients was the need for more flexibility while documenting in an exam. Since athenahealth’s “one-size-fits all” offering is quite rigid, it’s a huge limitation to our specialty clients.

Ethnographic research on-site at provider practices revealed these top needs:

High-volume specialists like orthopedics and gastroenterology are doing repetitive, specialized exams every day. Their workflows vary much less than a PCP. E.g. focusing on hips, knees, or ankles, as opposed to the entire body.
Specialist exams mostly revolve around surgery so their schedules are packed with short pre-op and post-op appointments. They want to get in and out quickly.
Specialists take extra pride in their craft. Each provider has unique needs that they want for their specific workflow.
On the administrative end, many practices don’t have the time or bandwidth to build out new workflows.

Photos (top two) from a client workshop to understand what exam sections are most important. Photo (bottom one) from internal ideation workshop.

Design and iteration

I created five different concepts and sent out a survey to score and rank them based on user feedback. The concepts demonstrated diverse themes such as backend configuration by administrators vs. in-the-moment configuration by the provider, as well as rearranging vs. removing sections. The surveys had users rate the usefulness of the solution, importance of the problem, likeliness to use, and satisfaction with current state vs. the new concept.

A round of user interviews discussing the top two scoring concepts revealed that to our specialist clients, “reducing the clutter” in the exam is the core of configurability. I moved forward with the most favored concept that emphasized user-led, customization of exam section configurations. My scrum team and I named it “The Focused Visit”.

Data and synthesis from user interviews along with top findings

Ideation

With the above pain points and feedback guiding my design strategy, I created “how might we” questions to determine what exactly “configurability” means to our users. I took these HMWs to our annual client conference and ran a pain point prioritization and solution ideation workshop with 40 clients from varying specialties.

How might we…
…create a tailored workflow that doesn’t require extensive set-up?
…make it easy for providers to manage their workflows?
…respect the diverse needs of different specialties?
…leverage the knowledge of our provider network?
…minimize context switching during a patient visit?

Outcomes from the client workshop informed another internal ideation workshop with engineering, product, design, and patient safety.

Five configuration concepts inspired by earlier ideation sessions

Usability and Validation

Further discussions with engineering and usability testing findings led to one more final iteration of The Focused Visit concept. Because The Focused Visit scored positively with 250+ users, received enthusiastic support in interviews, and aligned with the original user goals uncovered during discovery research, I felt confident to move forward to development.

Development and release

During development, I supported my scrum team with design specifications to implement The Focused Visit. To prepare for release, I helped with the alpha/beta recruitment process and designed user satisfaction surveys to measure success.

The Focused Visit went to alpha in May 2020 and become generally available to athenahealth’s customer based in March 2021.

Screenshot from a remote ideation workshop with my scrum team, along with the resulting design solution for saving a default set of sections.

Success Metrics

We received positive feedback from users and high user satisfaction scores in our alpha/beta survey.

As of March 2021, The Focused Visit makes up roughly 10% of all encounters in athenaNet. This is to be expected since there are 14 other exam layout options that can be used and not every type of provider will benefit from The Focused Visit.

Our analytics team determined that for high adopters of the feature, they experience a time-savings of ~1 minute per visit (8% time-savings) compared to time spent before adopting the feature. Over the course of a week, this could equal over 2.5 hours.

Alpha/beta feedback

The main piece of feedback I heard during alpha/beta was the need to edit the set of default sections for a visit, per provider.

I conducted a rapid ideation workshop with my scrum team and created a concept for defaulting a user’s exam sections. This design was spec’d out and added to the backlog.

Impact

Coincidentally, the types of visits that benefit heavily from this workflow such as vaccination/injection visits and telehealth visits became a huge share of visits that athena handled during the Covid-19 pandemic.

Thankfully we were able to predict this need and incorporated The Focused Visit exam layout into our suggested best practice workflows for telehealth visits and Covid vaccine clinics.

Because of our dedication to long-marginalized specialists, we were able to fill a critical need for all providers during the pandemic.