Improving remote patient care through nurse workflows

• Product Strategy

• UI/UX Design

• Add new features

• Re-design existing features

In an era of virtual care LucidAct is empowering nurses and patients. ADG re-designed the UX & UI of this critical interface for managing hundreds of chronic care patients and RPM devices.

Opportunity

The Healthcare industry is in the early stages of a renaissance. A combination of recent technological and regulatory changes in the United States have created opportunities for change and growth that were not even foreseeable at the turn of the millennium. With this stage set, in walks LucidAct Health. A Silicon-Valley healthcare startup.

Recent changes in 2015 to healthcare regulation administering Medicare created a new rapidly growing position in the healthcare space: the Chronic Care Manager (CCM). Millions
of Americans are suffering from chronic diseases, like heart failure, and too often end up in the emergency room when things suddenly take a turn for the worse. Medicare’s support for
Chronic Care Management pays for programs (to the tune of $5B/yr) where nurses monitor individuals on a monthly basis to reduce risk before things get worse and someone’s beloved father ends up in the emergency room. It’s a win-win. People live longer and Medicare saves money.

LucidAct is tackling this opportunity by building a SaaS product that helps Chronic Care Management programs manage their patient loads. At the cutting edge, LucidAct uses AI
and Medical IoT devices to assist the Nurses acting as CCMs.

I partnered with LucidAct to help them navigate this opportunity by using UX Design and Research to create the best product in the industry.

Our design made it easier for nurses need to monitor remote patient monitoring devices for risk factors.

Design challenges

Looking at the existing players, many existing healthcare products and Electronic Health Records (EHRs) have clunky designs that waste health professionals’ time and energy. There was an opportunity to beat existing players in the healthcare industry by having better UX design. Interface design can benefit the healthcare industry to improve the patient experience, streamline productivity, and empower people to do their best work for patient care.

Another core issue is that Nurse CCMs have an abundance of patients they need to be monitoring. Typically one nurse is handling over 300 patients. It’s obvious that with a vast amount of patients, there is an overflow of information. The patient’s health needs to be tracked and managed to allow for a smooth collaboration with the patient's doctor, pharmacist, oxygen provider, etc and to fulfill the necessary regulatory requirements.

Strategy & research

My strategy was to discover the common models that users (aka nurses) rely on when working through their patients. In my practice, I like to talk to my clients about desire paths. Meaning, in this situation there is a certain way that nurses are working here, and it’s my job to align the software as close to real life. It’s important to get to see the user in action. You will be more successful when your product aligns with the real world.

Through conversations with several users, I pieced this together. For example, one of the nurses showed me her workflow that began in Google Sheets and then eventually made its
way onto the LucidAct interface.

I saw the need for an interface where users like her could get the utmost information visibility. I incorporated this with AI, interface design and good information design to establish the right mix of consistency and flexibility.

Part of this was the AI algorithm that would assist the management of the patient list in terms of which patient to focus on and when, and so I developed the parameters around
that based on research insights. For example, one nurse told me she needed to go back and forth between LucidAct and other required software. Because of the limitations of the other software, it was more efficient to work on patients in groups by clinics.

UX/UI

The new UI/UX (above) significantly improved workflows and information management of patient records

The new design included essential information:

  • Organized daily nurse task list
  • Details on the best time to call patients
  • Call Patient button
  • The ability to mark whether they answered or not
  • Monthly charting
  • Review of medications, allergies
  • Conversation notes
  • Review clinic charts
  • Ability to alert other members of the patient’s
    health team

The original interface heavily competed for the user’s attention. Information was scattered and it was hard to see if the information was organized through the highest level of importance and there were no preferences to customize.

To finesse the UX:

  • Creating workflow frameworks
  • Incorporating algorithmic decision making to organize the patients vis a vis the Nurse’s day
  • Keep users within the software as much as possible.

Workflow view

Through research, I identified several of the nurses’ main task flows:

Monthly Checks are conducted to check the status of a patient and are a core requirement of medicare’s program. The workflow gives nurses the ability to see the preferred time to call a patient and clear actions to take next. For example, you can chart notes or create an incident to follow up.

Core service that has to be fulfilled
Calling the patient once a month and
charting their status
Helping the patient stay healthy by any reasonable means

- i.e. Ordering Oxygen for an elderly patient when low

Incident Resolutions let you follow up with issues that came up in monthly checks. This is a new feature that I introduced to further deliver the consistency and flexibility that the software needed. The flow here shows notes on follow-ups, chart notes, and the ability to alert members of the patient team. To resolve an incident, you can call the patient directly or the relevant member of their health support system (i.e pharmacy or relative). You can chart the status of the incident and set up a follow-up time.

Remote Patient Monitoring (RPM) alerts are placed in high priority. RPM enhances the monthly check-ins by having patients do self-tests at home through IoT connected devices that send the data through the cloud and then into LucidAct. An example of how RPM works is let’s say a patient checks their blood-pressure with their at-home device and their pressure is high. The device will automatically create an alert through LucidAct. The improved workflow can get the user working quickly and the interface gives them relevant options to resolve the issue as soon as possible.

Internet of things (IoT) - A consumer connected device in the field enables real-time remote diagnostics. It collects data and makes it accessible and actionable.
Train the patient to use their at-home device
Establish when an alert will be triggered
Check if the device is transmitting data correctly

Monthly Checks are conducted to check the status of a patient and are a core requirement of medicare’s program. The workflow gives nurses the ability to see the preferred time to call a patient and clear actions to take next. For example, you can chart notes or create an incident to follow up.

Core service that has to be fulfilled
Calling the patient once a month and
charting their status
Helping the patient stay healthy by any reasonable means

- i.e. Ordering Oxygen for an elderly patient when low

Incident Resolutions let you follow up with issues that came up in monthly checks. This is a new feature that I introduced to further deliver the consistency and flexibility that the software needed. The flow here shows notes on follow-ups, chart notes, and the ability to alert members of the patient team. To resolve an incident, you can call the patient directly or the relevant member of their health support system (i.e pharmacy or relative). You can chart the status of the incident and set up a follow-up time.

Remote Patient Monitoring (RPM) alerts are placed in high priority. RPM enhances the monthly check-ins by having patients do self-tests at home through IoT connected devices that send the data through the cloud and then into LucidAct. An example of how RPM works is let’s say a patient checks their blood-pressure with their at-home device and their pressure is high. The device will automatically create an alert through LucidAct. The improved workflow can get the user working quickly and the interface gives them relevant options to resolve the issue as soon as possible.

Internet of things (IoT) - A consumer connected device in the field enables real-time remote diagnostics. It collects data and makes it accessible and actionable.
Train the patient to use their at-home device
Establish when an alert will be triggered
Check if the device is transmitting data correctly

Impact

Better UX design is becoming an essential requirement. Healthcare is in dire need of UX design services.

I made sure to showcase that design can make a major impact on healthcare by creating a digital platform that nurses loved to use, met regulatory requirements, and most importantly - maintained the health of patients - I put LucidAct on a path to success to corner the CCM market.

LucidAct is currently helping over 20,000 patients.

The software is being used within the UCSF and Standford health networks, among others.

It is now managing $25 million in Medicare payments a year