Exposing the link between EHR configuration and Clinician Experience

Provider satisfaction with any EHR often rests on the ability to personalize and accelerate their particular workflows. That personalization, and all the other customizations that help make a practice efficient, usually rests on the shoulders of an EHR administrator who is responsible for overseeing and maintaining the system.

As a product organization, we spend a lot of energy on improving the experience of providers and staff. But we also knew that if the features we created to enhance their experience could not be configured effectively, we would still be missing opportunities to improve provider experience. And we needed to better understand the full breadth of things competing for the admins’ attention and bandwidth, which might stand in the way of their ability to optimally customize the system.


How might we increase the likelihood that features requiring configuration - those we know have potential to improve provider satisfaction - are adopted?

🔍 Discover

As an experience designer, the plight of those who have to maintain the system has long been a keen interest of mine. In fact, during my previous life as a site creator and advocate for design in the Drupal community, I even wrote a series of books for O'Reilly aimed at site builders, and I often gave presentations on the need to improve site builder and content admin experience. By the time I was approached to take on this work, I had already observed several ways in which configuration experiences could make an administrator’s life more difficult, and I put together a research plan that would help us understand:

  • how did our clients determine which features to adopt from a given release, and what role did configuration play, if any?
  • what other jobs might be competing for these admins’ attention, and what does that do to their bandwidth and willingness to take on new features?

The full research effort combined data from previous efforts to look at configuration experiences, combined with about a dozen interviews with EHR admins across a variety of practice sizes and specialties. To help broaden the reach of this work early on and get some help with analysis, I also invited designers from across the business to help listen in on the interviews and take notes.

📖 Define

The initial output of this research identified three specific personas that came into play during the lifecycle of a client’s experience with the EHR:

  • Wendy "the athena person:" she's the one who hits the buttons to make the thing go
  • Lisa "the change agent:” a more strategic persona, who interacts with leadership to optimize workflows, and which generally showed up in more complex practices
  • "the Deciders," a group persona which had significant influence over which features get adopted, as well as how the system ultimately gets set up

These personas interacted within a handful of "critical moments" I was able to identify and map each persona’s role in. Two of these moments - preparing for a release and adding/removing providers from the system - I was able to flesh out more detail around, and frame specific challenges within each moment that had potential to interfere with feature adoption decisions.

All this was represented in two key artifacts:

  • a detailed MURAL tour that combined personas, critical moments and problem themes into a tour-like format
  • a perspective deck that introduced the personas, critical moments, and design principles to consider when creating configuration experiences.
This MURAL captured all the details from our research, including themes, quotes, and critical moments in configuration.

📐 Align

Over the next several months, this work was socialized across multiple areas of the business, including our client-facing teams and the folks who prepped training content for releases. Teams across R&D started referring to the personas and principles as they created new and updated configuration experiences, and they added their research to the growing body of wisdom around Wendy’s experiences - and configuration more broadly. Outside R&D, this research also catalyzed a handful of important changes to various components of our release process:

The new Release Center helps segment billing/practice management features from Clinical features, and makes it easier for Wendy and Lisa to find the information they need to help the Deciders determine which features to adopt.
  • significant design changes to our Release Center, which better helped Wendy and Lisa find the features they may need to make decisions about
  • a new research effort to reimagine Release Notes, taken on by Ingrid Lange and Laura Kacir from our Design Research team
  • changes to the way we frame and measure release awareness, recognizing the role of so-called release gatekeepers (i.e. Wendy and Lisa) in making sure providers know about the features that matter to their organization

✅ Outcome

Since this research was completed, leadership in Clinicals has continued to beat the drum of creating better configuration experiences, and created a 2022 OKR and cross-functional initiative to define what optimal configuration of Clinicals looks like, with a plan to improve various aspects of how we configure and deploy the product across specialties. I have been leading this initiative with Megan Patterson from Clinicals Product Strategy spring 2022, which has allowed us to mobilize partners from across the business to help us envision and create what a better future looks like.

l was also able to contribute to an R&D hackathon project in Summer 2021, which resulted in a React framework for admin pages that has best practices baked into it, based on my initial research into configuration experience. The project won two separate Hackathon awards: “Most Useful” and "People's Choice," and was picked up by our Design Systems team. In July 2022, I started working on an initiative with folks across R&D to align on interaction standards for admin experiences and incorporate them into the framework. The goal of this work is to make it easier for teams to deploy effective configuration experiences across the application - including rebuilding old and outdated pages in the new framework.