Clinical Application Usabilityreport V04

EMR application Intake and HnP Usability Report

Redesigned Intake Screen based on Heuristic Evaluations

Updated Intake Screen based on High Fidelity Usability Testing

User Centered Design Process followed for Catalyst 3.0

Methodology Used Conducted Heuristic Evaluations on the clinical application to identify most obvious Usability Issues and came up with initial Screenings UI Conducted Low Fidelity Testing with users Conducted Remote Usability testing Across different sites using High Fidelity prototype User groups that participated in the testing Doctors Nurses PHS support team PHS training Team 20 users across different location participated in the user interview. Prioritized user feedback into High, Medium ,Low based on task completion percentage Came up with UI recommendations based on the user inputs

Critical Issues Non-Critical Issues wish list Additional navigational aid to navigate between Sections/Categories-90% of Users Size of the input fields (ex: yes, no radio buttons etc.,)-20% of users Custom control for Calendar functionality Secondary Navigation- 80% of users Disabled states should be clearly visible-20% of users Combine sub sections into one screen connectivity and bandwidth enhancements

Evaluation-Findings Positive Factors: No user had critical challenge with completing key tasks, Interface elements were well recognized. 30% reduction in task completion time All the Users were comfortable and positive about the new interface approach All the Users were able to relate to the progress and system status messages well User instructions were helpful in understanding what needs to be done on a particular screen Users were happy to find the Information at one location than scattered through multiple screens All the Users were comfortable navigating from one section to another section of Intake without any assistance

Evaluation-Findings Improvement Areas: 80 % users were initially confused with secondary navigation , navigation was found to be busy for the target users. 90 % users suggested adding additional navigational aid which would allow them jump to another section without scrolling 80 % of users were not comfortable with multiple next buttons, suggested simplifying nested navigation Users (doctors) suggested patient related input fields should be more customized per scenario. Ex: calendar should allow multiple formats based upon task Few users felt that they should be able to clearly read the disabled state labels.

Evaluation-Recommendations Simplify Subsection Navigation Definition of section and subsection should be clearly established Go to section navigation should be more obvious, and clear. This should be accessible to the user at any point of time Categorize interface elements so that it doesn’t look busy Increase the visual affordance of clickable elements in the content area. UI elements states ( inactive) should be more clearly visible

User Comments, Findings, Recommendations and Solutions

Evaluation-User Comments Help Desk : ‘ Finally this looks like a software” “ I would feel more comfortable is providing support to this than the previous Cat 2.0 “ Please make the current, active and visited states more clear” ( We addressed that) Training Team “ Tasks flows are very clear, there won’t be huge learning curve” “ I think it will reduce my training time” “ This restricted navigation works perfect! we will be able to control users task flows, which was not possible with Cat 2.0” Tina T, PHS Account Manager, location: PA “ I thought the demonstration showed major improvement. I appreciate the opportunity to see what is coming and how it would affect the process of flow from a site perspective.” Mr. Jimmy Webster: PHS Regional Vice President, Location: PA” I thought the flow change was excellent. The pages do not look as busy as before. I think the changes are definitely more easier and user friendly. On the first page the “next sections” can be a little brighter just so the user can see and differentiate what is coming up next. ( We addressed that) Regina J. Mays : Implementation Manager, PHS I have never seen Jimmy and Tina appreciating so much about catalyst. The fact that they are positive gives me a huge confidence

Evaluation-User Comments ( continued…) Some User comments (Doctors and Nurses) When I clicked on Next subsection I thought it will take me to mental health. But it did not. It took me a while to understand the way it works The interface is too busy. I am confused between so many Next buttons. “ The concept of tab works pretty well for me. Gives me a easier way of navigation from one category to another. ( Doctor) “ May be you should think of changing the verbiage from “subsection” to “Category” “ Having a Calendar is good but most of the inmates are born somewhere between 1950-1970” . So it will take me ages to select a date. “ Inmates do not remember the exact date or even month when they had the last breathlessness” It’s better not to enter inaccurate information” “ Why do I have to make a mistake, or skip a field to know what I am supposed to enter” “ When I am in middle of say section 5 or section 6 and I want to jump to section 1. How would I do that?. Because the numbers are not visible. So anyways I will have to scroll.” “ Grey areas in the screen are too grey. Can’t even read what is there”

Observations 50% of the users had difficulty in understanding the correlation between the numbers and the sections below. For the rest although they were able to establish the relationship, but thought it will be better if that was more clear and obvious. Doctors thought that the putting in the names instead of numbers will reduce the cognitive load. 90% of the users felt that this functionality, of allowing the user to jump to a specific section was very helpful, and will definitely reduce the number of clicks. But they recommended to think of a simpler way of doing the same 90% of the users felt that the design was too busy on the top. Recommendation was to reduce the clutter. 60-70% of the users were having difficulty in identifying Expand all collapse all at first. However most of them figured it out with minimum assistance. Most of the users were able to find of the progress bar and could clearly tell what it’s purpose was. However they felt it was “good to have” information, and not very critical for their day to day task. Secondary Navigation

Solution/Recommendation Simplify navigation secondary navigation (section to section navigation within a Screening) should be clearly visible and have section labels Figure out a way to ensure that user can always access “go to section” from any part of the screen without scrolling. Put more emphasis on the most critical tasks, and find a different place for placing good to have information ( e.g. progress bar) Solution Secondary navigation moved to the left with flexibility of hiding and showing the navigation Navigation menu is always visible and available to users and will allow them to jump to any section with in the screening (Auto Scroll Menu?) Secondary Navigation

Observations 80% of the users had difficulty in understanding the subsection level navigation Majority of the users used the next subsection button below instead of using the Next and previous button on the top beside the tabs When asked to navigate from Tab to Tab ( Asthma to Cardiovascular or Diabetes) users ( nurses in particular) used “ Next sub section” instead of directly clicking on the tabs. Users were also having challenge in understanding the concept of “Sub-section” and “Section”. The definition was not very clear. Some thought that clicking on subsection will take them to next section. The pattern of using next and previous with the tab was not understood by majority of the users. Although it’s an established pattern, this may not be appropriate for the current user group. Users thought that clicking on the “ Next ” will take them to the next tab, instead of next set of tabs. Sub Section Navigation

Recommendation Simplify the navigation. Reduce the number of next buttons from the screen. Tab to tab navigation should be centralized on one location. Next and Previous on the top should be changed to “Next subsection/Category” and “Previous Subsection/Category”, clicking on it should take the user to the immediate next tab. Remove “ Next subsection” button from below. Change “sub section” to “ Category” The next tab should turn active when the user enters the last question. Sub Section Navigation Solution Tab navigation is simplified and arranged in rows so that they are always visible. Next and previous subsection buttons are changed text links with subsections label. .

Observations Most of the users were more comfortable typing in the date than using a Calendar. However they felt having a calendar is helpful. But 90% of them typed in the date. Both doctors and nurses mentioned that the inmates do not remember the specific date ( specially when it comes to diseases e.g. “when did you have the last breathlessness” ) So in all such cases mentioning just the year or month and the year should be enough. The Text field should have the accepted date format. Clear instruction should be provided even before user makes an error. In the current scenario instruction is only given if user skips a question. Instead there should be some indication to mention what are the mandatory fields. And an instruction or a tip to help user enter correct information. Having a normal calendar with the current month date and year does not work for Date of Birth. To select someone’s date of birth who was born in 1940 will take ages. 90% of the users had difficulty in recognizing Calendar icon. It didn’t look like a calendar The area of the text field or the yes no button for the level 2 questions are too small. Users had difficulty in selecting. Data Input fields

Solution Mandatory fields are highlighted Date field is proposed to be accepting multiple date format. Forgive format? Unnecessary details from calendar icon are removed (same strategy will be applied for all the icons used) Data Input fields Recommendation Feedback mechanism should be more intuitive and proactive. Make the buttons, text fields, and other clickable areas bigger. Change the Calendar icon and make it look more like a calendar

Observations The sections which are inactive are hardly visible/readable. Make it more readable. Disabled/Inactive elements

Solution Disabled states are more simplified and now follows the standard disabled state indication style Disabled/Inactive elements Recommendation Improve the readability of the inactive states.

Catalyst 3.0 Intake (based on initial assumptions)

Catalyst 3.0 Intake (based on Usability testing)

Clinical Application Usabilityreport V04

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