Medical History App Story: Medical services of any specialty, and anywhere around the world, need to be efficient and have to deliver excellent care for the patient whatever the situation is. The most known scenario is the outpatient examination where the physician interacts with the patient, reviews his medical record, collects information about his illness, performs a physical examination and finally performs the diagnosis of the patient. It is important to note that this must be done in less than 15 minutes, so time is of the utmost importance for the physician to give a correct diagnosis of the patient. The patient is not hospitalized. For the physician to be able to examine the patient adequately and establish a good communication with him, he must be able to access the adequate information about the patient: previous medical records, laboratory exams, notes, observations. This information his collected in the medical history of the patient. The medical history of the patient (also called anamnesis) is the main tool used in a physical examination. It is the source of the clinical information about the patient, and the physician has to use it during an examination to get data about the patient and record all his observations, analysis, prognosis, medications and further controls. Most of the hospitals, clinics or medical services have implemented IT tools to automate the medical history, thus bringing the physician an application to record all the information he has gathered. But physicians complain that the tools and applications are hindering them from doing their work. In general, most of the physicians are not tech savvy and complex application screens (such as SAP Transactions) create a barrier between the physician and the medical record. This results in some people opting for alternative solutions such as, avoiding the use of IT tools and return to pen and paper. Other problems related to the IT medical history: - The application takes too long thus reducing the time to interact to the patient, extending the time for the consultation and further delaying the appointment time for other patients. - The tool does not provide all the information the physician needs for example previous examinations or laboratory results, medical imagery. Etc. - The physician has to open different applications to review previous medical history, perform a diagnosis and prescribe medications. - The patient perceives the physician is not giving enough attention to his illness. Further complaints Taking this in account, the Medical History App will have the objective of consolidating all medical information needed during an examination: previous medical history, integration with laboratory results, input of the examination results, diagnosis and analysis, further controls, exams and the prescription of medication. Moreover, it must follow the Fiori Design principles and need to address the issue of the complexity of previous applications. Finally, this app goal is to reduce the time the physician has to interact with the Medical History App and use this extra time to communicate and examine the patient further increasing his productivity and deliver excellent patient care.
Valentina Physician I deliver excellent patient care while having to deal with 2 jobs, my studies and my pseudo social life Paste a photo 28, single, 2 years since she graduated from medical school. Works in two clinics owned by the same hospital as a general physician. Proactive, has good attitude towards patients. Not tech savvy but willing to learn. Good communication skills. Mostly works alone in an examination room. Patients, secretaries, medical coordinators, nurses I have to examine 15 patients per 4 hour shift Every examination has to take less than 15 minutes I must comply with the clinic regulations and use the provided tools Deliver excellent service to my patients and help them with their illnesses. Make an accurate diagnosis of the patient in order to deliver the adequate treatment. Perform a thorough examination of the patient I have to establish good communication with the patient I need to record my examination results in the system as accurate as possible. I need to review the patients previous medical history I need access to the patients laboratory results, x-rays, or other therapies. I need enough time to perform a thorough examination and communicate with the patient to make an accurate diagnosis. I need to easily find medications by their name and their posology in order to make a good prescription. The system takes too long to load the medical history. I often lose what I have written in the history. I have to load several pages to get all the patients information. Labs and imagery are in a separate application or web page. I have to fill the prescription in the medical history and then I have to open another application to create the prescriptions again for the pharmacy. System crashes frequently. There are too many fields that I don t use and I can`t input any additional information that needs to be recorded. It takes too much time to record the patients examination, diagnosis and prescription. I frequently have to call IT or the nurses to get help about the application.
Introduction to Design Thinking User Experience Journey Current User Experience Journey Duration of the Journey: 15 min Mindset What is on the Persona s mind while taking the actions of their journey? How do they feel each step of the journey? Ok.. Who is the next patient :D. The patient is already here and It takes forever to load L What brings you here today? He looks bad! Does he have previous records? I need the lab results what was the page again? Let s see if I can find anything in the physical exam I have to type all of this! My diagnosis is Zika what was the code for that again? What? The pills are not in the system? And now i have to do it again??? Come back next week for a control! :D Actions What actions and activities does the Persona take while going thru the journey to achieve their goal? Sits on her desk, checks her list of patients Waits Asks the patient Opens archive Checks medical history Searches for laboratory results Performs physical examination Back to the desktop Searches for code Records findings Makes the prescription Creates an entry in the prescription application Orders a follow up appointment Touch points What touch points does the Persona have? (Tools, channels, devices, conversations, and so on.) Desktop computer, physical list of patients Patient Archive Medical history Laboratory application Medical instruments Medical history Reference book for diagnose codes Medical history Prescription application List of approved medicaments Patient schedule / nurse 2016 SAP SE or an SAP affiliate company. All rights reserved. Public 1
Point of View: Valentina needs a quick way to enter information into the medical history of the patient in order to spend more time communicating with the patient and performing the examination. Valentina has to be able to quickly access all patient information so she can use analyze it with the physical examination to elaborate an accurate prognosis of the patient illness. Mockup: https://standard.experiencesplash.com/api/projects/a9cd482670418e0c0bb5a799/protot ype/snapshot/latest/index.html - /1458755896626_S0
Study: https://standard.experiencesplash.com/home/projects/a9cd482670418e0c0bb5a799/research/participant/ cb1a38724c71c6b70bb5f515 WebIDE Prototype Video https://youtu.be/p8lmnu24kz0
SAP Web IDE App Prototype 1. Web IDE file structure Controllers There is one controller per floorpan view, (worklist, master, detail). All controllers are derived from BaseController where common functions are located. i18n.properties file where all translatable texts are maintained Mockup Data EDMX file was loaded and mockup data was created for the 3 entity sets in the model (Appointments, MedicalHistories, Patients) XML Views Views were created for each floorpan (worklist, master-details) an additional view was created as a container for the master-detail floorplan. The detail view contains a Icon Tab Filter control, to reduce the complexity of the detail view additional views were created for each of the tabs. Component.js This file was not modified. Created from the WebIDE worklist template. manifest.json This file was modified to add the routing/ navigation of the app. 2. Data Model metadata.xml Data Model (design) There are 3 entity sets defined in the EDMX file: -Appointments -Patients -MedicalHistories further navigation properties were included from: -Appointments - Patients -Patients - MedicalHistories -MedicalHistories - Patients
3. Navigation Worklist ( / ) Route: medicalhistory Targets: ["medicalhistor ylist", "nomedicalhisto rydetails"] MedicalHistories ( /{patientid}/ ) Route: medicalhistorydetails Targets: ["medicalhistorylist", "medicalhistorydetails"] Button - Navigation Back (BaseController) Button - Navigation Back in Master List (MedicalHistoryList.controller) MedicalHistories ( /{patientid}/{historyid} ) Data Binding worklist - Appointments masterlist - Patient Detail - Medical History
4. Worklist Filter filter -> all worklist.view.xml filter -> today worklist.controller.js 4. New Medical History MedicalHistoryList.view.xml app.controller.js MedicalHistoryList.controller.js