Improving efficiency in remote teleconsultations

Medgate, a prominent Swiss telecare provider, encountered a challenging software transition necessitated by technical constraints within their existing EHR system. The decision to replace this legacy system with a new web-based software was driven not only by the need to update outdated technology but also by the primary objective of optimizing the efficiency of Medgate doctors. The goal was clear: to empower doctors to prioritize patient interactions over cumbersome documentation tasks, ultimately enhancing the quality of care provided.

Client
Medgate

Year
January 2023 – now

Role & team
Leading designer and design system manager, working with Product Owners, Developers and Doctors

TL;DR

Challenge

Medgate doctors have worked with the electronic health record we set out to replace for more than a decade. The software had been designed and maintained by Medgate itself. New features have been added over the years based on the requests of users and stakeholders. No UX professionals were involved during this evolution and most of the time no documentation was available, which made it challenging to understand which features were not needed anymore.

Besides replacing outdated technology, the primary goal of the new software is to enhance efficiency, enabling doctors to complete more patient consultations while simultaneously creating high-quality documentation.

Approach

Given the limited time and resources available for user research, I maximized opportunities by shadowing doctors during their daily work and consulting with Product Owners to gain insights into workflows and the current software. However, the bulk of user research was conducted through usability testing. I led a team of 3 developers, who created a code prototype that enabled us to stress-test the designs early in the process.

For the final implementation, I worked as the sole designer with up to 7 Product Owners, which made it challenging to stay abreast of all topics sufficiently to make informed design decisions. To address this, I engaged the Product Owners in human-centred design methods, such as involving them directly in the usability testing sessions.

Result

The previous software did not have a single major efficiency killer; instead, it suffered from numerous small inefficiencies that cumulatively wasted time. In addition to reducing unnecessary clicks, we managed to improve the information hierarchy to lower the cognitive burden on doctors. The new software is designed to reveal just the right level of information at the precise moment it is needed. This ensures that doctors are not distracted by the software during patient interactions but are instead guided seamlessly through their conversations.

The new software is currently being tested in a pilot phase with selected users. Despite receiving only a fraction of the training provided for the old software, most users have successfully utilized it during patient calls without issues. The overall feedback has been very positive. Although the most performance-enhancing features are not yet implemented, making it difficult to measure efficiency gains at this stage, we are optimistic that the key workflows will ultimately improve efficiency and allow doctors to focus more on patient care rather than navigating the software.

Centralized medical information for enhanced efficiency and patient safety

While observing Medgate doctors using the previous software, I noticed that they frequently had to navigate between different pages during patient consultations. This observation led to a key decision: reorganizing the information architecture and layout to consolidate all medical information on one page. The new layout is structured as follows:

  • Center: A chronological feed of progress notes displaying information about the patient's current and past encounters with Medgate.
  • Right Side: An overview of general health information, providing a quick summary of the patient's health status, including allergies, family history, and more.
  • Left Side: A zoomed-out timeline of all Medgate visits, organized by diagnosis.

To accommodate all relevant content, temporary surfaces appear on the right side, allowing the user to obtain or edit specific information without losing context. For example, doctors can document allergies while still viewing the medication list, or quickly determine if a piece of information is relevant only for the current anamnesis or should be documented in the general conditions for easier access by other Medgate doctors in the future.

A three-step approach for efficient care provider search

One of the most time-consuming interactions in the previous software was finding the right care provider for specialist referrals. Upon closer investigation, I discovered two primary scenarios in which a Medgate doctor needs to search for an external care provider: either the patient already knows which care provider they want to visit, or they have no idea and seek a suggestion from the Medgate doctor.

To address these scenarios efficiently, I segmented the search process into three steps:

  1. Favorites and past visits: When the doctor clicks into the search field, any care providers marked as "Favorites" by the patient appear immediately, along with care providers the patient has visited in the past.
  2. Dynamic search: As the user starts typing, results surface based on the search term using fuzzy logic. This allows the doctor to type partial keywords, such as "Zur" and "Derm," to find dermatologists in Zurich. The search accommodates queries by care provider name, address, or specialty.
  3. Extended search: For more precise results or browsing options, the doctor can open the Extended Search. This feature allows filtering by a wide range of parameters, including opening hours, language, and diagnostic capabilities.

Leveraging AI for enhanced communication and medical documentation

The recent boom in AI technology offers new possibilities for efficient documentation in healthcare. While significant efficiency gains for Medgate doctors were anticipated through the use of AI tools, it's crucial to carefully consider unwanted outcomes.

For instance, a tool that corrects a doctor's chat message to ensure it's patient-friendly and grammatically correct is relatively harmless. However, using AI to summarize a patient questionnaire might be riskier, as important information could be lost. Additionally, it is important to avoid giving doctors the impression that they might soon be replaced by AI.

These factors require careful consideration when designing AI tools. We addressed these challenges by clearly indicating when information was enhanced by AI and branding the AI tools as "Assistant," rather than using any term that might suggest doctors are gradually being replaced by machines.