Week 9 – Finishing Up

This week was a hectic week for the team. With a clearer understanding of how to develop quality solution concepts from our analysis, we delved into user scenarios and point of views. At the beginning of the week, we go together to pull quotes and scenarios from the interviews and survey results. We chose 2 different scenarios that we thought narrated the problem clearly:

1. Patient enters the doctor’s office and has to tell 4 separate people the same story about why they’re seeing the doctor: making the appointment, the front desk, nurse, and then finally the doctor.
   Problem: This feels impersonal and implies a lack of communication or a disconnect between members of the office.
2. Doctor goes back and forth between the patient and the screen (EMR) during an appointment to record all necessary information.
   Problem: This doesn’t allow for the conversation to flow naturally between the patient and the doctor.

We then discussed the ideal situation for both of these scenarios in order to develop solution ideas that are directly aimed to achieve this ideal experience.

1. Patient: The patient should feel like the appointment is personalized and they don’t have to tell the doctor what is wrong because they already know.
   Doctor: Appointment is more efficient because they already know the patient’s needs.
2. Patient: Feels like they’re in a comfortable environment and that its a conversation about health (with eye contact!)
   Doctor: They feel like they are getting back to why they got into medicine in the first place: to help people and interact with patients using eye contact. However, they are still able to record necessary information that is required of them.

Having clarified these two scenarios, we were able to come up with more original solution ideas that we could confidently say, with some further research, has the potential of being very beneficial for both doctor and patient.

Throughout the week, we have also been working on our poster for presenting next Wednesday. We started out with an extremely text heavy poster which we were able to cut down by talking to our instructor about the most important information we wanted to convey to our audience. On Thursday, we received feedback from our sponsors and they were extremely helpful with coming up with different layout ideas, how to visualize our results, and how to pull people in to talk to us about our project. Here is the development of our poster:

1st version:

 

Current version:

 

Next week we will be finishing up our (1) final report, (2) poster, and (3) presenting to our sponsor, SonoSite, and the rest of the HCDE community.

 

Week 8 – Preparing for the Final Home Stretch

At the beginning of this week, we consolidated our remaining plans for the next three weeks into a “sprint schedule”. By creating this schedule, it allowed us to be more organized as we venture into the final stretch of the quarter, while preparing us for our weekly meetings with SonoSite.

From analyzing our interviews for milestone 2, we decided that we still needed to go further and familiarize ourselves with distinct EMR systems, which was accomplished through reviewing tutorials of these systems on Youtube. We reviewed several EMR systems including Cerner, Centricity, and Meditech. As a group, we came together and discussed the pain points of these systems as we had observed through the tutorials, regarding problems with the overall interface, difficulties that physicians might encounter through using these EMRs, as well as some of the strengths of the systems that we will consider for recommending solutions.

After putting out the survey for physicians and scribes in the previous week, we looked through Reddit and found some interesting threads that were relevant to our project, including this one:

EMR Redesign Reddit Thread

This thread had numerous physicians and medical scribes that chimed in about the problems they experience regularly with EMR systems, going as far as describing their needs when documenting medical records and proposing solutions! It was definitely an interesting, entertaining, and useful find.

On Wednesday, our team regrouped to discuss design solutions for the high priority problems that we had outlined in milestone 2. After a full session of whiteboarding, we narrowed the problem scope to one overarching problem: that EMRs make the doctor-patient encounter impersonal. We decided to focus on one problem due to the time and resource constraints of our project. We brainstormed how different technologies that are already being produced could alleviate this problem.

At the end of the week, we met with our team at SonoSite to get them up to speed with the progress of our capstone and to seek out some feedback for the design solutions. They were extremely helpful in advising us to take a step back and answer the following statement:

_______ need _______ because _____________________.

In our case, doctors need a more personal interaction with patients because ___________. We still need to define our motivations for solving this problem, which will be pulled directly from the research that we’ve obtained thus far from the interviews, and from what we still need to analyze from the survey responses in the next week. From there, we will focus more specifically on how we will design a solution for this statement.

 

 

Week 7 – Second Round Research

This week we worked on developing and deploying a survey to get quantitative data about our user group. Instead of doing a second round of interviews, which would be too costly, we decided to create surveys to understand more about how physicians and scribes interact and use EMR/EHR systems along with other technologies in the medical office. From our previous interviews, we identified areas where we could use more information and demographics to fully analyze the themes we were identifying. We brainstormed lots of questions to ask physicians and scribes, decided on two different surveys for the two groups, and got feedback form our instructor and peers. Below are snippets of our survey which we finalized and posted to multiple forums online that target our specific participant groups.

  

 

We also got feedback from our sponsors on the questions which was extremely helpful and made our survey concise and clean. We hope to get at least ten participants (if not more) for each survey. Analysis will begin this week.

Week 6 – Wrapping up interviews & beginning the analysis

At the start of the week, we wrapped up our final interview with a physician and were able to move forward with coding our interviews and articles using Dedoose. Overall, coding on Dedoose went very smoothly, and we coded in accordance with the terms that we had outlined and defined in the week before last. Unfortunately, on the day of our group meeting – where we had planned to begin the analysis of the interviews – Dedoose decided to crash on us. We got in touch with the support staff, but they informed us that they would not be able to recover all of the data that we had already coded. So, we decided to rapidly recode everything straight from Google Docs, using sticky notes.

The codes from the interviews are grouped by color, according to the code word that they belong to. For the sake of making the most out of group meeting time, we decided to narrow down the amount of code words that we would focus on. After the whiteboard was filled with codes, we were able to group those that were similar and from there, spotted some recurring and notable themes that we plan to put into our Milestone 2 document (the analysis of our first round of interviews). This process was great preparation for our team in helping us understand how design recommendations can be grounded in user research.

This week, we also met with our sponsors from SonoSite. We shared the ups and downs of the project thus far. Ups being all of the interviews and the interesting findings. Downs being Dedoose crashing and losing all of our coding. We laughed about it and our sponsors reassured us, saying they frequently use sticky notes since they allow you to step back, quite literally, from the findings and see the overarching patterns. We shared our idea of doing surveys in place of a second round of interviews, which was met with approval. This week, we’ll be pulling together some overarching findings, deciding on what we’d like to delve more into, and create surveys to post on internet forums.

Week 5 – Setting up interview analysis

 

This week we finished up recruiting for the first round of research interviews, having to reschedule them a few times unfortunately. We interviewed one doctor on Wednesday and have our last doctor interview on Monday. While we wait to finish our data gathering, we put our existing interviews into Dedoose and began coding using the words we decided on last week.
This week was mainly individual work where we each went through the interviews to look for interesting information to analyze. We look forward to doing affinity diagramming on whiteboards next week to analyze and find themes to begin brainstorming design solutions.

Week 4

Accomplished Last Week:

• Interviewed a doctor at the UW Medical Center who gave us a good sense of what it’s like not having a medical scribe.
• Finalized our coding words to start analysis with.
• Started putting interviews and coding words into the analysis tool ‘Dedoose’.
• Recruited two more doctors to hopefully interview this week.

Work for this Week:

• Interview two more doctors to get a a holistic view of the doctor’s side
• Set up and interview a few more scribes.
• Continue putting interviews in ‘Dedoose‘ and coding.

We decided to switch from Saturate to Dedoose because Dedoose has more capability than Saturate. It allows us to add as many codes as we want on only highlighted pieces (that are easy to identify) and allows us to log who coded what. We inputted our list of codes into Dedoose and each member of our team is going through each interview to see where our code pop up.

Week 3

What we accomplished:

• Actually conducted an interview with the EMR director at the UW Medical Center – we jumped the gun the previous week, got to the med center for the interview and realized the interview was scheduled for one week later. Ah well, dry runs are important! Gained a couple of fantastic contacts for potential interviews.
• Got stood up on our phone interview (which is entirely understandable because physicians are insanely busy!) so we emailed some questions to the doctor in Dallas. Will hopefully hear back with answers and more contacts.
• We transcribed and pre-coded the 3 scribe interviews on Google Docs. Before we get started with the official coding in Saturate, we have been going through the interviews, deciding together what codes we’d like to use and why so we’re all on the same page and analysis goes a bit more smoothly.
• During our peer group meeting, we received and incorporated their feedback into our analysis of the scribe interviews.
• We began analyzing the 3 scribe interviews based on:
  1. Software and technologies used
  2. User groups that interact with medical records
  3. Each participant’s day-to-day responsibilities, workload, and needs
  4. Notable and reoccurring themes

Scheduled for next week:

• Focus on gaining more physicians as contacts for potential interviews.
• Get more referrals from the interviewees and schedule more scribe interviews.
• Finalize coding words that we will use once we transfer the data over to Saturate.
• Start thinking about how to narrow down our project focus for our second round of interviews, based on our analysis.

Week 2

Work Accomplished:

• Finalized interview questions and protocol thanks to feedback from Kevin Flick and Mobina Imtiaz from SonoSite.

• Conducted 4 interviews with a medical student, two medical scribes, and a EMR director at the UW Medical Center.
• Scheduled an interview for next Monday (4/14) with a doctor in Dallas, TX
• Continued to recruit potential participants.

Scheduled work for next week:

• Conduct more interviews (for sure Monday)
• Recruit more for second round of interviews, a lot from referrals from interviewees
• Start transcribing interviews
• Begin organizing data and analyzing (with Saturate and affinity diagramming)

Week 1

Before this quarter began, we met up with SonoSite to discuss our thoughts about what exactly we should research for our Capstone project. We met with the UX team at the company headquarters in Bothell, WA where they presented three potential projects: remote control recording in the doctor’s office, Medical Scribes, and overlay wizard for learning how to use EHR systems. After a long discussion, we decided to go along the route of researching how doctors interact with EMRs while with patients which includes Medical Scribes.

For this first week of the spring quarter, we focused on recruiting participants for the first round of interviews. We did this through convenience sampling and by posting an ad on Craigslist (which has yet to be successful). We managed to reach out to roughly 10 people, 5 of whom have committed to an interview with us next week, either in person or on the phone. Next week will mainly be focused on conducting interviews and ensuring our interview questions are returning the information we want. Over the past week we have brainstormed interview questions that we will pilot this upcoming Monday for the following interviews that week. We are looking forward to talking with medical scribes and physicians to learn more about this problem.