Chairside

Project

CLIENT   //   DaVita

TYPE   //   Internal application

PLATFORM   //   Desktop

TIMELINE   //   12 months

Goals

  • Create a new platform for doctors, nurses and PCT’s (Patient Care Technicians) to use while interfacing directly with patients during dialysis treatment
  • Have the program synchronize with all other CWOW related applications, including health records, patient portal, treatment plans, and supply/medication orders
  • Reduce the overall training time required for new users, which was six months on the legacy system

Team

  • 2 Product Owners
  • 1 Project Manager
  • 1 Core UX Designer
  • 2 Secondary UX Designers
  • 3 UX Researchers
  • 1 UI Designer
  • 1 Internal Tech Lead
  • 5+ Internal Developers

I inherited ownership of the UX for Chairside a few months after starting at DaVita, and the initial ask was to prove that dialysis treatment could be performed via an iPad. I gathered a team of two more designers, one with more experience in the current treatment system, and we began to storyboard the current process of treating a patient on the legacy system, Chairside Snappy.

Once we had the flow for treatment, we began to whiteboard the screens. We broke this out into three core tasks we discovered in the storyboarding; loading the patient (pre-treatment), tracking of vitals and treatment tasks (during treatment), and offloading the patient to prepare for the next one (post-treatment). This entire process takes on average around three to four hours, per patient, per treatment.

Our team received an award for being able to build this entire flow out into a clickable prototype within ten days, it consisted of over 130 screens in total. This gave the us something to take to the stakeholders and show them that treatment could, in fact, be done on an iPad vs. the old black and white computer screens they had been using for over 25 years.

Discovery was not done however, as we quickly learned taking that prototype into the field that it didn’t actually work for the users. The original idea was to give each clinician their own iPad, allowing them to walk through, patient to patient, just selecting the one they were at currently, similar to a contact list, and allowing them to work. The issues we discovered while testing is that they didn’t actually want anything to carry around and preferred the stationary devices that they currently had. Clinicians would also be changing their gloves in-between stations, often multiple times, averaging well over 300 pairs of gloves, per user, per shift. This, combined with discovering that the gloves often didn’t work well with touch devices that would also have to be wiped down every time they switched to a new patient, gave me the data I needed to return to the stakeholders and present them with a new approach: A web application, capable of working in an offline mode, meant for larger monitors.

Research
  • INTERVIEW
    • Users and SME’s
  • DESIGN EXERCISES
    • Whiteboarding
    • Group Talking Sessions
    • Internal Content Audit
    • Storyboarding
    • Process Flow Discovery
Synthesis
  • Personas
  • User Journey Map
  • Mental Models
  • Content Strategy
  • Workflows
  • Information Architecture
  • Experience & Design Principles
  • Clickable Prototypes
  • A/B Testing
  • Time-on-Task Analysis
  • Contextual Enquiries

As previously stated, the initial design was focused around using an iPad. For this, we went out to meet with Apple at their HQ in California, giving us an opportunity to show our initial concept and whiteboard with them directly. This led to us altering the design patterns for a new proof of concept, still built around the iPad, but adapting to their newer (at the time) Human Interface Guidelines.

The more we worked with this, the more we began to realize that we we’re trying to force a square peg into a round hole in the form of a touch device for each user instead of the desktop setup that it would inevitably shift to. Once the stakeholders were convinced and the change was made, we went through a complete design overhaul.

The first desktop concept was simple, grouping patients by section of the facility and which clinicians were assigned to them, but providing access to the entire patient list at all times. This meant that users could have a station at each patient, but still be able to quickly access or view other patient’s profiles from anywhere in the facility without the need to walk over to them for quick checks. This also meant less changing of gloves and time saved for minor edits or quick checks on the patients.

The design continued to take shape over the next several months; testing, gathering feedback, presenting the ideas to the stakeholders, but we kept hearing the same pain points over and over:

"I want to see everything! It's a hassle to have to constantly scroll up and down while also managing needles or medications."

“It isn’t a straight through process, we just want to get the patient started as quickly as possible, and deal with the extra stuff later.”

This led me to an epiphany while whiteboarding with one of the other designers and one of the key stakeholders/SME; we allow for a split screen and divide the required content into tiles that can individually be submitted. This would give the users the ability to complete the bare minimum required to start treatment, while also giving them the ability to compare pre-treatment, in treatment, and post treatment vitals at any time they want.

Testing for Chairside, and all CWOW/HWOW applications in general, we’re conducted throughout the design process. We had a dedicated team of UX Researchers that did the bulk of the testing, but at least once a month we would have the opportunity to join them and assist in the testing of our own, and others designs.

Several tools and tests were performed including explorative/assessment testing, which was typically moderated by one of the researchers while the rest of us watched and took notes. A/B testing, which was performed when we had more than one idea for a design and navigational path the user could take, and some guerrilla testing, where we would have a new concept or idea that we didn’t necessarily want to go through the whole process on, and instead would take sketches or very basic prototypes to the local facilities or share them remotely with SME’s.

The vast majority of these tests were recorded, which allowed us to also line up the videos, and identify hot spots where users were getting caught up, and see what their exact time-on-task was.

Due to both business privacy and HIPPA guidelines, those tests cannot be shown here.

All data from the numerous user tests were compiled for both qualitative and quantitative feedback to the stakeholders. The videos specifically became incredibly useful in showing the development team why we had to design things in a specific way, to reduce the users time-on-task, based on how their brains worked when looking at these screens. Engineers tend to think like, well, engineers, and not as a clinician treating a patient.

This feedback was documented and presented in bi-weekly meetings to make sure everyone understood when we felt a component was finished and in a good place, or why we we’re still working on the design and recommending to not proceed with development. In the end, this saved the company millions on labor and technical debt.

96%

Ease of Use

92%

Increased Productivity

4.87 / 5

Overall Satisfaction

600%

Training Time Reduction

Unfortunately, I left the DaVita before the final rollout of CWOW and Chairside, however, it was very well received by the initial test clinics. And in talking with my former colleagues, it has been expanded to be in use in several hundred clinics at this point, with the plan to shift all clinics to it completely within the next year.