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Sunrise: How user-centered design shapes the EHR

It’s always exciting to discuss what’s coming next. At the recent Allscripts Client Experience (ACE) conference, I discussed plans for Allscripts Sunrise™ and modernization that moves us from an EHR solution to a “consumer-of-health” platform.

Our vision for the future is to evolve to a consumer-driven platform. The changes we make to Sunrise arise as we look at the market and ask our clients: What’s missing from a core platform that makes sense to add?

Our solutions managers analyze the market and decide what we need to build, buy or who to partner with. We are always analyzing gaps. Sometimes it makes sense to build it on top of Sunrise and sometimes not.

The below illustration shows how the Allscripts platform has evolved to surround our clients by making specific investments based on strategy that focuses on our client’s objective for a connected community.

Allscripts connected community provides clients a relationship where there are no blind spots when they care for patients. We ensure solutions are integrated and information is obtained in the right time and place. Our strategy to address this involves consumer-first platforms that prioritize interactions like self-service and virtual visits.

We work closely with strategic partners to develop our strategy. In doing so, we all focus on the bigger picture and how we can decrease physician burden, a consequence not just of EHRs, but also of regulatory, financial and many other systemic pressures.

User-centered design is a powerful tool in achieving the needed changes. Here’s our approach to reduce physician burden:

  1. User-center design process: Ross Teague, Ph.D., leads user experience team. We routinely bring this team into the development process and they engage our clients in the testing of the designs.
  2. Science of design: Small changes make big differences. Did you know there is 33% faster read and recognition of items displayed on a screen just by going from an 8- to a 10-size font?
  3. Helper philosophy: We employ solutions within our applications that advance our philosophy to help physicians achieve their goals, such as more face time with patients.
User-centered design process

User-centered design is an essential component in improving safety and the satisfaction of physicians, patients and medical professionals who use EHRs. The American Medical Association and MedStar Health National Center for Human Factors in Healthcare ranked 20 EHRs by vendor’s use of user-centered design best practices. Allscripts EHRs ranked highest.

Allscripts is the only vendor with perfect scores in the evaluation of safety-enhancing design certification submissions. Many EHR vendors don’t meet best practices for user-centered design but are still certified by the ONC.

We use our System Usability Score (SUS) as a standard of measuring usability, with the stated goal for Sunrise new feature development at a 75 score or better.

Science of design

Let’s say you are tasked with renewing a medication. Now if there’s a 100% task competition, why aren’t our clinicians happy? Because a lot more goes into this action than just renewing a task. We examine the factors below to determine usability.

Real-world example: Sunrise Prescription Writer

Sunrise Prescription Writer is a product that has a current SUS score of 49. It meets functional and regulatory requirements, but it isn’t easy to use due to high cognitive load on the users.

Therefore, we conducted interviews asking clients what their ideal prescribing scenario is and what would be most helpful. These are the results:

This development process has been underway for more than a year. Changes we made include:

The result

We achieved a 78 SUS score upon first test by meeting usability goals. We took feedback and retested, resulting in an 88 SUS score. Physicians comments include: “This is beautiful!” and “This is the best solution for rounding options with calculations I’ve seen among EHRS.”

This is how we will achieve better now and in the future.

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