Documentation

Documentation was a multi-fold effort: a study of the competitor’s workflows, a gap analysis based on a comparative observation of similar features to reveal differences and incompatibilities, and a collection of references from other systems. We would collect screenshots, video screenshots if the interaction observed was relevant, and build high-level interaction workflows.
 

Platform Comparison

We were working within an existing environment with two functioning platforms and we needed to compare them to see if the medical platform had equivalent features, workflows and components to see if anything was salvageable.  We - the UX team - focused on workflow differences and user experience requirements while a product manager focused on technicalities such as comparing data schemas and what is necessary to define a user, and documenting the processes triggering records or notifications.

We found some essential differences that would eventually have a significant impact on development:

  • The medical platform doesn't allow contact between patients and providers prior an appointment

  • The behavioral service has defined user roles: a staffer can handle appointments and other administrative tasks on behalf of a provider

  • The behavioral site uses an instant messaging system for users to negotiate an appointment with a relatively advanced in-thread appointment editing widget

  • The duration and pricing of a consultation is flexible

 

Broken scheduling workflow 

We found a significant gap in the consultation request process for our medical application: patients were left with the impression that they could contact any doctor they liked. If a provider didn’t plan her online presence and no appointment hours were available in the near future, a dialog window  would let the patient send a message to the doctor. That message was  actually sent to customer service in an exception queue.

Then customer services would  act as an appointment broker and contact both parties to negotiate then set the appointment. The workflow wasn’t enforced and, needless to say, patients would never hear back about their consultation request.

Administrator tool
We explored the administrator tool and studied how an appointment was created. The patient who makes a request is manually added to a doctor’s queue; by doing so, a notification is sent with the appointment’s details  via the antiquated internal message system which was heavily criticized by providers for being cluttered by notifications. Consequently providers would miss appointments, and patients would call to complain to customer service and only then get connected to a provider who was online at that time.

 

How online behavioral therapists take appointments

Based on interviews with therapists working on the platform we listed the following key behaviors:

  • Most providers would react to notifications sent by email more than by systematically logging in. Email notifications prompt the provider to log in, then to check their appointment list and identify the requests.

  • Providers  would consult their personal calendar to define their availability.

  • Providers  would answer requests with up to two appointment proposals. They would message patients through the platform to address issues or questions. Some may send a personalized message to engage the potential client.

  • Newly confirmed appointments would show in a specific column. Providers would take notes and edit their personal calendars.

  • None of the providers we talked would use the application calendar because it didn’t reflect the entries in their primary calendar.

How a major major electronic medical record (EMR) handles appointment

Another project gave us an insight into the scheduling system used by one of the largest EMRs. This gave us a good idea of the workflow for a system with an integrated calendar. The workflow can be described as such. A staffer (administrator, nurse, doctor, etc…) will:

  • Select the patient

  • Find an action dropdown that contains “set appointment” (this differs based on the front end configuration by type of users)

  • Define which providers gives the consultation (if not already defined by default for “self”)

  • Define appointment frequency  and appointment offer expiration date.

  • Define a number of appointments planned. Each appointment generates a” ticket”.

  • The appointments are generated.

    • IF the request was made online the patient will receive a prompt to check the appointment proposal

    • IF the appointment is made over the phone staff will describe availabilities

  • The patient chooses a first appointment.
    If more appointment tickets are emitted the patient will have the opportunity to choose for the following appointments within the parameters initially set by staff.

How competitors take appointments

We looked at other telehealth application workflow and focus on those who had a psychiatry network.
The workflows were very straight forward:

  • User looks for a provider

  • See days where consultations are available

  • Finds where consultation are available

There was no opportunities to find based on earliest availability.