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Thazin.
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Sutter Health is a large healthcare network of 24 hospitals and over 200 clinics in the Northern CA area.
At the time I started on this project they were growing even larger by adding new cardiology clinics. Resulting in a population of patients not enrolled on the Sutter My Health Online (MHO) patient portal.
The staff misses to mention My Health Online to patients in more than 60% of visits. I found that the biggest reason was that staff wasn't sure how to enroll patients. Patients had to call for everything, leading to frustration with long call times and more importantly not receiving timely care information.
Expected Outcomes:
Increased MHO patient enrollment is expected to improve patient outcomes, reduce call volume, and set up clinic staff to optimize time and workflows.
With constraints of time and resources, I decided to work with the lean UX principles and process. This allowed me to move quick and collaborate with the staff.
Some benefits of using this methodology included:
- Early customer testing and validation
- Collaborative design with clinic staff
- Measure KPI of successful and missed enrollments
- Nimble design to implement quickly
Ethnographic Observations:
Watching the staff in action, I recorded time to tasks, flow of patient journey and the timely process of printing out enrollment letters.
Leading Co-Design Workshops with Nurses and Patient Reps:
Clinical staff didn't all have the same information on what MHO is.
Brainstorming brought ideas on when in patient journey to enroll patients
Patient population is elderly and low tech. Some low income without web access.
Albert 61, Patient
"I only use my phone to text and call my grandkids"
Rebecca, Registered Nurse
"I'm not sure when is a good time to ask patients to enroll"
Sam, Patient Services Rep
"I spend too much valuable time helping elderly patients enroll"
Engaging nurses and patient reps, I ...
- Implemented staff workflows using EPIC SMS capabilities
- Trained staff on MHO app features
- Documented the process for scaling to other clinics
1. Text link initiated at Check-in
2. Gives patient opportunities to enroll while in clinic (waiting times)
3. Engages MA and RN to incorporate it into their conversations with patients
4. Follow ups w/ patient at check out and follow up calls
With how hectic it can get in the clinic, staff often forget to ask patients to enroll. And even when they do they forget to track the enrollments in the EPIC system so patients are getting repeat asks.
The clinic manager and I implemented a friendly competition between clinics to drive higher engagement.
GOAL: Less than 30% missed opportunities
- Out of 2 clinics these solutions were tested at, Clinic #1 reached our goal of decreasing the missed opportunities 30% decrease target
- Clinic #2 was trending down week after week. However had a high influx of patients the last week of September. This helped me realize the solutions may not be foolproof when there is higher patient volumes.
PATIENT IMPACT
- Positive patient satisfaction scores on timely communication.
- Staff reported patients felt more in control being able to see
their labs, bills, and appointment details.
Next steps
- Although successful, the most ideal solution would take the clinical staff out of the enrollment process. I explored other solutions such as iPads in the waiting room that allows patients to sign up. This is something I’d want to explore more if there were more resources and less constraints.
Legacy System of EPIC
It was challenging designing within usability constraints of a legacy system like EPIC.
I was forced to consider we had little to no budget and implementation effort had to be scaleable without a lot of training. This made a lot of the ideas I had to be out of reach. However, I was able to think within the current systems to make small improvements that will deliver the most impact.
