A-Line

From a healthcare provider's perspective, time is crucial. Their main goal is to interact with patients to provide the best quality of care. However, this goal is often overshadowed by the daunting task of documentation. This can involve sifting through pages of documents to understand a patient's medical history, typing notes during interactions with patients and their families, or completing paperwork at the end of a workday to ensure correct billing. Despite the advent of electronic health records, even simple tasks like locating specific medications, hospital visits, or procedures can be time-consuming, impacting accuracy and timely decision-making.

A-line offers a convenient method for visualizing a person's health record at a glance. It offers a horizontal timeline view of events, with points on the timeline linked to individual chart notes. It includes colour-coded events and icons for ease of scanning. It allows you to zoom in to see details of a specific medical event or to zoom out to give an overview of a person’s health over the years. A-line enables healthcare providers to focus on what's most important - providing care.

Comparative Analysis

Current electronic medical records (EMR) systems like EPIC, Cerner, MEDITECH, AthenaHealth use a grid based view of information in patient files. Certain category of events (lab tests, therapy notes, etc). can be viewed as a list in ascending or descending order, however there is no comprehensive summary timeline available.

The BC Health gateway provides a list view of events as a timeline with some filters but it is available only for patients to view their records and is not available for physicians to view a patient’s history. It uses icons but doesn’t have color categorization. Also the list view in multiple pages makes it difficult to visualize trends, patterns and summarize the medical history. See images below.

Objectives

To improve overall efficiency of chart review by healthcare professionals, using icons, colours and timelines for viewing information instead of pages with multiple tabs simulating a paper folder.

Success Metrics

Improve user (healthcare provider) satisfaction while interacting with a patient chart
Increase speed of chart review and reduce errors of omission

Personas

The primary target users for this product are healthcare providers who have to deal with complex medical histories in fast paced clinical situations or even providers who are covering for another clinician’s patients and need to review information quickly. The information needs to be visually easy to understand, it should have in-built options for comparisons, analyses and it should be easily searchable to allow clinicians to locate specific information.

User Scenarios

Clinic doctor meets a new client with a long medical history for the first time. The patient has had several doctors, specialists, hospital visits, medications, diagnostic tests over the last 15-20 years. The patient is having an acute flare up when visiting a relative and needs to consult the local doctor for further investigation. Instead of having to fill up paperwork, rely on memory to provide his medical history or spend a lot of time getting his file transferred from his previous doctor, the patient can use A-line to provide the doctor with a timeline of his medical information, which can provide the doctor a quick summary as well as the opportunity to look up specific information relevant to the current visit.

Hospital nurse is covering for another nurse’s patients and needs to find when the last pain medication was administered. The covering nurse needs very specific information and has to provide care for patients with whom she is not familiar. Finding information from a search function can make it quicker to find the necessary information instead of a regular grid based chart.

Community Occupational Therapist just received a new referral for chronic pain management and wants to review the psychologist’s evaluation and treatment notes. Instead of perusing through 200 pages of a PDF document, with intermittent scanned pages and blurry notes, the app will allow the OT to filter notes by professional or look up key words specific to her search.

Features for MVP

P0 MVP

As a doctor reviewing a patient file with a long medical history, I want to see the major events concisely on one page with the ability to go into the details of any specific event that I select.
As a healthcare provider, I want to quickly search for key words in a patient’s file to find the appropriate clinical note or test result
As a healthcare provider, I want the patient file to be intuitive to read and understand without requiring additional training.

As a healthcare provider, I want to be able to sort notes by type of provider, event type, lab and imaging results, etc.
As a healthcare provider, I want to view comparative graphs of items I select, over a time period I select, instead of viewing it in tabular form
As a healthcare provider, I want to be able to customize my patient home screen and be able to add, remove key components depending on my area of practice.

As a healthcare provider, I want add external files to the patient file but have them appear in the same format as all other notes and reports

Patient Profile Page

Daily View

10 Year Highlights

Wireframes

Timeline/Release Planning

Phase 1: Beta Testing - Start with a small group of users who are familiar with the issue & the proposed solution, the early adopters. Use this group to fine tune the features to ensure the product actually solves the problem of efficient chart review and does not add unknown layers of complexity

Phase 2: A/B testing - Once a stable Beta version is finalized, introduce the product to small subset of users (example a small group of nurses in a large hospital). Collect relevant metrics (speed of chart review, number of clicks to find specific information, qualitative feedback and customer satisfaction)

Phase 3: Analyze and Modify - Based on A/B test results and additional feedback from Beta testers, make necessary modifications and improvements to the product

Phase 4: Product launch - Conduct thorough testing to identify and resolve any remaining issues. Create user documentation, tutorials, and any necessary training materials to support users during the launch. Continuously monitor user feedback and product performance post-launch. Be prepared to address any emerging issues promptly.

A/B testing and iterative feedback are going to be key for this product. It is a structured approach that helps ensure the product meets user needs and maximizes its chances of success.

Future Features

A-line will allow for separate read only and document modes. The read only mode will include timelines, graphs, icons for ease of visualization, the document mode will include features like speech to text, templates for reports and provide easy review of prior notes for comparison.
Possible integration with a medical chatbot feature to allow easier access to information
Possible integration with an AI based auto-scribe feature to allow for easy clinical note writing based on physician-patient conversations.