Hospital Medication Database
streamlining a user experience for three key personas
Background
Hospital executive staff wanted visibility and oversight into the prescribing practices of their doctors and NPP's. Administration determined this would be accomplished by tracking the medications patients were on at three key points of their stay in the hospital. The long term goal was to have a database that could allow staff to run queries for quality assurance purposes. The hospital did not have an electronic medical record, but rather various databases within their own proprietary software, as well as paper records. They needed to create one place where all patient data resided. They wanted for the various databases and the paper records to be normalized, so that the data could be analyzed for specific queries in report form. They wanted what would be referred to as a Medication Database.
Tackling an inefficient 4 hour process and making the job easier for three key roles...
Our Personas
Joanna
Quality Assurance Assistant
Goals and Needs:
Needs to create and maintain a medication database that tracks all elements of a patient's records, including medication, into one cohesive repository.
Pain Points:
Manually enters all patient info needed for the medication database, daily.
Gathers that information from paper records and various databases.
Takes 3-4 hrs. per day to gather and enter this information.
Monique
Research Assistant
Goals and Needs:
Generates reports for the hospital's administration based on specific queries using the department's SPSS software program.
Pain points:
Currently no single database from which to pull the necessary patient medication information to generate reports about the prescribing practices of the hospital's doctors and NPP's, as such she is unable to meet Administration's needs.
Janette
Quality Assurance Manager
Goals and Needs:
Wants to oversee the quality of prescribing practices of the hospital's doctors.
Needs to track the medication patients are on at various stages of their stay.
Pain points:
There is no single way to track patient's medication as there is no database tracking that information.
“"Having to manually review a list of medications is stressful. If I make a mistake it could really hurt one of our patients. That really scares the heck out of me."
— Joanna, Quality Assurance Assistant
Understanding the initial user flow
For this example, I am using Joanna, The Quality Assurance Assistant and outlining her daily tasks. The less than ideal process involved multiple steps, multiple sources, multiple formats and took three to four hours daily to complete
initial medication database userflow
Devising a solution
Streamlining the process, reducing risk and ensuring compatibility.
Considerations
The hospital does not have an electronic medical record.
Patient information is kept both in paper format and in the hospital's proprietary software consisting of multiple databases
Need to normalize patient data across several databases and allow a user to track a patient's total medication, both standing and PRN across 3 key points in their hospital stay.
Goals
Create an integrated database containing all patient information, including medication records.
Streamline a process which currently takes a user 3-4 hours daily working with paper documents and multiple databases.
Ensure the medication database is compatible with the SPSS software program used by the hospital for statistical analysis to generate reports as needed by Administration.
Interviews
… it begins with listening...
Once the goals and challenges were understood I conducted interviews with the directors of several departments to understand where patient information resided, how we could normalize all this data into one comprehensive database and what functions were crucial for this database. These interviews included discussions with the Head of Nursing, the CEO, the Quality Assurance Manager, the Director of Psychology and the Director of IT.
Defining the key features
With the challenges and goals understood, these were the key features I identified as necessary.
Integration
The new medication database needed to extract information from existing databases including those from which paper print outs were generated, into one cohesive database that touched on all aspects of a patient's chart.
Dosage Calculations
The database needed to calculate the total daily dosage of each medication regardless of how it was prescribed and dispensed throughout the day.
Medication Tracking
As far as the medication records were concerned, the database needed to distinguish between Pre admission standing medication, Pre admission PRN (as needed), Admission standing medication, Admission PRN, Discharge standing medication, discharge PRN.
Naming Conventions
To eliminate risk of inconsistencies and human errors through the manual entering of information, the database needed to be able to take misspelled medications and offer the user the ability to correct medication as well as register that misspelling and its corrected name for the future.
Medication Consistency
To eliminate risk of inconsistencies and human errors through the manual entering of information, the database needed to understand both the generic and brand name of over 70 medications used by the hospital and provide the user with a drop down for each to chose either the brand or generic name.
Analytics and reporting
The database information needed to be able to exported into a format compatible with the SPSS analytics and statistics software used for generating custom reports.
The end result
The end result is an integrated Medication Database that pulls information from the hospital's various databases to create a complete patient record which includes the medications a patient was prescribed throughout their stay. This information is no longer entered manually by the Quality Assurance Assistant thereby reducing human error and inconsistencies. As a single repository for this information it allows the Quality Assurance Manager to see that data, track the prescribing practices of doctors and NPP's and request a variety of reports and analyses from the Research Assistant. With this new medication database the Research Assistant now has access to the data she needs to generate the reports asked of her by the Quality Assurance Manager and Administration.
A streamlined and efficient user experience for our personas
The end result is an integrated medication database accessible to our three personas.
Joanna
Quality Assurance Assistant
The Quality Assurance Assistant no longer needs to gather data from interofficed hardcopies and hardcopies printed from various databases then manually enter that information. It is now pulled from the necessary databases and all she needs to do is verify it and correct any medication errors.
Monique
Research Assistant
The Research Assistant can chose a Range of dates from the medication database and save the selection as an excel document which she can then import into SPSS in order to perform her analysis and reports. With this new integrated medication database she can meet the reporting and analysis needs of Administration.
Janette
Quality Assurance Manager
The Quality Assurance Manager now has the ability to track medications across three points of a patient's stay as well as request a variety of queries and reports from the Research Assistant.
The updated structure
image of updated medication database userflow
Medication Database UI
The UI below is not the actual UI from the database as that is proprietary to the hospital it was created for, but rather this is a representation of the final outcome.
Functionality Notes: Throughout this demo functionality notes will be displayed here.
User is presented with date range selector based on FROM and TO calendar UI elements.
DONE is only selectable once a date range has been selected.
The user has selected their date range and now they click done.
This screen illustrates the presented database and highlights how doctors prescribed both generic or brand name medications. Our user would need to visually scan the medication list to identify potential misspellings.
Our user has found a misspelled medication… Sertraline, misspelled to Sertralene. The user would then right click the medication to correct it.
The name correction modal opens. Here the user follows the onscreen instructions. The user knows that Sertraline is the generic name of this medication and so uses the Generic name drop down to make their selection.
This screen illustrates the now corrected Sertraline. The database would register the misspelling of the medication and know that should it encounter that misspelling again to fill in the corrected name in the future.
Conclusion
4 hours became 20 minutes…
This was the most exciting project I worked on in the hospital. It allowed me to see the various needs and pain points of different departments and to create something that became integral to the hospital and its administration. This new integrated database allowed for patient information to be pulled into one place and it opened doors for various kinds of reporting allowing the hospital to improve the quality of its services. Several months after its creation I was asked to work with the IT department once more to help with the transition from this integrated Medication Database into its new Electronic Medical Record to ensure that the needs all of the personas above would continue to be met once it was implemented.
It was this project, just prior to the COVID outbreak and my subsequent furlough that really caused me to step back and look at what it is that I enjoy doing, what my strengths are and to reconsider what I might want to be pursuing for the remainder of my working career. I enjoyed the puzzle that this project represented; the organization of thoughts and concepts, working with individuals to meet their needs as a part of a bigger picture and creating a solution that served not only the three personas identified above, but the hospital as a whole, helping them in their pursuit of continuously improving their services for their patients. UX seemed to be a natural fit and this is where my journey ultimately began.