Hospice Savvy is an app developed specifically for nurses that work in hospice. It encompasses all the important features a nurse would need for working in the field.
Project Details
Project Type
Healthcare app creation
Project Role
Project designer owning the UX research and UI design of project from branding, to prototyping, to testing, and to iterations
Project Duration
80 hours
Background
According to IBISWorld and Statista, in 2020, the home health care services industry brought in about $97 billion in revenue in the United States. There are approximately 15 million patients and with about 600 million patient visits a year. 10,000 baby boomers turn 65 years old each day. According to the Census Bureau, all baby boomers will be over 65 by the year 2030.
From a stakeholder perspective, there is potential for revenue to steadily increase in this industry but there are areas that need attention to avoid stunting growth.
Highlights
Problem
A software engineer who used to have a home health/hospice background in nursing approached me with a project idea. She stated that a big frustration that she and her coworkers had was lack of a well running and useful electronic medical record (EMR) for nurses to use at the company.
Solution
An app was designed with the purpose of having all the tools a hospice registered nurse would need to do their job efficiently and pleasantly.
Outcome
100% of the nurses that tested the prototype were excited about the app and gave it a rating of 8 and over out of 10. The app eliminated several pain points that were experienced by other nurses in their current or old work environment.
Research
Research Goal
Before approaching the creation of the hospice app, we want to learn about a user’s goals, motivations, pain points at work and more importantly the product they use to care for patients to improve their experience and work flow.
Research Objectives
Explore the pain points users have with their EMR regarding usability, navigation, data entry, and more
Identify the most essential features the users desire or find useful in an EMR
Learn about the efficiency of the EMR and the time it takes to complete tasks
Learn more about competitors and their strengths and weaknesses
Research Participants
Home health and or hospice registered nurses
Registered nurses with acute care experience
Users that have insight on a current or past EMRLocated in California
Competitive Analysis
This was a challenging part of research because when researching “competitors” or products for this industry, what populates is apps regarding managing payroll, staffing, and other all-inclusive features that a nurse may not need to perform their day to day job.
A common weakness that many customers brought up that is in my control is the extra steps it takes to perform a task.
Although this was a bit challenging for me to find products close to what I was searching for (more documentation oriented for nurses), I discovered helpful information to help guide the in -depth interview questions.
Post In-depth Interviews Affinity Map
The interview results were a bit perplexing because the patterns were not as obvious because the nurses all had varying pain points.
Pain points mentioned:
4 of 5 nurses stated frustration with charting taking too long and the redundancy and or content of charting assessment also affected that. Several mentioned that they would spend more time documenting than when they were with their patients and would at times document late into the evening to catch up.
The next pain point was brought up by two nurses regarding onboarding and learning how to use the EMR.
Overall, the bigger picture is that the nurses desire to save time with more efficient charting and effective communication.
Due to lack of obvious patterns, the pain points will guide in developing the end to end EMR app that is to come.
Potential areas of focus found: patient assessment, care plan, team communication, MD orders, handoff access/file access
POVs and HMWs
I’d like to explore ways to help a home health or hospice nurse document with more efficiency and ease so that they can spend more face time with their patients.
How might we either remove the frills that come with documentation?
How might we reduce the number of tools that a nurse uses for more cohesion and simplicity?
How might we develop an app that is intuitive and promotes a pleasant work flow for the nurses using it?
I’d like to explore ways to improve communication better among team members so that the patients can have what they need in a timely manner and for better patient outcomes and satisfaction.
How might we have more seamless communication among team members of different disciplines?
How might we identify the gaps or barriers in communication that team members are experiencing with one another?
User Persona
One user persona was created to represent the group of hospice nurses that were interviewed because their motivations, goals, needs, and pain points as nurses in general are along the same wavelength. The pain points are highlighted because they guide the solutions relating to time management, communication, and tools. Through creating a user persona, I’m able to continue to put myself in the shoes of a user to help guide the development of the app.
Product Development
Site Map
A rough sitemap was created to outline the features that will be shown on the app. The ones in gray are the ones that belong in the “nice to have” and “can come later” features. The ones in blue are the “must haves” and users are able to interact with them on the prototype.
What it has evolved to is the navigation bar is scroll-able and looks like what is shown below. The goal was for the most essential features a hospice nurse would need to be easily assessable.
User Flow
The original flows that were created were:
documenting vital signs
documenting assessment
creating a care plan
creating a note
In the process of creating the wireframes, a different structure made more sense. Instead of having a flow for “creating a care plan”, it was now under the same area as note. A new flow was created, which was messaging the physician for a new order and acknowledging the order. These new flows were tested in the prototype, which can be found in the “Usability Testing” section.
Low Fidelity Wireframes
After sketching out the low fidelity wireframes, it was evident which screens were the most essential. To ensure none of the features were missing, the user flows that were going to be tested were also kept in mind in the creation of the mid fidelity wireframes.
Branding
“Hospice Savvy” was the selected name for the app to convey not only simplicity but also the goal of this app-to help hospice nurses be even more savvy with their work through this powerful app.
The colors were selected with calmness and peace in mind because this job can be demanding, stressful, and burdensome for nurses.
The function and clarity of this app is most important, so a sans serif font was chosen for not only it’s modern but simple appeal.
With the user flow in mind, mobile screens were sketched to help envision and craft the solutions the users desire.
Mid Fidelity Wireframes
High Fidelity Wireframes
Log In and Home
Entering Vital Signs
After incorporating the branding into the mid fidelity wireframes and refining them, the high fidelity wireframes were created. Then, they were converted into a prototype to be tested by users to confirm whether or not this product and features are what users are looking for.
Usability Testing
Hospice Savvy Prototype
User Testing on Prototype
Research Goal
To observe nurses completing several task flows on the hospice app and discover any pain points to help with the iteration process
Success Metrics
Users are able to complete the tasks with little to no confusion.
Users have positive reactions to this feature
Users are able to give specific feedback comfortably on how to improve the app as a whole
Research Objectives
Discover any gaps found in completing their tasks
Learn about the strengths and weaknesses of this app
Learn if this app improves the user’s workflow
Validate that this app would be useful and pleasurable to use
Flows Tested in Order
Logging in and accessing dashboard
Entering in patient’s vital signs
Messaging doctor for a patient order to be put in
Entering in patient’s assessment
Entering in patient’s note
Entering an Assessment
Messaging Doctor for Patient Order
Creating a Note
Participants
A mixture of participants from the previous interview and new participants
Nursing background (half hospice, half acute care)
Have some sort of experience with EMRs
Located in Northern California
Affinity Map Post Prototype User Testing
The prototype interviews were insightful for learning the weaknesses and strengths of the app through the creation of an affinity map.
Half of the participants were baffled by not knowing where to go to create a note because they did not realize the navigation bar was scroll-able because it was cut off in a way to look like it was permanent. Before interviewing the rest of the participants, a quick adjustment was made to it to make it more obvious that it had a horizontal scroll and that seemed to fix the problem for the nurses that were interviewed after.
100% of the interviewed participants gave favorable overall reviews for the app, “Hospice Savvy” with the lowest rating being a 7.5 and the highest score a 10/10. Participants mentioned how straightforward, simple, and easy to use the app was. Each participant was able to complete each task fairly quickly, taking no more than three minutes to complete the task.
Despite the raving comments, there was constructive feedback that would elevate the user experience for these nurses.
Iterations
The screens on the left are the screens that users were tested on and the screens on the right show the iterations made according to observations and their feedback in performing the tasks.
Navigation Bar
Change: Making it more obvious that the navigation bar is scroll-able
Context: When it came to creating a note, users could not figure it out until the adjustment
Patient Profile Dashboard
Change: More information was added to the patient dashboard to make sure it has all the essential information a nurse would need to deliver the best care for their patients.
Vital Signs Dropdown for Pain Label
Change: Made it more clear that the user can choose more than one option
Context: Half of the users mentioned doing a check list style instead of a drop down menu. The other half enjoyed this cleaner set up.
I created a check list version similar to assessment after user testing but it looked very busy. After investigating with the users again, it was most important to make it more obvious that users can select multiple options so “Select all that apply” replaced the original labels for the ones that had the option of choosing more than one description.
This call was made because some users mentioned that if they were on the go for something important like vital signs, they were less likely to make a mistake and select the wrong options due to their “fat finger”. Whereas assessment was fine because usually, the nurse would have to sit down and dedicate more time to that section.
Creating a Note Labels
Change: The type of note that the nurse can make was changed.
Context: This makes sense because a nurse wouldn’t need to write a “physician note” or any other discipline. This decreases clutter and allows the user to be more specific with the type of note they’re writing.
Descriptive Note Labels
Change: More descriptive label
Context: A more descriptive label allows the user to sift through with more easy and find a specific note they’re looking for with more ease. This was important to the users being tested.
Wrap Up
“It’s comprehensive, covers all the bases you need for the hospice app. You thought of everything and it has everything I’d need. I’m just really fascinated by this app. ”
“You basically made the app that I wish I could’ve used when I was in hospice.”
Takeaway
Hospice Savvy personally feels fulfilling being able to bridge health and tech even though it currently is not being used yet because the nurses that used the prototype were so excited about this product knowing what it could do for them and other nurses.
Skills that were strengthened/reinforced:
adapting research according to project needs
creating the branding with the company mission and vision in mindhaving mindfulness of assumptions and personal biases being somewhat of a subject matter expert for EMRs
Next Steps
If more time was available, it would have been nice to:
continue working on all of the features in the horizontal navigation bar
interview more nurses from different hospice companies
fine tune more of the small interactions that may have been overlooked or missed
Eventually, my software engineer friend who suggested this project will be building out this app in hopes of future adoption from hospice companies.
Thank you
Thank you
Thanks for learning more about Hospice Savvy. Please feel free to reach out for feedback, work, and or collaboration!