A Guide to User-Centered Healthcare Software Design and Development

Understanding and Addressing Clinicians Needs

Patients are not the only users who stand to benefit from patient software. Clinicians — including physicians, nurses, and nurse practitioners — can benefit as well. As noted by K.T. Fuji and K.A. Galt, “Healthcare providers want access to a patient’s aggregated health record to enhance their own abilities to accurately and comprehensively treat and monitor the patient.”

While our advice is that patient software should always be designed with the patient as the primary user, patient software needs to provide enough value to clinicians to outweigh its perceived risks.

Set Patient Expectations Up-Front

Clinicians are very concerned about the expectations of patients entering health data into a patient software system. If a patient enters information daily, will that patient expect his doctor to be checking it daily and to have read all of the information before the patient’s next appointment?

When inviting a patient to register to a portal, set expectations. For example, if the software allows patients to leave a message in the portal for a provider, work with the client to make the rules of engagement clear. If a patient enters a very high blood pressure reading that the doctor does not see until days or weeks later, will the patient blame the doctor if he suffers a blood pressure-related problem before his next visit?

The care team should set expectations up front when first speaking with the patient about the portal, and the software should support the rules of engagement by displaying the appropriate warning messages at key times — including during registration and before data is submitted. For example, “This portal is not meant for urgent care. If you leave a message, expect a minimum of two business days for a reply. For an emergency, call 911”.

Address Privacy & Security

Privacy and security concerns will often create a barrier. Healthcare providers in the United States are bound to comply with the Health Insurance Portability and Accountability act (HIPAA) regulations, and in Canada they are bound by the Personal Information Protection and Electronic Documents Act (PIPEDA). For these reasons, security has always been a top concern for the industry when dealing with the adoption of patient portals. Providing clinicians with an audit trail of all interactions and allowing patients to see exactly which providers have access to their health data can help address some of the concerns that will be raised by providers.

Tip: Regulatory Requirements

Privacy and Security concerns aren’t going anywhere. This is why we consider regulatory / business requirements as the third circle of healthcare applications. Review our section on regulatory requirements to understand more.

Self-Scheduling

Many clinicians we have spoken with are uncomfortable with the idea of having a patient schedule an appointment via a portal. Patients are not qualified to judge the amount of time a visit will take and many doctors only schedule appointments for certain activities (such as physicals) at specific times or

on specific days of the week. If you do design a patient self- scheduling application, start small. Only allow patients to request an appointment rather than to schedule one. Or, work closely with your client to identify routine procedures that can be made available for self-booking during a specific block of time. For example, your system could act like a seat reservation system for an airline and allow adult patients to book a 20-minute consult for a physical on Wednesdays between 9:00 a.m. and noon.

TIP: Secure Mail and Calendar Functions

When thinking about scheduling, it’s a good time to reference the tech requirements of secure mail and calendar functions. If you’re considering adding these features in, you’ll want to read our tech section about this.

Billing Questions

A significant barrier to physician adoption of patient software is remuneration. How can physicians bill for online interactions with a patient? Ideally, your patient software should take this issue into consideration by allowing physicians to issue invoices and collect payments online. The Canadian Medical Association’s www.mydoctor.ca Health Portal is an example of a portal that allows physicians to bill patients directly for uninsured services, such as requests for prescription refills and remote monitoring of chronic conditions.


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