Caroline Keem, UX Design

Allscripts Care Director Plan

Rebuilding an outpatient care coordination platform to support scalable, integrated care

A fragmented outpatient care tool couldn’t scale with evolving clinical workflows or integrate with inpatient and payment products. We needed a redesigned platform that supported collaborative care across multiple settings, while improving usability and integration.

My role

As the sole UX designer on a 10-person team (8 devs, 1 lead), I led visual and usability design from research through delivery.

Conducted contextual research to understand how care coordinators actually worked
Mapped out real-world workflows and surfaced unmet needs in the legacy tool
Collaborated with devs and stakeholders to reimagine a more holistic care coordination model
Built and tested prototypes, informing the concurrent Care Director redesign
Developed a robust usability and visual design guide to streamline team-wide design decisions

The Impact

The new Care Director Plan launched with immediate adoption: 30% of existing customers onboarded rapidly
Outcomes included a 40% reduction in utilization, higher program participation, and improved patient experience
Development teams were empowered to make consistent design decisions using the shared style guide

Empathize

Qualitative Research

Observed 19 medical professionals

What are they doing?

Copying and pasting between multiple tools
Creating their own templates in Word
Creating their own task list in Excel
Duplicating efforts by writing on paper and transcribing into computer

Who are they?

Late-career, in their 40's or older & primarily female
Incredibly devoted to patient health & preventing readmissions
Unable to read small type on screen
Experiencing wrist pain

Consolidate user data

Pulled all observation notes into consolidated data models to discover themes

Affinity diagram

All notes consolidated across users to uncover themes

Flow Diagrams

Flow model allows better visualization of user journey and highlights common breakdowns

Create personas

Create persona libraries based on real qualities that users embody

Additional writing on personas

Heuristic evaluation

Gained a thorough understanding of inherent usability problems

Performing a heuristic evaluation on the current product revealed how it failed to adhere to usability standards and provided quick-win insights to act on while user data was being collected and consolidated. This evaluation also helped me show the CDP development team what NOT to replicate as we built the new product.

I examined the product one heuristic at a time to specify how Care Director needed improvement in each of these areas:

Visibility of system status
Recognition rather than recall
Flexibility & efficiency of use
Help and documentation
Consistency & standards
Error prevention
Helping users recover from errors
User control & freedom
Match between system & real world
Aesthetic and minimalist design

Ideate

Vision Sessions

Lead vision session

Team members of all disciplines "walk the wall" to absorb user data & have design ideas

Team members then split up into groups to brainstorm & storyboard on a particular issue

Jobs-to-be-done

Identified jobs-to-be-done and matched these with solutions generated during visioning session

Prototype

Sketching

Paper and pen have no limits

Wireframe

Wireframes are an easily sharable sketch to work out choices and content possibilities

Hash out the possibilities for each screen.

Discuss how these choices will work for personas. Will Not-tech-savvy Nora understand this? Will this make Resouceful Rebecca's work easier? Will this help Empathetic Emily to see what she needs to easily so she can do patient care?

I primarily use these with just the immediate development team to work through the details and flesh out requirements.

Interactive prototype

Interactive prototype with styling applied

Get the full feel for the user flow.

Validate design with development team.

Present to additional stakeholders. Since this product integrates with other patient care tools, the interactive prototype was validated with other product teams to ensure consistency.

Test

Remote testing of interactive prototype

I recruit 5-10 users from an advisory board consisting of customers willing to participate in product imrpovement. Our participants join in a Webex call and are given keyboard and mouse control so they can directly interact with the UI.

A variety of roles are sought for most testing. In the case of CDP we really were only focusing on Care Coordinators and Managers.

I am in charge of setting the test objectives, writing the test plan, create at least 3 different presentations of test results depending upon the audience.

Successful or failed assumptions are a clear benchmark to reference when making follow-up design recommendations.

CDP was being developed in tandem with the UI uplift for the legacy Care Director toolset. I was not given legal clearance to test CDP directly because it was a new product.

But, since I was also updating Care Director to match this new product, I evaluated CDP's interaction models as part of the user testing our existing product. This allowed me to validate and update designs before CDP went live.

Iterate

Spring 2019

CDP launches as a component within the Allscripts Sunrise EHR

A care coordination tool that is patient-centered, not data-centered

The CDP care coordination home page was housed as a window within the Sunrise EHR. Since Sunrise had a complicated and visually VERY LOUD interface the look and feel needed to be muted and carefully call attention to the most important items (e.g. overdue tasks). It's more grey than I would have preferred. But, if you imagine this screen surrounded by a 3-ring circus, the grey becomes a welcome and legible reprieve.

To address users' accessibility issues seen in our research the base font size was set larger, and the interface was tested to ensure that it both could be controlled entirely from the keyboard & would not break if the browser font size were increased.

Late 2019

Patient programs feature added

Built for responsiveness and expandability

CDP had to adapt to multiple screen sizes. For this reason the sprawling data tables were abandoned for cards that could easily wrap & stack depending upon window size and still provide an at-a-glance snapshot. I also knew that this footprint would be easily replicated as CDP's capabilities grew. I also hoped that eventually users would be able to reorder the cards as they saw fit or drag and drop between CDP and the EHR.

In late 2019 - early 2020 CDP was expanded to include additional patient information. The project went smoothly despite an entirely new team of developers taking on the work because they were easily able to reuse the standards and styles to integrate more patient data.