Inefficient system design causes mistakes, stress, and risks to patients. Prioritizing user-centered solutions can save lives and enhance care quality.
Inefficient system design causes mistakes, stress, and risks to patients. Prioritizing user-centered solutions can save lives and enhance care quality.
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Inefficient system design causes mistakes, stress, and risks to patients. Prioritizing user-centered solutions can save lives and enhance care quality.
Inefficient system design causes mistakes, stress, and risks to patients. Prioritizing user-centered solutions can save lives and enhance care quality.
What are EHR Systems?
EMR stands for Electronic Medical Record, which is a server-based system that hospitals can use to manage their patients. These systems are equipped with patient management profiles, order tests, record diagnosis, analyze past diagnoses, etc. These systems were created to improve efficiency and reduce the loss of data due to analog data storage.
Problem Statement
Upon researching EMR systems, it was found that these systems were failing at what they were supposed to do. Due to bad design and usability issues, these systems were causing decrease in efficiency. These effects compounded as the system started to cater to more users. This propelled the occurrence of more errors, which even cost lives. The mental burden imposed upon the users is extreme, which resulted in such errors.
Design
Design process
/01
Research
Competitive analysis
Quantitavtive Analysis
Quantitavtive Analysis
Empathy Map
User persona
Kano Analysis
Competitive analysis
Quantitavtive Analysis
Quantitavtive Analysis
Empathy Map
User persona
Kano Analysis
/02
Ideate
Kano Analysis
Task Analysis
Wireframe
Kano Analysis
Task Analysis
Wireframe
/03
Design
Colours & Typography
Final high fedelity deisgns
Colours & Typography
Final high fedelity deisgns
Conducted an in-depth competitive analysis of the Bahmni EMR system, comparing it with other EMR systems available in the market. The study identified key strengths and weaknesses, providing actionable insights for system improvement and market positioning.
Research
Competitive analysis
Strenght
Weekness
Dr. Chrono
Kario Clinic
RXNT
Can fillout paper work directly by patient before visit to the hospital.
Extremely customizable SOAP notes.
Patient portal is completely customisable.
Can be used on mobile devices.
Can fillout paper work directly by patient before visit to the hospital.
Extremely customizable SOAP notes.
Patient portal is completely customisable.
Can be used on mobile devices.
Very user friendly with minimal learning curve.
Regularly used features are easily accessible.
E- Prescribing medicines.
Intiutive scheduling system.
Ability to create custom reports.
Ease of entering progress notes.
Customizable dashboard
Proper labeling by using colors.
Direct integration of e prescription to pharmacies.
Low implementation cost.
Ease of entering progress notes.
Customizable dashboard
Proper labeling by using colors.
Direct integration of e prescription to pharmacies.
Low implementation cost.
Needs to have a low implementation cost.
Highly Customizable screens are a must.
Minimal learning curve is better.
Cognitive load should be low.
Scheduling system must be highly integrated.
Raising price every year.
A difficult learning curve in each part of the software.
The template construction is sometimes cumbersome.
Does not allow varying appointment times.
Patient portal doesn’t allow viewing and scheduling appointments directly.
Prescribing controlled medication is a hassle.
Calendar integration is extremely limited.
Poor documentation.
Difficult to set up
Some key features are difficult to understand.
Many dropdowns making it difficult to select.
More steps to do a single task.
Medication range setting is difficult to manage.
Should be easy to setup.
An easy way to customize the screens is needed.
Key features must be readily available to the user.
Calendar and appointment flow should be easy to use.
Every process should generally take less time.
Conducted an in-depth competitive analysis of the Bahmni EMR system, comparing it with other EMR systems available in the market. The study identified key strengths and weaknesses, providing actionable insights for system improvement and market positioning.
Research
User Servey
Quantitavtive Analysis
we had talks with few doctor who had handle their own EMR systems
I am a dentist and the diagnosis and procedure for evaluation in dentistry is different. This software doesn't accommodate that. Also, the options are labelled confusingly. To create a diagnosis form for dentistry, I tried using the form builder but it was very difficult and seemed to require somebody to set it up. If it was easy to set up then it would be great for doctors of other fields.
I am a dentist and the diagnosis and procedure for evaluation in dentistry is different. This software doesn't accommodate that. Also, the options are labelled confusingly. To create a diagnosis form for dentistry, I tried using the form builder but it was very difficult and seemed to require somebody to set it up. If it was easy to set up then it would be great for doctors of other fields.
I am a dentist and the diagnosis and procedure for evaluation in dentistry is different. This software doesn't accommodate that. Also, the options are labelled confusingly. To create a diagnosis form for dentistry, I tried using the form builder but it was very difficult and seemed to require somebody to set it up. If it was easy to set up then it would be great for doctors of other fields.
When duty doctors fail to update the system regarding their diagnosis, it will be difficult for us to keep track of the situation of the patients in the wards. Few of them enter all the diagnosis in the end notes rather than filling the forms.
When duty doctors fail to update the system regarding their diagnosis, it will be difficult for us to keep track of the situation of the patients in the wards. Few of them enter all the diagnosis in the end notes rather than filling the forms.
When duty doctors fail to update the system regarding their diagnosis, it will be difficult for us to keep track of the situation of the patients in the wards. Few of them enter all the diagnosis in the end notes rather than filling the forms.
We cannot enter equipment unavailability and turn-in time for tests on the system. During initial days of getting hang of the software, it was bit confusing but with everyday use I got used to it. We have staff for managing other work , I just keep checking the drug inventory once in a while to keep track
We cannot enter equipment unavailability and turn-in time for tests on the system. During initial days of getting hang of the software, it was bit confusing but with everyday use I got used to it. We have staff for managing other work , I just keep checking the drug inventory once in a while to keep track
We cannot enter equipment unavailability and turn-in time for tests on the system. During initial days of getting hang of the software, it was bit confusing but with everyday use I got used to it. We have staff for managing other work , I just keep checking the drug inventory once in a while to keep track
I am a Gynecologist, so my patients are regularly recurring. I cannot set up a follow-up appointment while doing the consultation. I have to completely get out of the consultation panel and head over to the appointments screen to schedule one.
I am a Gynecologist, so my patients are regularly recurring. I cannot set up a follow-up appointment while doing the consultation. I have to completely get out of the consultation panel and head over to the appointments screen to schedule one.
I am a Gynecologist, so my patients are regularly recurring. I cannot set up a follow-up appointment while doing the consultation. I have to completely get out of the consultation panel and head over to the appointments screen to schedule one.
I have had many of my subordinates complaining that the system is confusing to use. In my opinion, the system is not intuitive enough to guide a person using it. Once I was trying to enter a prescription for a controlled substance, the system was supposed to respond with a warning as these are to be recorded in the patient medication history with utmost care. The system failed to indicate this, and the patient got processed for improper conduct.
I have had many of my subordinates complaining that the system is confusing to use. In my opinion, the system is not intuitive enough to guide a person using it. Once I was trying to enter a prescription for a controlled substance, the system was supposed to respond with a warning as these are to be recorded in the patient medication history with utmost care. The system failed to indicate this, and the patient got processed for improper conduct.
I have had many of my subordinates complaining that the system is confusing to use. In my opinion, the system is not intuitive enough to guide a person using it. Once I was trying to enter a prescription for a controlled substance, the system was supposed to respond with a warning as these are to be recorded in the patient medication history with utmost care. The system failed to indicate this, and the patient got processed for improper conduct.
Medical Receptionist are the people who had some experience with the computer yet they face these few issues
first time using the software was a disaster i was stuck in registration page from almost 2-3 hours, it has some big errors which created confusion but now its fines only cause I know about it.
first time using the software was a disaster i was stuck in registration page from almost 2-3 hours, it has some big errors which created confusion but now its fines only cause I know about it.
first time using the software was a disaster i was stuck in registration page from almost 2-3 hours, it has some big errors which created confusion but now its fines only cause I know about it.
I am not used to computers. So it is difficult for me type medicines
I am not used to computers. So it is difficult for me type medicines
I am not used to computers. So it is difficult for me type medicines
It is difficult to manage consultations because i couldn't figure out what to do by myself
It is difficult to manage consultations because i couldn't figure out what to do by myself
It is difficult to manage consultations because i couldn't figure out what to do by myself
Medical assistant don’t have much medical knowledge they are helping hand of the doctor in the clinic.
I am not used to computers. So it is difficult for me type medicines
I am not used to computers. So it is difficult for me type medicines
I am not used to computers. So it is difficult for me type medicines
During the early days of the EHR implementation, as an intern it used to be very difficult to navigate the system's menus. Patient appointments keep getting jumbled due to poor organization by the software. Also, our hospital uses various codes to indicate the seriousness of a specific appointment, and since the system didn't have an option, the nurses have to page us if there is an emergency like a TA patient. It would be great if the software can order the appointments and alert in case of emergencies in the wards.
During the early days of the EHR implementation, as an intern it used to be very difficult to navigate the system's menus. Patient appointments keep getting jumbled due to poor organization by the software. Also, our hospital uses various codes to indicate the seriousness of a specific appointment, and since the system didn't have an option, the nurses have to page us if there is an emergency like a TA patient. It would be great if the software can order the appointments and alert in case of emergencies in the wards.
During the early days of the EHR implementation, as an intern it used to be very difficult to navigate the system's menus. Patient appointments keep getting jumbled due to poor organization by the software. Also, our hospital uses various codes to indicate the seriousness of a specific appointment, and since the system didn't have an option, the nurses have to page us if there is an emergency like a TA patient. It would be great if the software can order the appointments and alert in case of emergencies in the wards.
When there are many patients it is difficult to use the system
When there are many patients it is difficult to use the system
When there are many patients it is difficult to use the system
Data Logging for tests is very time consuming and can make errors
Data Logging for tests is very time consuming and can make errors
Data Logging for tests is very time consuming and can make errors
Sometimes, we would want to issue a few notes regarding the patient for a specific test while ordering tests. That seems to be absent in this software.
Sometimes, we would want to issue a few notes regarding the patient for a specific test while ordering tests. That seems to be absent in this software.
Sometimes, we would want to issue a few notes regarding the patient for a specific test while ordering tests. That seems to be absent in this software.
Interview
To gain more insight on the problem, we interviews 10 different people from differenet places and collected data. here are 2 interviews transcript
Person’s name and occupation
my name is Saroj ghusti. I work in shri diagnostic center, its diagnosis center.
How long have you been in this field?
I’ve been working in the hospital sector here for the last four years.
Are you satisfied with the software you are currently using?
yes, I’m satisfied with the software
Chief point: Satisfied. (only cause user is using it for a long time)
How much time does it take to learn this software
it was difficult. It took me around 3-4 months to learn the software. But it’s like new things take time of courses and then slowly-slowly I learned the whole process.
Chief point: 3-4 months
Have you faced any difficulty while using EHR?
There’s not particular, but it’s like maintaining the whole software is a difficulty, cause I was new, I didn't know which option takes were but now when you keep on doing this stuff you learn and become friends with it.
Chief point: Navigation is not easy for beginners.
Have you ever used any better EHR system than the one you are currently using?
I’m an accountant by profession, so for me, Tally software has always been my first choice. I’ve known that software for a very long and I'm very comfortable with it, and I think it’s the same case with every accountant.
Cheif Point: Accountants prefer the Tally software interface
If you ever got a problem, then to whom do you contact?
We directly talk to the company person, and he’d fix everything, and we directly talk to him as we know him directly.
Chief points: prefer to contact company’s guy for problems
Is there anything you want to change about the system as a user? It can be anything (the way it looks or any function that is difficult to work with)
well, no software can be 100% right. There are always some faults, and we have to adjust according to them.
Now there’s a major problem when we register a patient ID; the software also creates a booking ID, Here the patient ID is unique, and we think that the booking should be remaining to connect whenever a patient comes.
Like take a situation if a patient has a bill of 5000, but he only pays 3000, and he pays left 2000 after two days, then the patient should become zero cause everything is done now it doesn't have like this you have to track the patient ID to remove the patients, it should become zero from the booking ID.
Now, if I can get four times here in a year, then how can I know with booking iD how much I've paid.
Chief point: Patient ID is not connected with Booking ID, results in adding up extra work and loss of data.
Person’s name and occupation
my name is Saroj ghusti. I work in shri diagnostic center, its diagnosis center.
How long have you been in this field?
I’ve been working in the hospital sector here for the last four years.
Are you satisfied with the software you are currently using?
yes, I’m satisfied with the software
Chief point: Satisfied. (only cause user is using it for a long time)
How much time does it take to learn this software
it was difficult. It took me around 3-4 months to learn the software. But it’s like new things take time of courses and then slowly-slowly I learned the whole process.
Chief point: 3-4 months
Have you faced any difficulty while using EHR?
There’s not particular, but it’s like maintaining the whole software is a difficulty, cause I was new, I didn't know which option takes were but now when you keep on doing this stuff you learn and become friends with it.
Chief point: Navigation is not easy for beginners.
Have you ever used any better EHR system than the one you are currently using?
I’m an accountant by profession, so for me, Tally software has always been my first choice. I’ve known that software for a very long and I'm very comfortable with it, and I think it’s the same case with every accountant.
Cheif Point: Accountants prefer the Tally software interface
If you ever got a problem, then to whom do you contact?
We directly talk to the company person, and he’d fix everything, and we directly talk to him as we know him directly.
Chief points: prefer to contact company’s guy for problems
Is there anything you want to change about the system as a user? It can be anything (the way it looks or any function that is difficult to work with)
well, no software can be 100% right. There are always some faults, and we have to adjust according to them.
Now there’s a major problem when we register a patient ID; the software also creates a booking ID, Here the patient ID is unique, and we think that the booking should be remaining to connect whenever a patient comes.
Like take a situation if a patient has a bill of 5000, but he only pays 3000, and he pays left 2000 after two days, then the patient should become zero cause everything is done now it doesn't have like this you have to track the patient ID to remove the patients, it should become zero from the booking ID.
Now, if I can get four times here in a year, then how can I know with booking iD how much I've paid.
Chief point: Patient ID is not connected with Booking ID, results in adding up extra work and loss of data.
Person’s name and occupation?
my name is Vasundhara Gupta. Currently, I’m working in P.V Sharma Hospital as a r receptionist.
How long have you been in this field?
I’ve been working here for the last two years.
Are you satisfied with the software you are currently using?
Yeah, it’s just working.
Chief point: Software is just ok-ok for the user
how much time does it take to learn this software
It took around two months for me to become comfortable with the software. In the starting, it was very complicated, and I kept on making mistakes here and there.
Chief point: it took two months for a user to get comfortable with the software
Have you faced any difficulty while using EHR?
In the starting, yes, it was, I made a lot of mistakes like name and spelling, and there was no one to taught me the software properly.
Chief point: Proper navigation guide was not available for beginners.
Have you ever used any better EHR system than the one you are currently using?
No, I haven’t used any other software other than this, but I’m sure there are. There should be better software than this.
Cheif Point: Hoping for a change
If you ever got a problem, then to whom do you contact?
We directly talk to the company person, and he’d fix everything, and we directly face speak to him as we know him directly.
Chief points: prefer to contact company’s guy for problems
Is there anything you want to change about the system as a user? It can be anything (the way it looks or any functions that are difficult that is difficult to work with)
During the early days of the EHR implementation, as an intern, it used to be very difficult to navigate the system's menus. Patient appointments keep getting jumbled due to poor organization by the software. Also, our hospital uses various codes to indicate the seriousness of a specific appointment, and since the system didn't have an option, the nurses have to page us if there is an emergency like a TA patient. It would be great if the software can order the appointments and alert in case of emergencies in the wards.
Chief point: navigation was hard. It would be great to have a seriousness rate button or emergency option on the software.
Person’s name and occupation?
my name is Vasundhara Gupta. Currently, I’m working in P.V Sharma Hospital as a r receptionist.
How long have you been in this field?
I’ve been working here for the last two years.
Are you satisfied with the software you are currently using?
Yeah, it’s just working.
Chief point: Software is just ok-ok for the user
how much time does it take to learn this software
It took around two months for me to become comfortable with the software. In the starting, it was very complicated, and I kept on making mistakes here and there.
Chief point: it took two months for a user to get comfortable with the software
Have you faced any difficulty while using EHR?
In the starting, yes, it was, I made a lot of mistakes like name and spelling, and there was no one to taught me the software properly.
Chief point: Proper navigation guide was not available for beginners.
Have you ever used any better EHR system than the one you are currently using?
No, I haven’t used any other software other than this, but I’m sure there are. There should be better software than this.
Cheif Point: Hoping for a change
If you ever got a problem, then to whom do you contact?
We directly talk to the company person, and he’d fix everything, and we directly face speak to him as we know him directly.
Chief points: prefer to contact company’s guy for problems
Is there anything you want to change about the system as a user? It can be anything (the way it looks or any functions that are difficult that is difficult to work with)
During the early days of the EHR implementation, as an intern, it used to be very difficult to navigate the system's menus. Patient appointments keep getting jumbled due to poor organization by the software. Also, our hospital uses various codes to indicate the seriousness of a specific appointment, and since the system didn't have an option, the nurses have to page us if there is an emergency like a TA patient. It would be great if the software can order the appointments and alert in case of emergencies in the wards.
Chief point: navigation was hard. It would be great to have a seriousness rate button or emergency option on the software.
Quantitavtive Analysis
An online survey to observe any pattern and similarity in what tha majority of the user and what all problem they face. we got multiple detailed answers
hard to keep track
hard to keep track
7
system is confusing
system is confusing
3
options on dashboard are labelled confusingly.
options on dashboard are labelled confusingly.
2
not used to using computers
not used to using computers
2
Warning alerts missing
Warning alerts missing
1
poor organization
poor organization
2
Data logging is very consuming
Data logging is very consuming
4
add note feature missing
add note feature missing
2
Difficult to navigate through menu
Difficult to navigate through menu
5
Difficult to manage consultations
Difficult to manage consultations
5
difficult to use
difficult to use
5
Research
Empathy Mapping
In order to better understand user behavior and decision-making, we developed an empathy map tailored to our target user group. This process facilitated a shared understanding of user needs and played a crucial role in making informed design decisions.
reloads the page
reloads the page
reloads the page
takes help from someone
takes help from someone
takes help from someone
presses back button to go back
presses back button to go back
presses back button to go back
ask someone else to do it
ask someone else to do it
ask someone else to do it
goes back to home page
goes back to home page
goes back to home page
It reduces pen-paper work load
It reduces pen-paper work load
It reduces pen-paper work load
it’s hard to register a
new user
it’s hard to register a
new user
it’s hard to register a
new user
Cannot customize for our usecase
Cannot customize for our usecase
Cannot customize for our usecase
Causing many errors
Causing many errors
Causing many errors
cannot enter equipment unavaiblity
cannot enter equipment unavaiblity
cannot enter equipment unavaiblity
the system is not optimal fordentistry
the system is not optimal fordentistry
the system is not optimal fordentistry
The system could add an emergency
appointment option
The system could add an emergency
appointment option
The system could add an emergency
appointment option
Says
Does
frustration
frustration
frustration
confused
confused
confused
not intuitive enough
not intuitive enough
not intuitive enough
hard to navigate
hard to navigate
hard to navigate
why is it hard to undo my action
why is it hard to undo my action
why is it hard to undo my action
waste of time
waste of time
waste of time
angry
angry
angry
where to add in-time of tests
where to add in-time of tests
where to add in-time of tests
where to add notes for patient?
where to add notes for patient?
where to add notes for patient?
How do I undo my
action?
How do I undo my
action?
How do I undo my
action?
where to add notes for patient?
where to add notes for patient?
where to add notes for patient?
how to I add a follow up consultation?
how to I add a follow up consultation?
how to I add a follow up consultation?
no warning alerts for
crucial data entry
no warning alerts for
crucial data entry
no warning alerts for
crucial data entry
Dignosis procedures are different
in dentistry
Dignosis procedures are different
in dentistry
Dignosis procedures are different
in dentistry
Thinks
Feels
Research
User persona
Created a common user persona for the targeted group based on all the information gathered by the research. This user persona represents the target user group.
DR. Prabhu Saravanan
Age
Age
34
34
Occupation
Occupation
Dentist
Location
Location
IT Specialist
GOALS
GOALS
The goal is to minimize the time spent managing patient data while ensuring quick access to past reports. This facilitates detailed comparisons and accurate diagnoses, leading to improved efficiency, enhanced patient care, and better clinical decision-making.
Pain point
Pain point
Confusing flows significantly increase the time required to complete tasks. The extremely cluttered interface makes it challenging to read and navigate effectively. Errors frequently occur due to a lack of clear indications, causing frustration and inefficiency in operations.
DR. Gayatri Banerjee
Age
Age
31
Occupation
Occupation
Gynecologist
Location
Location
IT Specialist
GOALS
GOALS
The aim is to reduce the time spent managing patient records while ensuring seamless access to historical reports. This enables gynecologists to perform detailed comparisons, make precise diagnoses, and deliver enhanced patient care, ultimately improving efficiency and supporting better clinical outcomes.
Pain point
Pain point
Complex workflows unnecessarily prolong task completion times, while an overcrowded interface hampers readability and navigation. The absence of clear guidance often leads to frequent errors, resulting in frustration and reduced operational efficiency.
Research
KANO analysis
Combining all the feature requests and changes which were identified through research an extensive list of features of the app was arrived upon. The features are now sorted with the help of KANO model according to its importance. As the time is limited, this helps in finding the most important features to be devoloped in the app.
Research
Final insights based on research and analysis
Considering all teh data, noted down the final insight
Patient arrival time record and sort
Patient arrival time record and sort
Patient arrival time record and sort
Labeling major buttons
Labeling major buttons
Labeling major buttons
Add consultation notes to each diagnosis
Add consultation notes to each diagnosis
Add consultation notes to each diagnosis
Including a back button
Including a back button
Including a back button
Only available details visible in patient history
Only available details visible in patient history
Only available details visible in patient history
Favourites and grouping
Favourites and grouping
Favourites and grouping
Chart analysis and pre diagnosis
Chart analysis and pre diagnosis
Chart analysis and pre diagnosis
User customizable dashboard
User customizable dashboard
User customizable dashboard
Automatic appointment scheduler
Automatic appointment scheduler
Automatic appointment scheduler
Suggestion list in username field
Suggestion list in username field
Suggestion list in username field
Record vitals during diagnosis
Record vitals during diagnosis
Record vitals during diagnosis
Patient list view
Patient list view
Patient list view
Diagnosis related medication suggestions
Diagnosis related medication suggestions
Diagnosis related medication suggestions
Displaying Turn around time for tests
Displaying Turn around time for tests
Displaying Turn around time for tests
Easy to understand labels for fields and options
Easy to understand labels for fields and options
Easy to understand labels for fields and options
Editing order panels on summary
Editing order panels on summary
Editing order panels on summary
Displaying selected order summary
Displaying selected order summary
Displaying selected order summary
Increase clickable areas of buttons
Increase clickable areas of buttons
Increase clickable areas of buttons
Credential specific task flows
Credential specific task flows
Credential specific task flows
Credential specific task flows
Credential specific task flows
Credential specific task flows
New diagnosis local save
New diagnosis local save
New diagnosis local save
Grouping similar features
Grouping similar features
Grouping similar features
Ideation
Task Analysis
Considering all the data, noted down the final insight
Ideation
Task Analysis (revised)
Task Analysis (revised)
Considering all teh data, noted down the final insight
Ideation
Wireframes
Design
Colour
Design
UI-Kit
Final
High Fidelity UI
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