I led the full redesign, working end-to-end from early ideation through high fidelity, prototyping and testing. I worked in close collaboration with a project manager and two engineers.
ABOUT THE PROJEcT
Help clinicians deliver excellent patient care
Primary.Health started scaling out clinical offerings by partnering with more telehealth clients. We began to hire more internal nurse practitioners and needed to update our platform alongside them to reflect our changing model. The work involved evolving how clinicians manage and document patient encounters, with improvements in UX and visual design.
At the same time, we needed to ensure changes to the platform were equally clear and intuitive to non-clinical focused clients.
The project began in August 2024 with a planned launch in October.
KICKOFF
My approach
Gather context
Starting out, I met with the provider leadership team to define requirements, gather context, and ask clarifying questions. I also met with internal stakeholders whose clients use our platform in a non-clinical capacity, to ensure my design direction balanced all client requirements.
Aligning on scope
I ran a quick audit of the current flows to map out the current experience, calling out the planned areas to update. This helped me quickly get up-to-speed on the current experience in our platform.
I arranged my notes in a figjam board and collaborated with a project manager to align on priorities and scope for our initial launch. From there, I shared it with the provider leadership team to collaborate async, update them on our game plan, and jumped into exploratory design work.
Untitled has saved us thousands of hours of work. We’re able to spin up projects and features faster.
Web Developer, Quotient
discovery
Insights & Problems
I gathered notes from my early kickoff calls with the provider leadership team and other internal Primary staff to summarize different needs and pain points and arranged them in the same figjam board. This helped me inform initial design priorities. Normally I would like to conduct additional interviews with more of the user base (in our case this would be on-staff nurses). Considering they're part time staff with limited schedules and availability, and I had enough context from other meetings, I instead moved first to initial design explorations.
This shift let me put together early screens and prototypes to test with them when we would later meet. It was a much more efficient use of our limited time together.
One appointment: endless rows of data
Users were frustrated that there wasn't a simple view for each appointment. Instead, there was one row per test. For a single appointment, if a patient had 5 tests, there would be 5 rows of data.
This required a lot of mental gymnastics.
"Were all tests were accounted for when making calls to patients?" Extra time was needed to QA as a workaround to this constraint.
"Which rows of data need my attention?" Clinicians only contact patients for abnormal test results, but normal results, abnormal results, pending results and closed cases are all grouped in a single table.
Untitled has saved us thousands of hours of work. We’re able to spin up projects and features faster.
Web Developer, Quotient
Suboptimal path to contact patients
There are no automatic notifications when a nurse needs to contact a patient regarding abnormal test results. Instead, someone from our Client Success sends them a link in Slack for each individual test. Not the greatest use of their time.
One appointment: endless documentation
Users were annoyed with the redundancy involved in documentation. They expected to log their notes in a single case report, but needed to repeat documentation for each abnormal test.
This is a direct result of how the table is structured. There is a case report for each test.
More work for non-clinicians
Not all clients who document on abnormal test results are trained clinicians. They may not be able to glance at a test result, see "Positive" or "Negative" and immediately know if it's normal or abnormal. They would need to click through additional pages to answer that question.
Limited area to add / edit documentation
While there is a larger area to add initial documentation (under "Log contact"), if for any reason a user needs to make edits to the submission, they have to scroll a teeny tiny text field. This becomes excruciating when they need to edit a long text response.
the framework
Design direction
I reviewed different competitors, including project management software like Jira and my physician's software (discreetly) while at a recent doctors appointment. Those learnings acted as inspiration for my initial design explorations.
Consolidated case manager table
Early explorations of different layouts to streamline path to view case reports and perform documentation. All tests from an appointment live in a single row. Updates to columns reflect new model.
Merged case reports
Early explorations of different layouts to support faster documentation. All tests from an appointment live under a single case report.
Documentation made easy
A card overlay offers more surface area to add documentation, while preserving view of important participant details. Users can add general notes for all tests, as well as test-specific notes. For test-specific notes, users can apply a more clinical note format known as a SOAP note (shown on right). In clinical settings, a SOAP note organizes content by 'Subjective', 'Objective', 'Plan', and 'Assessment'.
testing and refinement
Insights & Problems
The next couple weeks I began interviewing all of our clinicians (8 nurse practitioners). I wanted to learn more about their current experiences using our platform, their daily tasks, and any frustrations they face. I also used this opportunity to share early designs for their feedback.
To ensure designs scale to all client types, I also met with clients from UCSF who use our platform in a non-clinical capacity. I made a rough interview guide, had clear goals, and captured invaluable insights in each session, without ever going over time. It's very important to me that a participant's time and schedule is respected.
I uploaded recordings of my meetings into Dovetail and used that to quickly transcribe and review findings. Their new (to me) AI feature saved a good amount of time summarizing key takeaways from the different calls.
Using color-coded sticky notes (1 color per participant), I organized comments and feedback by theme. The colors let me see at a glance common pain points of behaviors across multiple participants.
While Dovetail has the ability to group notes by theme in their platform, I like keeping these notes within the figma file for smoother collaboration / creating a single source of truth.
Key takeaways
Show results When adding documentation, users need to see results at a glance to add to their notes. In the current design, the card overlay covers them entirely.
Clinicians use a template For clinician users, they copy and paste content from a template created by our medical director on a google doc. It includes SOAP note content for each test result in scope for their client.
3-panel Case Reports adds value Across all participants, most preferred the 3-panel layout over the 2-panel. They loved to see more at a glance.
Anxiety over manual data entry Several clinicians mentioned feeling anxious about data entry errors when free texting labs. Manually copying and pasting labs also felt redundant. SOAP notes are 1 big note In the clinical world, they aren't split up as visualized in the designs. Each part of the SOAP note and each test is included in a single note field.
Value in defining which results were consulted When meeting with UCSF staff, they mentioned different staff consult on a subset of test results. I have a hunch this is a workaround to the current way case reports are split by test. But the affordance to split documentation by what was consulted would help scale designs. Show more of submitted notes More context at a glance means less time re-opening a note to see the next few words in their submission. For 99% of the time, there will be one contact. As a result, there would be only one long form note per case report.
Who did the log? Clinicians and provider leadership often review case reports and scan for notes by name, if updates need to be made.
Untitled has saved us thousands of hours of work. We’re able to spin up projects and features faster.
Web Developer, Quotient
vision
Let's go big
There were so many exciting moments during my clinician interviews. It was incredible. I loved discovering all different ways we can improve their day-to-day as part of this project. And I was beaming with the idea for us to go above and beyond to make their work easy-breezy.
Pre-fill notes with lab results
No more stress or frustration about copying lab results from the case report into the note field. Primary can automate it.
Lean in to the template model
Dot phrases or SmartPhrases, common in EHR's like EPIC, let clinicians enter notes more efficiently. We can pre-fill notes, pulling relevant content from the template.
visual design
Reimagined case management
Where case management was redundant, difficult, and anxiety-inducing, Primary made it effortless, efficient and calm. With it's design and decision making, you're guided through tasks with ease..
See the status of cases and priority tasks at a glance
In the priority tab of the case manager, users can see a filtered down list of cases that need attention, as well as their overall status. One crucial part of the new table design is it scales back what data is immediately visible to users, showing only information relevant to decision-making at this point in their journey.
The high level summary count of abnormal test results jumps them directly into the case report to begin their documentation.
One appointment, one page
Users now have a central view for all tests for a single appointment. For each test, an "Abnormal" status appears next to abnormal test results, democratizing clinician knowledge across all users types, with results sorted to show abnormal results first.
Users can perform the test-specific actions like "view test details" and more (nested in the ellipsis). They can see critical patient details and more test results at a glance, while also reviewing contact history, removing the need to constantly scroll back and forth.
"Log contact" begins the flow to add documentation.
Simple, smart documentation
By default, Primary will assume all test results were covered during the contact, reflecting the vast majority of uses cases. When adding a note, the form field hugs the content, keeping documentation in full-view.
Additional features to document patient encounter
When the status is "Contacted" users can apply the SOAP note format and pull content from the template.
Selected test results determine what content is pre-filled, ensuring concise, correct documentation. I defined the different possible combinations and mapped them out to validate with a product manager, engineer, and provider team.
Patient age and labs are also pulled into the note. I collaborated with engineering early on to ensure feasibility and functionality of these interactions.
Peek into contact history
Users can expand different contact cards to review any notes. They can re-open the edit view with "View/Edit" or remove the contact from view.
Variations on contact cards
If the contact only included a single result, that nuance is indicated in the contact cards. This helps scale across clients who use different documentation processes.
impact
Creating value
View notes in their entirety
Users no longer have to scroll a small form field to enter or update their documentation. Their note is in full view as they log their encounter.
Pre-filled notes save time
The extra time once needed to document on each abnormal result can be used to deliver more in-depth, compassionate patient care.
Less clicks to vital information
Complete more tasks in less time, with a greater sense of calm. All critical information is surfaced in-context, when they're needed most.
Reduced reliance on QA
Automated filtering of cases by priority makes it harder to miss tasks to complete.
Simplified billing and more
Will streamline billing and invoicing, and simplify future API's with telehealth tools.
lessons learned
Reflections
Ensure prototypes reflect realistic scenarios
I noticed some users would get distracted if there was placeholder copy or design that was unexpected, or misaligned to their process. Making sure that placeholder text reflected more realistic use cases could save time during research sessions.
Untitled has saved us thousands of hours of work. We’re able to spin up projects and features faster.
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