Redefining the Primary Care Operation with a Live-Data EMR Prototype

A live-data EMR prototype that streamlined clinic operation and enhance product development.

A live-data EMR prototype that streamlined clinic operation and enhance product development.

A live-data EMR prototype that streamlined clinic operation and enhance product development.

Client

ĒSEN Clinic

Services

No-code Development Product Planning

Team

Shawn Tsou (COO) Hebe Wu (Operation Manager)

Date

November 2021

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Introduction

Founded in 2020, ĒSEN Inc., a medical and healthcare startup based in Taipei, Taiwan, focuses on redefining the clinical experience and healthcare services for the primary care industry. As the sole product designer at the company, my role encompasses designing and developing digital solutions to optimise workflows and enhance the overall operation of ĒSEN Clinic, the company's primary care facility. This case study presents the design and development of a live-data Electronic Medical Records (EMR) prototype using Airtable and Zapier.

Problem

The traditional workflow in the medical industry heavily relies on paper-based processes, which have been one of the main hindering factors that prevent efficient coordination among providers for years. The antiquated system posed several challenges, including the inefficiency of searching and retrieving patient information, the risk of misplaced paperwork, and the limited accessibility of patient records across various departments. The lack of a systematic approach to ensuring data entry has also compromised the uniformity and consistency, resulting in dispersed data across multiple documents that make the communication process prone to errors.

These issues are particularly prevalent in primary care, where providers are the principal point of continuing care for patients within the healthcare system. ĒSEN Clinic was no exception. Despite the management team's efforts to incorporate digital solutions, such as Calendly and Airtable, to streamline some of the operation workflow in the clinic, the scope had always been capped within a certain part of the process due to the aforementioned nature of traditional clinician workflows, which were more challenging to address. Most of the data were still documented on various paperwork, requiring additional effort to maintain afterwards. With the goal of establishing continuous healthcare, the clinic was aware that this was their first obstacle.

Recognising the issues, I was tasked with continuing the development of digital solutions for ĒSEN Clinic. The project initially aimed to improve the existing digital solutions, as the clinic had just started its business when I joined the company. After studying the tools in place, I soon realised that the value Airtable alone could bring was far beyond being just an internal tool for the clinic. With features such as relational database, automation, and interface builder, Airtable could easily become every product team’s go-to tool for proof of concepts on product ideas. Being the only member of the software development team at the time[*], I brought the idea to the management team and decided to not only expand the current digital solutions on Airtable to a data system for the clinic but also to position the data system as a functionable Electronic Medical Records (EMR) prototype, from which we could learn real-world insights for future product development. 

[*] Noted: I was interviewed by the company's CTO and subsequently recruited as the first product design hire. However, just before I joined, things took a weird turn as the CTO decided to resign. Long story short, upon joining the company, I was the only person on the software development team and was responsible for designing and developing digital solutions using Airtable and Zapier for the first 2 months. 

Project Objective

  • Streamline the workflow of clinic operation and build the EMR prototype in accordance with the requirements of primary care.

  • Incorporate the operation workflow with EMR prototype, the data system on Airtable.

  • Kickstart a POC with EMR prototype in ĒSEN Clinic.

Process

Research - Needs Assessment and Requirement Gathering

The project began with an extensive research phase. To break down the wide variety of directions I could take, I took the time to familiarise myself with the entire workflow of ĒSEN Clinic, understand the context of primary care, and identify opportunities for systemisation and digitisation that could simplify processes and enhance data connectivity.

The research phase included interviewing the clinic personnel, going through the paperwork in place, and experiencing the entire care flow myself to understand how the workflows reflected on regular patients. I then mapped out a patient’s journey in ĒSEN Clinic, segmented it with different stages of workflow, and listed out the pain points and opportunities of each station. After gaining the insights, I honed in on the following features and functionalities that could be implemented with Airtable.

Planning - System Design and Customisation

During the planning phase, my primary focus was to streamline the digitisation of the workflow and the creation of a functional prototype that would serve as a stepping stone towards building an EMR system in the future. To facilitate effective communication and align expectations between the software development team and the clinic, I developed a detailed roadmap for the project, outlining the objectives for each stage of implementation.

The roadmap outlined the objectives for each stage of implementation, providing a clear direction for the software development team and enabling effective progress tracking. By breaking down the development process into manageable stages, we aimed to deliver incremental value, continuously improving the clinic's workflow as we progressed towards the ultimate goal of an EMR system.

Design & Development 

Database

Known for its robust relational database capabilities, Airtable is widely used in various domains such as project management, content management, UX research, CRM, and many more. Its spreadsheet-like interface allows users to store, collect, organise, collaborate, and create databases that enforce data integrity, all without the need to acquire prior SQL knowledge. 

Coming from a background that equipped me with the knowledge of Excel and Spreadsheet, it didn’t take long for me to understand Airtable and its relational features. Coupled with my experience in product planning, I began to break down the data associated with each feature and structuring the database accordingly. This involved defining fields for demographics, medical history, diagnoses, medications, lab results, and more.

Automation

Having a deep understanding of each workflow touchpoint, I had also incorporated automation into the design of the EMR prototype's database to streamline workflow. For example, I set up triggers and actions to automatically create new patient records when appointments were scheduled. 

While Airtable does offer an in-built feature for creating custom trigger-action automations within the system, its functionality and supported apps are relatively limited compared to Zapier, a third-party automation platform. To ensure optimal performance of the EMR prototype, I utilised Zapier to integrate external services, effectively making Airtable as the system's central hub.

Interface

Shortly before the project started, Airtable announced the beta launch of its entirely new suite of features - Interface Designer. This feature enables users to build custom interfaces by effortlessly dragging and dropping components that directly connect with the data. The timing couldn't have been better. Before the announcement of Interface Designer’s beta launch, the management team suggested exploring Softr, an interface building platform, to assess its suitability for constructing the system. After considering budget and development efforts, we eventually decided to go with Airtable’s beta feature.

Given that the initial targeted market of Interface Designer was enterprise tools, which aligned well with our requirements, the development of the interfaces went smoothly despite not being able to fully customise some UI components and interactions. The entire design and development process was essentially like utilising an existing design system, of which constraints and boundaries were clearly defined. A lot of effort went into figuring out the workarounds with the available design components, if possible, and into communicating with the clinic's personnel to ensure the overall usability of the interface.

Testing and Implementation

With the help of Airtable's Interface Designer, I seamlessly designed, developed, and connected the interfaces directly to the database, transforming the prototype into a fully functional system capable of being utilised in real-life scenarios. However, as the system also served as an immediate solution to the clinic's digital workflow, testing was, without a doubt, essential.

The testing process involved alpha testing and rigorous iterations. Armed with the powerful features provided by Airtable and Zapier, I was able to build and put the ideas to test at an insane speed, enabling rapid iterations with the internal team. When moving onto the implementation phase, I conducted training sessions at the clinic to ensure a smooth transition. The training covered various aspects, including data entry and record retrieval. Following the launch of the EMR prototype, I maintained an open line of communication through the support channel, actively collecting user feedback and promptly addressing any issues to ensure the transition to the new workflow.

Result

The project eventually delivered a successful development of a live-data EMR prototype. The prototype incorporated several essential features, including medical intake form, appointment management, vital form, SOAP form, invoice system, and operation report. These features streamline workflows, improved data integrity, and enhanced collaboration. The live-data EMR prototype provided a centralised platform for managing patient records, enabling not only data accessibility and collaboration but also new business strategies. Key impacts:

#1 Enhanced Workflow Efficiency

The EMR system streamlined documentation processes, allowing healthcare providers to enter, retrieve, and update patient information more efficiently. This resulted in improved workflow efficiency, reduced paperwork-related issues, and optimised patient care delivery. Key improvements included:

Appointment management:

By integrating Calendly with Airtable through Zapier, the EMR prototype eliminated the need for manually copying appointment information from Calendly to paper form for the following day. This automated process streamlined appointment management, allowing administrators and nurses to seamlessly access and organise scheduling information.

Invoice system

The invoice system on EMR prototype revamped the clinic's revenue management by consolidating multiple income streams into a single reliable source. Through the implementation of an automated invoice generation process using Zapier, the system streamlined the entire invoicing workflow, from item keying to invoice signing. This enhanced efficiency and improved financial processes within the organisation.

SOAP form/Vital sign

The EMR prototype successfully replaced traditional paper-based documentation by developing interfaces for doctors and nurses to enter vital signs and SOAP notes directly into Airtable. This transition successfully centralised the storage of medical records and significantly improved data entry efficiency and accuracy, eliminating the need for paper forms.

#2 Improved Data Accessibility and Collaboration

The EMR prototype enabled seamless access to patient records across different workflows, enhancing collaboration and communication among healthcare personnels. This improved coordination, patient assessment, and decision-making, leading to better operation efficiency.

Patient records

The EMR prototype provided quick access to patient records, including self-reported medical history, visit records, and purchase records. Doctors and nurses no longer needed to search through cumbersome binders of hardcopy records. Instead, they could easily retrieve patient information by simply entering the name or date of birth.

Operation report

The interconnectivity of patient records enabled the generation of a real-time operation report, offering instant updates on the clinic's revenue performance. This feature made it easier to track and review financial matters related to clinic operations.

#3 Increased Revenue 

The implementation of the EMR prototype resulted in various benefits for the clinic. The availability of patient information within the system fostered customer relationship management with the patients and enabled the management team to develop targeted up-selling strategies, ultimately leading to a boost in clinic revenue

Sales strategy

The operation report provided by the EMR prototype empowered the senior manager of the clinic to simultaneously review patients' booking and purchase records. This valuable insight allowed the manager to devise tailored up-selling strategies, further contributing to revenue growth.

Fostering new business

The EMR prototype's data infrastructure opened up new opportunities for the clinic. It facilitated the expansion of their business into care management, specifically with the introduction of ĒSEN Care. This extension allowed for a more meaningful patient journey, ensuring continued care from anywhere, and supporting the clinic's overall growth and success.

Streamlined Product Development

The EMR prototype played a pivotal role in empowering the software development team during the planning and development stages. It not only provided valuable real-world insights that helped shape the actual EMR system but also achieved an unprecedented reduction in data migration costs.

Data migration

The data migration process witnessed a 98.61% reduction in time and effort after the implementation of the EMR prototype. Initially, manually entering around 100 patient records from paper documents took 3 business days. However, 4 months later, after adopting the EMR prototype, the migration of around 600 patient records from Airtable to the newly developed system took a mere 2 hours. This streamlined process of data entry and record migration not only saved valuable time but also enhanced operational efficiency.

Product development

The successful demonstration of various use cases and scenarios in primary care through the EMR prototype provided valuable insights for the software development team. These insights not only facilitated product planning but also guided strategic decision-making. As a result, the proof of concept solidified the direction of building the EMR system, known as "Harrison”, specifically tailored for primary care, setting the stage for future development and business expansion.

Conclusion

The project presented a unique and valuable learning opportunity for me, as it involved a completely unfamiliar domain of work. The unconventional product development approach at ĒSEN provided me with the opportunity to expand my skill set and take on responsibilities that went beyond my usual scope. This experience deepened my understanding of product development and facilitated effective collaboration with the full-stack developer on the team.

If I were to take another lesson away from this project, it would definitely be: never limit yourself. The tools and technologies we use are meant to empower us to push boundaries and explore new possibilities. This project served as a reminder of the importance of embracing experimentation and being open to learning. As a result, I have emerged as a more well-rounded product designer, equipped not only with the ability to create interfaces but also with a deep understanding of the underlying data schema that powers them. This valuable learning experience has undoubtedly strengthened my capabilities and prepared me for future challenges in the field of product design.

Built with Framer from Taipei, Taiwan

Built with Framer from Taipei, Taiwan

Built with Framer from Taipei, Taiwan