Mapping Health IT Journeys to Improved Patient Care
 
EHR Association members share a desire to improve the user experience of EHR software for physicians, clinical staff, and patients. That’s why they incorporate user-centered design – such as considering individual users’ preferred style, vocabulary, information visualization, and workflow – in software development decisions. EHR developers are committed to continuously improving usability through research, innovation, testing, user feedback, and observation.
 
At EHRA’s 2020 Usability Summit, attendees participated in “journey mapping” – a process that considers the EHR experience of individual users as a fundamental component of software development.
 

What is a Journey Map?

All journeys start with the people that we are designing for. At a previous Usability Summit, EHRA members and other stakeholders created a series of user personas to represent the wide diversity of the people that an EHR needs to support. The personas capture the roles and responsibilities for each type of individual and help designers to understand a little bit about what it is like to be in those people’s shoes. 
Courtesy of USA.gov
 
  • What kind of organization does this journey relate to?
  • Who is involved in the journey and what do they do?
  • What are the stages of this journey? 
  • What activities happen in each stage?
  • What are common challenges associated with each activity?
  • What are solutions, and who would be responsible for implementing them? Developers? Regulators? Payers? Providers?

What are potential opportunities associated with each activity? 

Journey maps serve groups of developers and decision makers by providing a clear visual to drive conversation, build consensus, and ensure that real problems are being addressed in a holistic manner. The basic elements of a journey map are:

  • An ‘actor’
  • The steps they take through a ‘flow’
  • Opportunities or challenges encountered

The actual form of the journey map varies widely, based on what questions we need to answer. Journey maps can focus on the experience of groups of interrelated actors, or of a single actor.

 

 

Courtesy of Mad*Pow 
Mad*Pow has taken a very sophisticated approach in their interactive journey map of the continuum of an adult patient’s experience. All of the basic elements of a journey are there, but they leverage interactivity to allow exploring different options, outcomes, and choices that can affect the journey. This is an example of how a journey map can be a living reference that informs the design approach throughout the lifecycle of design, execution, and refinement. Learn more about the background on their blog.

 

 

Mad*Pow calls out what informs and allows for ‘garden path’ or less desirable paths through the journey. The publicly available version has much of the detail for the ‘insights’ links removed, but is a useful framework for where to add additional details.

 

 

This example from Macadamian visualizes the journey of labor and delivery, including the patient, clinicians and the patient’s caretakers. It focuses less on the subjective experience of feelings and attitudes, and more on the touchpoints and moments of involvement. In addition relevant quantitative data is layered in to give more context to the journey presented.

 

EHRA Journey Mapping Workshop

 

At EHRA’s 2020 Usability Summit, attendees participated in a journey mapping workshop. Attendees included those with a wide range of experiences in the healthcare ecosystem including clinicians, user experience designers, product managers, health IT administrators, academics, and policymakers.

 

 

 
 
 

Workshop Process

 

At the EHR Association’s 2020 Usability Summit, attendees identified many EHR workflows that would benefit from journey mapping. Our workshop included:

 

1. Defining focus areas: Generated themes that are most relevant to the current state of healthcare IT
2. Prioritization: Voted on themes to define those for the journey mapping activity
3. Breakout groups: Each group focusing on one journey
4. Presentations: Each group presented their journey to the larger group for feedback and comments
 
Each of the breakout groups created its journey map based on the following process:

 

Roles

  • Who is involved in this journey and what do they do?
  • When are they involved in the journey?
  • How do their roles work together?

Stages

  • What are the overarching stages of this journey? 
  • Where does it typically begin and end?
  • How would you group the activities together?

 

Actions

  •  What are the activities that happen within a particular stage?
  • Do these activities happen once or are they part of a recurring process?

Pain Points

  • What are the common challenges associated each of the activities?
  • What are the typical dependencies, constraints or limitations?

Opportunities

  • What are the potential opportunities associated each of the activities?
  • What are the solutions, and who would be responsible for implementing them?
    • EHR vendor
    • Government/Regulatory
    • Payers
    • Providers
 

Workshop Outcome

 The end result of the workshop produced a series of documents representing the collaboration of all event attendees.

 

 

 

 

 

https://www.madpow.com/insights/2019/11/interactive-journey-maps

https://madpowprojects.com/IJM/

https://www.macadamian.com/learn/healthcare-customer-journey-mapping/