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Readers Write: Guiding Principles for Designing a Useful Healthcare Mobile App

July 27, 2017 Guest articles 1 Comment

Guiding Principles for Designing a Useful Healthcare Mobile App
By Calvin Chock

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Healthcare mobile apps can provide many benefits to busy physicians. Roughly 80 percent of healthcare providers use smartphones and medical apps, and more than 25 percent rely on mobile apps to provide patient care. In discussing mobile app usage, physicians strongly voice the need for quicker and easier access to patient data. If a mobile app is well designed, enables efficient access to patient data, and is easy to use, it can serve as a powerful companion to an EHR. By following some basic guidelines during the concept and development process, a robust, user-friendly mobile app can be built that meets a physician’s need for quick and easy data access.

The methodology outlined here is specifically targeted towards large applications with hundreds of features, complex workflows, and a vast number of users interacting in different ways. For these complex applications, the challenge is to design a solution that is useful but that will also fit into a much smaller form factor. Often, the trade-off involves realizing the full application cannot be fully converted into a mobile app, and instead making a version that is less complex, sequestering a subset of valuable features that are not meant to replace the full application but instead complement it.

Guidelines for Developing Critical Elements Help Ensure Success

There are several basic elements that require much thought and consideration when building a mobile app from a complicated application such as an EHR. This includes the overall design and layout, the types of user interfaces, and user experience.

Follow Design Principles and Build a Strong Foundation

First and foremost, realize that it is unlikely that all the information in the application can be crammed into a tiny screen. Distil the information down by breaking it into smaller subsets using a few logical steps:

Build an inventory of workflows.

Physicians, nurses, pharmacists, and other key staff all have different screen sets. Take an inventory of the workflows for various users to find out what they do during the day. Watch, observe, study, and write down each user’s role and their distinct user pattern.

Determine which items on the list are a good fit for a mobile app.

Look at the subset list closely and decide which workflows make sense to put in a mobile app and which will be challenging or cumbersome due to the limited size. Also, review each one and ask yourself, “Was the user able to fully complete a useful task?” If the answer is yes, keep it on the list. If not, then consider whether that specific workflow is a good candidate for a mobile app.

For example, during office visits, physicians document a wide range of a patient’s medical details. This function is probably not the best candidate for an app due to the large number of data entry fields and content. Phones are not great data entry vehicles, so trying to type a lot of information in can be cumbersome and frustrating. In contrast, physicians spend a tremendous amount of time reviewing patient data and acknowledging this review was done.

An example of a typical day would include a review of hundreds of lab results, dozens of notes, and several new orders. Lists of data that require limited data entry lends itself well to a mobile app. This tedious and time consuming work can now be done outside of the office, which now gives physicians the flexibility to do this work on the go.

Rank each item’s value.

Of those workflows that you determine will work well on a phone, rank the value of each subset based on potential user utilization of the app or other factors.

Once the subsets have been ranked, establish one theme for the app’s purpose. Too many different themes are confusing. For example, if the main goal is to empower the user to perform tedious work on the go, then define that as the primary goal and rank the features based on achieving that goal.

Utilize the Minimum Loveable Product (MLP) concept. In many applications, there is a choice between speed of delivery versus quality. If the mobile app is meant to be a compliment to the main application versus a full replacement, then designing an MLP will allow you do deliver a solution quickly and with high quality. Start the design work of just the most valuable workflows first, building one highly usable feature at a time. As users rally around that one feature, they get eager for the next one. You won’t sacrifice quality, and will still deliver new features at a good pace.

Lastly, use smart phone features to your advantage. Incorporating Location Based Services can save the user time in filling out location-related data entry fields, notifications can provide important alerts to users while the app is not in focus, and the camera phone can be used to take photos of documents or patients for immediate upload.

Create a Great User Experience with a Simple Layout and User Interfaces

Once the main theme is selected and an initial set of features has been identified, the last step is to take the time to think about how the app will look and how the user will interact with it. Going from a wide screen to a tiny one is challenging, so screen element choices are critical to maintaining a high level of usability. Only essential information can be shown, and creative ways must be utilized to display information. For instance, instead of showing the full directory of a file system, a hierarchy can be represented by descending shades of a color, saving time and real estate.

Be consistent with elements used throughout the app. If a field is accepted by clicking a button or swiping left to right, the same method should be used on every single page. Having a consistent user interface is key to the learnability of an application.

Employ user-friendly interface elements, such as big toggle switches, buttons, swipes, or gestures. Entering a lot of data using a phone is frustrating, so limiting free text entry when possible is important.

Make the app look simple and easy to use so practice staff can absorb the view quickly. Avoid too many user interfaces, text, and other details, or the screen will look cluttered and confusing.

Finally, verify that the user interface design will work on the majority of phones users have. While phones today are standardizing, it is still important to check. Time and expense can be saved by building the app to support only the top two or three phones potential users have.

Calvin Chock is VP of product management and engineering at McKesson Specialty Health in The Woodlands, Texas.


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News 7/26/17

July 26, 2017 News 1 Comment

Top News

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The House Ways and Means Committee announces the Medicare Red Tape Relief Project, which will work to reduce legislative and regulatory burdens on Medicare providers. The three-stage project (the name of which is eerily similar to AMA’s Break the Red Tape campaign) is initially seeking feedback from stakeholders on how Congress can deliver statutory relief from current mandates, and how it can work with HHS Secretary Tom Price, MD and CMS Administrator Seema Verma to provide that relief. Feedback is due August 25.


HIStalk Practice Musings

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I added a landline several days ago in an effort to take back my cell phone from certain members of my household whose friends love to call and chat for extended periods of time. It’s been about 10 years since I’ve had a home phone, and I had forgotten how many telemarketing calls they attract. It didn’t take me long to look up the particulars of adding my new number to the National Do Not Call List. The CDC, which tracks mobile phone and landline use in households as part of its focus on the health habits of American domiciles, reports that cell phone-only homes are now in the majority. Fun/sobering fact: Nearly 30 percent of wireless-only adults are binge drinkers, while “only” 18 percent of adults living in landline households drink heavily.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Announcements and Implementations

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ATI Physical Therapy (IL) develops an app to give its physical therapy patients access to their treatment plans and related content while on the go.

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Digital health company Livongo Health will make its high blood pressure- and diabetes-related educational resources available to patients through its new membership in the American Heart Association’s Center for Health Technology and Innovation Tech Collaborative.

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Radiology Associates (AR) selects enterprise imaging software from Mach7 Technologies.


People

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Therapy Source hires Tracy Sippl (Cross Country Staffing) to head up its TheraWeb virtual therapy staffing services.


Telemedicine

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The Memphis, TN-based Southern College of Optometry’s new paperless FocalPoint clinic rolls out telemedicine services from EyecareLive.

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Telemedicine startup OmniaMD – founded by cardiologist Jorge Castellanos, MD and Lauren Timpe, RN opens for business in California.

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Abundant Life Social Services (UT) will offer remote mental health therapy through white-label telemedicine services from Doxy.Me


Government and Politics

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CMS adds new APIs and Github Repositories for developers working on QPP reporting.


Other

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The majority of Wisconsin tech company Three Square Market’s 80 employees have agreed to embed RFID chips in their fingers to free up time when accessing the building and purchasing things at the on-site cafeteria. CEO Todd Westby has downplayed any concerns around privacy by pointing out that cell phones report “100 times” more data than do RFID chips.

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The Onion publishes a funny piece on the damage Dr. Mario is doing to the practice of medicine:

“You see, unlike Dr. Mario, I’m constantly forced to make nuanced, complicated decisions. There are more than three germs out there. And there’s more to medicine than spinning pills in the air and lining them up according to color in columns of four or more. In my practice, I write prescriptions, conduct examinations, order diagnostic tests and scans, and break the bad news to terminally ill patients about how long they have to live. It really is an extremely difficult job.

Just yesterday I picked up my forceps and—being ever so careful not to touch the sides of the incision and get shocked—removed an ice cream cone from a man’s skull, successfully treating his brain freeze. For real doctors, it’s all in a day’s work.”


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Jenn, Mr. H, Lorre

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News 7/25/17

July 25, 2017 News No Comments

Top News

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Maven Clinic secures a $10.8 million Series A round led by Spring Mountain Capital, bringing its total funding to $15.8 million. The company, which offers its virtual maternity services to employers and directly to consumers, launched in 2015 and now boasts 25 employees and 100,000 users. Lauren Breuggen (Spring Mountain Capital) and Rachel Winokur (Bright Health) will join Maven’s Board of Directors.


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Acquisitions, Funding, Business, and Stock

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PhysIQ will use $8 million raised in a Series B funding round led by 4490 Ventures to ramp up commercialization of its VitaLink remote-monitoring and analytics technology. The AI-powered software is geared towards ambulatory patients and clinical trial researchers from the worlds of pharma and medical devices. Dan Malven (4490 Ventures) and Zafrira Avnur (Quark Venture) have taken seats on the company’s board. The company has raised nearly $20 million since opening its doors four years ago.


People

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Daniel McCarter, MD (University of Virginia Health System) joins ChenMed as Richmond CMO at its JenCare Senior Medical Center in Virginia.

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Telemedicine company HealthPoint Plus hires Justin Holtzman, MD (South Shore Hospital) as CMO.

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CNBC reports that Amazon has hired Box healthcare and life sciences VP Missy Krasner in an unnamed role.


Announcements and Implementations

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Aprima teams with Patient identification Platform to help physicians more efficiently match eligible patients with clinical trials.

Idaho and Utah will connect their HIEs to share patient admission, discharge, and transfer notifications with PCPs. Both are part of the Strategic HIE Collaborative’s Patient Centered Data Home hub that connects HIEs in Arizona, Nevada, Nebraska, and parts of Colorado.

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ChiroTouch develops tablet-based self check-in technology for patients.


Government and Politics

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The HHS Office on Women’s Health disseminates $1,600,000 to 16 organizations – including community clinics, health centers and health departments – to fund projects that will seek to prevent opioid abuse by women and girls. The awards – $100,000 to each organization – comes on the heels of a OWH report that focused on the impact such abuse has on females.

The FDA will hold the inaugural meeting of its Patient Engagement Advisory Committee October 11-12 in Washington, DC. The gathering, which will focus on the patient-identified challenges associated with clinical trials, will mark the first time the agency has focused on patient-related issues related to medical devices.

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Senators vote along party lines to continue efforts to repeal the ACA. The “motion to proceed” enables them to begin debating the ins and outs of formal legislation.


Research and Innovation

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A look at 200,000 patient satisfaction surveys finds that personal interaction with physicians trumps online tools, customer service, and waiting room amenities when it comes to customer loyalty and recommendations to friends and family. The data also showed a direct correlation between provider and overall practice satisfaction rankings.


Other

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Remember when?: Microsoft clears up confusion around reports that its 32 year-old Paint app will be scrapped once Windows 10 updates go live. The art app will be available for free via the Windows App store – a move the company made after the “incredible outpouring of support and nostalgia around MS Paint.” The news takes me back to when our family installed our first PC. We quickly became accustomed to the static-y noise of dial-up, and the accumulation of AOL CDs brimming with free access to a social media-free Web.


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Jenn, Mr. H, Lorre

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News 7/24/17

July 24, 2017 News No Comments

Top News

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Private equity firm KKR will acquire WebMD for $2.8 billion. Founded in 1996, WebMD began looking at possible suitors early last year as its revenue from pharmaceutical ads began to dry up. Analysts at the time gave it a $2 billion valuation. Its websites include WebMD.com, Medscape.com, and MedicineNet.com – all of which will now live under the same umbrella as KKR’s DentalPlans.com and AllAboutCounseling.com sites.  


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Announcements and Implementations

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Commonwealth Primary Care ACO taps Sonora Quest Laboratories to be its diagnostic testing provider of choice. (SQL is a joint venture between Banner Health system (AZ) and Quest Diagnostics.) The ACO, made up of 130 independent physicians in Arizona, will use SQL’s population health analytics to better identify high-risk patients and close gaps in care.

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In an effort to better assess and improve quality, Orthopaedic Associates of Michigan will use Code Technology’s benchmarking reports to help it develop a patient-reported outcomes program.

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Child and family services provider KidsTLC (KS) selects NetSmart’s EHR.


Acquisitions, Funding, Business, and Stock

Portland, ME-based healthcare financial and advisory firms BerryDunn and Compass Health Analytics decide to merge.


People

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Primary Care Development Corp., a nonprofit dedicated to investments and policy initiatives around primary care, appoints Altruista Health CMO Munish Khaneja, MD to its development committee.

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Casey Liakos (Huron Consulting) joins Carex Consulting as president.

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The Vermont Medical Society promotes Jessa Barnard to EVP. She’ll take over leadership of the 2,000 physician organization when current EVP Paul Harrington retires this December. 


Telemedicine

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Birmingham, AL-based AlternaVisit – best, if not widely, known for its white-label telemedicine solutions – begins offering website development and management services to physician practices. It’s a logical step, according to CEO Tom McDougal, given that a professional, easy-to-navigate website is a practice’s first step in adding telemedicine services.

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In a move that I predict will become increasingly common amongst physician practices, Keady Family Practice rolls out virtual consults in an effort to make accessing healthcare easier for their patients, many of whom live in rural areas. “It’s just the convenience of having that face-to-face virtual appointment with your provider,” says Krista Wilson, a KFP medical support staff member. “It’s not that we don’t want our patients to come here, but we want to add benefits for patients without added stress to their schedules.”

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New Benefits adds telemedicine services from MDLive to its line of healthcare discount plans for employers.


Other

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@Rachel_LEAD and Politico pick up on a new trend in health IT marketing – enticing potential customers with high-tech gadgets that become operational once a demo is scheduled.


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Jenn, Mr. H, Lorre

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News 7/20/17

July 20, 2017 News No Comments

Top News

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One Medical Group CEO Tom Lee, MD will step down in August. Lee founded the tech-savvy membership-based primary care company in 2007, raising over $180 million and expanding it to include 60 clinics across markets in eight major metro areas.

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Amir Rubin, an EVP with UnitedHealth’s Optum division, will take over from Lee, who will become executive chairman. Rubin has already let it be known he intends to continue opening new clinics and growing the company’s employer business. While Rubin has ruled out near-term plans to chase additional financing, he’s not ruling out acquisitions. One Medical’s most recent was nutrition coaching app Rise in February 2016.


Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre for information on webinar services.


Announcements and Implementations

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Care3, Mirah, PatientMD, TechSoft, and VitaTrackr join DirectTrust, bringing its total membership to 129 organizations. The five year-old nonprofit reports steady growth of Direct exchange users, addresses, and transactions. The second quarter of 2017 saw over 40 million Direct exchange transactions – a 74-percent year-over-year increase.

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Medical Associates of Clinton (IA) will roll out 10e EHR software from EClinicalworks to its 49 physicians across four locations.


Acquisitions, Funding, Business, and Stock

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Online appointment scheduling vendor DocASAP raises growth capital from Cohen Private Ventures, likely bringing its total amount raised to over $1 million since launching in 2012.


People

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Greg Armer (Anthem) joins Mobile Health, an employer-focused population health management company, as VP of strategy and growth.

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Better Health Partnership, a primary care transformation nonprofit based in Ohio, promotes Rita Horwitz to president and CEO.


Telemedicine

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GenieMD launches a new telemedicine service that incorporates a diagnostic questionnaire for more efficient video visits.

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Salus Telehealth offers its VideoMedicine customers prescription savings discount cards through a partnership with MedImpact Healthcare Systems and its pharmacy network.


Research and Innovation

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PCPs saw a 3.2-percent increase in compensation in 2016, while other specialties experienced an average 2.8-percent increase, according to the latest AMGA stats. Both figures are similar to those from 2015. Just over 60 percent of respondents reported their compensation was based on meeting or exceeding value-based measures. “[The] move to value-based incentives is happening,” points out AMGA Consulting President Tom Dobosenski, “albeit at a slower pace than anticipated. However, value-based incentives do not lessen the economic pressures on medical groups, as they do not necessarily mean reductions in compensation.”


Government and Politics

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North Carolina’s Cumberland County Health Department finds itself in hot water after an audit uncovers a trail of oversights that resulted in 160 women not being notified of abnormal cervical cancer screenings over a four-year period. Multiple fingers (plus firings and departures) have pointed to a lack of timely data entry in the department’s computer systems as one of the root causes of the lack of follow-up.


Other

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AAFP launches the Primary Care Innovation Fellowship to encourage family medicine providers in their use and optimization of health IT. The year-long commitment includes expenses-paid travel to industry events, access to AAFP experts, a $5,000 stipend and up to $30,000 for the completion of a health IT-related project. Applications are due August 31.

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Pride, prejudice, and the pound: Being a big Jane Austen fan, I hope to some day get my hands on the £10 plastic note featuring the author coming soon from the Bank of England. The bill, which will mark the 200th anniversary of Austen’s death when it debuts in September, will ultimately replace the paper tenner.


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Jenn, Mr. H, Lorre

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