The Optimal Vision Care Prototype

Exploring novel ways to quickly and accurately capture the initial assessment, triage and the continuum of follow-up care.

The optimal, vision care, prototype logomark

I was tasked with designing a logo for the OVCP. The logomark went through a process of a being pretty literal representation of "vision care" to a more abstracted but precise and quickly understandable mark that embodied the OVCP.

The problem list is the problem of all EMRs, no one does a good job of presenting them.

- Neuro-ophthalmologist

The problem list is a problem

The industry standard problem lists were basically laundry lists of problems, all stacked on top of each other. Even though our patient had suffered a relatively normal amount of issues, his problem list was becoming insurmountable.
A hospital is a messy place
We learned about how many balls clinicians must juggle in hospital. To deliver care in time, clinical specialists must see a patient for a very limited time and pass him or her to whoever can contribute meaningful, in-time care.
The problem list shouldn't add to the mess
A clinical SME explained that sometimes one doctor will see a patient and make a preliminary diagnosis, then pass the patient along as more diagnoses are added, and it all ends up in a big mess. This doesn't help anything, and I took on a personal mission to do a little something to fix it.

"For example you have pancreatitis and a subset of that is vomiting; it lets you relate things to each other and replace and update.

I feel like there’s no functionality like that in any EMR I’ve ever seen.

- Emergency Physician

The aha moment

During the same call with the emergency physician, she presented a Microsoft Paint sketch of what she was thinking could work for consolidating the problem list: a user interface where you could "move this diagnosis under this one". She described a function for creating hierarchy.

I had a call with Skype where an emergency physician on our team tried to get across to me what she thought might help her begin to not despise the problem list so much. She mocked up an example of what she thought would work in Microsoft Paint, and we talked through it in the context of a stomach issue.

Relating items 2

The design provided a way to group problems other problems that they were children of (secondary to) or similar to of (duplicates of).

To access this dialog to relate problems, the provider would need to select an "edit" button in the problem list next to the problem.

Something that lets you somehow update the problem list in a user friendly way that takes like 5 seconds."

- Emergency Physician

Simplifying for speed

Direct manipulation

Instead of requiring the users to click or tap a button, figure out a new window, click or tap again to close/enter their changes, I thought that making the problem list editable directly would work better. Dragging problems on top of one another to create a relationship became the crux of the design.

Similar to or Secondary to

Another hindrance to speed was the amount of choices available when relating two problems. I consolidated the choices to "similar to" for duplicates and closely related problems, and "secondary to" for problems that were results of or symptoms of others.

This is a great way to provide a sub-structure to the overall list, a great feature to reduce clutter."

- Neuro-ophalmologist

With a focus on timing

With feedback from our clinical team referring to how diagnoses may become active, then go back to inactive, and again back to active and how these recurrences often provides clues to a need for changing the provider's strategy or approach to care.
Sorting by last active

Based on feedback, I thought that the list could be sorted better to provide more context at first look. When problems were last seen as active as a sorting mechanism combined with problems tagged by their status (putative, active, quiescent, and resolved) gives the provider lots of timing context at a glance.

More context

To give the problem more context, a user can open an Info window about a problem, revealing the it's complete history (labs, referrals, notes, etc.), which they can scrub through using an activity pic-list that displays and links to times of low or heightened activity levels.