Back in 2004, I started working on a project to build the first web based electronic medical record system in the country, with Jim Turley, RN, PhD – an amazing bioinformatics expert and Dr. Buck (David) – who was then the President at HealthCare for the Homeless - Houston. This was part of my graduate school thesis work, trying to figure out workflow models and data entry flows that worked best for street outreach.
We spent countless hours designing theoretical workflow models and designs for data entry screen, focusing on speed and ease of use when on the street. Somehow, each time, it just didn’t fit the requirement exactly the way we wanted. Frustrated, we decided that I would go on street outreach with David for the next couple of months, both of us with tablets and me duplicating the workflow and data entry along with him, to really understand how the system was being used. That is when I realized the challenges of the environment and what it was like trying to engage with a person who is in line for breakfast at a soup kitchen, with a tablet in our hands, sweating in the Houston heat with the sun reflecting on the tablet screen! Little did I know at that time that we were implementing what is now called a User experience (UX) driven model of software development – building with the end users experience as the focus rather than just the core functionality.
Today at PCIC we are developing a variety of software and technology solutions for our intervention teams and our patients – from patient data entry and tracking solutions, to data analysis solutions to scheduling and alerting solutions. The experience I learned 13 years back is at the core of all our software development projects: they must all be developed with a user experience driven model – where we try as much as possible to walk in the shoes of our care coordinators, have them involved in the design process and have an effective feedback loop between the different teams. Today, when a new staff member is hired to the technology division, they are required to go on a patient home visit with the intervention team to feel the experience. I believe this is a core requirement, especially in the healthcare industry, where we see so many software solutions and Electronic Health Record system being designed without a tightly integrated feedback loop, resulting in subpar experiences for the physician, provider and in turn the patient.
At PCIC, we have four principles that we try and follow when designing our care coordination software:
Adaptive framework
A number of software solutions we are developing at PCIC are the first of its kind. We are building them simultaneously as we are testing the model in the field with our patients. A great example is our Unified Care Continuum Portal (UCCP) – where we build care plans that revolve around the patient’s goals using behavioral health techniques, which can then be shared with other care providers of that patient. Being at the cutting edge of developing such solutions requires us to be open to constant modifications, to be able to change as our model changes and perform rapid prototyping. We have quickly learned that the one constant in our model is change.Agile development
This brings us to our second principle – iteration. This is at the heart of setting up an agile development model. We define small iterations of work that are designed to be completed in a short period of time – usually a week, then reviewed, then iterate to the next work item. This helps especially when working in an environment of fast changing requirements or a “never before done” idea.UI/UX driven approach
Our third and most important principle is the development of all User Interfaces (UI) of our applications with the User Experience (UX) as the focus. I believe that this is what makes or breaks a product in the market. Gone are the days where the worry of memory or processor consumption is the core of software design and development (we can thank Moore’s law for that).Client driven
At PCIC, we have always tried to implement a model of care that revolves around the patient’s needs and their goals, and less about our goals. We apply that same principle to our technology development process. At the end of the day, the software we develop is to help our care coordination team and ultimately our patients. We try and remind ourselves that every day – we build with our client’s goals in mind, with them at the center.