TARA Mind
EHR User Research
2024
Role UX Researcher & Designer
Tools Google Docs • Google Surveys • Figma
Team UX Researcher & Designer • CTO • Overseas Engineering team
Timeline 2 Weeks
Overview
The team at TARA Mind was developing an MVP for Synapse, a coordinated care platform tailored for therapists and prescribers overseeing patients undergoing Ketamine-Assisted Therapy. Although the product boasted numerous features, it was not informed by input from users. Recognizing the importance of user feedback, I championed in-person research sessions to ensure that our product resonated closely with user needs.
Research Goals
Understand therapists’ relationship with their existing electronic health record (EHR), the features they use most frequently and consider most important
Understand the ease of completing a clinical intake note and users’ impressions of the note
Outcome
I identified the most frequently used and valued features among therapists, which directly informed our feature prioritization process. The research findings underscored the importance of conducting comprehensive competitor audits to gain insights into existing EHRs.
Usability testing revealed numerous usability issues with our clinical intake note. Leveraging these insights, I spearheaded design revisions to address these pain points, ultimately enhancing the overall user experience of Synapse for therapists.
Participant Recruitment
I joined our Clinical team at the American Counseling Association’s annual conference in New Orleans to meet therapists and learn about their thoughts and habits with Electronic Health Records (EHRs). I approached conference attendees, confirmed they were practicing therapists who used EHRs, and invited them to participate in my study in exchange for an Amazon gift card. I sourced 5 participants.
Participant Information
Demographics
5 Therapists age 28-45
Years practicing: 1-14
PAT experience: None
Professional Info
2 Therapists in group practices
1 Solo Practitioner
2 Therapists in Community Health
EHRs Used
2 Simple Practice
1 Valant
2 Other (Community Practice)
Methodology
Three-part qualitative in-person interviews at the American Counseling Association’s Annual Conference.
Part I
General Questions about Users’ EHRs
Part II
Feature Ranking & Usage Surveys
Part III
Usability Test on Clinical Intake Note
PART I FINDINGS
EHR Insights
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Participants paid between $60-$120 monthly for their EHR and didn’t feel strongly about the cost. They were interested in a free EHR but needed a trial and more information to consider switching.
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Two out of five participants switched EHRs because they lacked needed features to support their practice. They were willing to pay more for these features and reported the switching process to take ~3 months.
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Participants all spoke to the importance of a mobile app because it allows therapists to be engaged on the go and keep track of notes & scheduling while working remotely.
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The majority of participants considered scheduling to be an important feature because it helps them track appointments, however, they didn’t want patients to have the option to schedule directly with them because of no-shows etc.
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Most participants opt out of certain features in their EHR and turn to outside methods due to convenience, inadequacy of a feature in their EHR, or security needs.
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Security in an EHR was critical to participants who emphasized the need for HIPAA compliance and high-tech encryption. They put security before cost and convenience.
“The mobile app allows for texting via secure messaging, seeing cancellations, checking on the go, and not being tied to the computer” -P5
“I turned off the client messaging feature for clients to book directly because of no-shows and double bookings” -P3
“Free would be amazing, making sure it has HIPAA & high-tech encryption is the most important part” -P2
PART II FINDINGS
Feature Usage & Ranking
Most Frequently Used
Completing & e-signing progress notes
Very Important
E-signatures for notes and treatment plans
Customizable paperwork
Least Frequently Used
Reaching out for customer support
Not Important
Secure messaging
Easy direct booking for appointments
Applying findings into actionable next steps
Takeaway
Participants didn’t feel strongly about the cost of their EHR and it wasn’t a driving factor for switching EHRs.
Recommendation
Consider deemphasizing “free” as a key selling point in marketing communications.
Takeaway
A mobile experience is vital to keeping providers on top of their scheduling and enables them to complete notes on the go. Our provider platform was desktop-only.
Recommendation
Scope out the lift of building a mobile-facing platform for providers. Conduct competitor research on mobile-optimized EHRs.
Takeaway
Completing and e-signing therapist notes was considered the most important and one of the most frequently used features of an EHR.
Recommendation
Focus efforts on optimizing notes for therapists. Audit competitor EHRs to understand conventions of notes.
PART III
Usability Test
The final phase of my research was to understand users’ impressions of Synapse’s Therapist Initial Evaluation (TIE) note and its ease of completion.
Test Setup
Scenario
You’re a therapist who recently conducted your Therapist Initial Evaluation (TIE) with a new client.
Task
Locate the Therapist Initial Evaluation note, complete it, and submit it for payment.
PART III
Findings
1.
Participants unanimously liked the language on the prompts and felt that the questions were comprehensive.
3.
Participants liked the feature of sending survey scores to patients at the end of the intake.
2.
Participants commented that the form was easy to read and user-friendly,
PART III
Points of Friction
TIE Note Findability
Two out of 5 participants struggled to find the TIE note. Both looked at the client dashboard and needed help finding the entry point. One participant said that notes are created via the patient profile in SimplePractice.
“I can’t find it. In Simple Practice, it’s on the patient profile page.” -P5
Radio Button Selection
On the ‘Observation of Client’ section, users wanted to select multiple options on the radio buttons. Additionally, participants disliked the length of this section and wanted the option for a check box to select “all within normal limits” and then adjust selections manually.
“It would drive me crazy. I would miss one nine times out of ten and it would eat up all of my time” -P2
Pre-Populated & Fixed UI
Participants were unanimously confused by the pre-populated UI on the form. They didn’t recognize the content was coming from the patient, and became frustrated as they tried to click on the toggles and “buttons.”
“Why are they there if they’re not functional?” -P3
Form Length
The majority of participants said that the form felt long, but didn’t know if that was due to learning a new system. They didn’t want to dilute the comprehensiveness of the form but hoped for it to be quicker to complete.
“The more I click, the more I wanna know when this is gonna end” -P1
PART III
Design Updates
BEFORE
The pre-populated UI on the TIE note confused and distracted users.
AFTER
Created label for “Self-Reported Patient Information” and visually distinguished content.
BEFORE
Users wanted more control in this section, including the option to make multiple selections for each category, to know which question they missed if they forgot to make a selection, and an “all within normal limits” checkbox.
AFTER
Allowed option for multiple selections for each category. Created error message when no selection was made for category. Did not add “all within normal limits” checkbox because clinical team didn’t want users speeding through this section.
Final Thoughts
Getting feedback directly from our users was invaluable. It shed light on flaws within our existing product process where a Google Doc from the Clinical team was passed directly to the Engineering team for development without user input or design. It also showed the need for conducting visual audits of competitor sites to understand conventions and standards and the value of user feedback.