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Clinical Quality Improvements and UX Design for HIT | CHC17 Day 5

Published on 10/12/2017

The last full day of CHC17 wrapped Wednesday with the annual Cerner Bash, a neon-themed chance to unwind, unplug and catch up on happenings around the conference at Kansas City's Power & Light district. Emerald City Band kept the party going all night with cover songs that hit all the right notes with CHC revelers, and the entertainment district provided the perfect venue for one last chance to network before Cerner put a bow on the conference for yet another year.

The Solutions Gallery had an opening reception on Tuesday evening, and then was open from 10 a.m. to 5 p.m. on Tuesday and Wednesday and from 9 a.m. to 1 p.m. on Thursday. For a total of 23 hours, the Solutions Gallery featured Cerner’s solutions, services, partners and client achievement stories on full display. 

On Thursday, we had a half-day of education sessions covering topics from clinical quality improvement to user experience (UX) design for health IT (HIT). Here are today’s highlights: 

Process improvement: Optimizing flow and improving quality

With the changes in health care today, organizations are more concerned than ever with efficiency and productivity. Ellen Noel, transformation sensei at Virginia Mason Institute, reviewed ways health care organizations can establish a health care culture to sustain the implementation of process improvement methodologies and support continual improvement.

"Every day we need to shoot for zero defects,” Noel said. 

Improving the health system is key through utilizing data, knowledge and optimization. Noel discussed how she takes cues from Japanese culture and lean methodology to direct the Virginia Mason health system and make a patient-first culture. She discussed how her work analyzes waste in health care organizations, defining value as what the patient is willing to pay for and waste as what the patient does not see value in. Process improvement, she said, is what helps us get to the value.

Durenda Juergensen, chief nursing officer of health care operations at Cerner, shared the stage with Noel to discuss the importance of data-driven decisions to deliver value to patients.

Accountable care organizations: Changing the landscape of health delivery

This is a pivotal time for the accountable care movement. Over the past six years, the number of Accountable Care Organizations (ACOs) has grown from 61 to 923, today covering more than 32 million lives. 

Future ACO growth will determine whether accountable care moves from a series of exploratory programs to mainstream adoption. The success of current ACOs and how committed they are to the model is a significant contributor to future growth. We heard from Tom Merrill, ACO research manager at Leavitt Partners, and Ray Herschman, vice president of population health accountable care strategy at Cerner, as they discussed how the ACO model has matured and developed and where the market is headed.

“You can’t talk about ACOs as a monolith,” Merrill said. “There are very different strategies depending on how they are structured.” 

Upwards of 80 percent of ACOs are improving health quality scores through Medicare, he continued, but only one in three are creating savings. 

“That means that two of three ACOs are in the program and are trying to do good things but they’re not all actually reducing costs,” Merrill said. “A lot of health economists will make the claim that if you improve quality, costs will go down. But we’re not seeing that yet, probably because these programs are not quite mature enough.” 

Health IT, he concluded, will play a big role in determining where additional cost savings might come from. 

Applying UX design thinking in health IT

On the Solution Gallery floor, a team of Cerner User Experience designers presented on how they use the design thinking process for health IT builds. They walked through the five steps: 

Empathize – The first step in design thinking calls on us to understand the concerns, views and environment of the end user, often through observation, research and other study. 

Define the problem – Empathizing helps us define the problem that the end user faces, which helps us create a problem statement to solve for. We analyze our observations from the previous step. 

Ideate – In this step, we sketch, brainstorm and collaborate with the whole team to come up with potential solutions for the problem. 

Prototype – Prototyping is where we complete small-scale builds of our ideation solutions, to test what might work. At Cerner, there are a few different tools that we use to prototype, such as inVision, Flinto and Axure

Test – In the testing phase, we focus on the final solution and work through usability testing, internal testing and design evaluation.

This process is not always linear, and it generally relies on field and user research. As Cerner’s UX designers went through a hypothetical design example with attendees, they posed a question: What are the things we want our user to experience while enjoying this solution? Our goal, they said, is patient satisfaction, improved user experience and, for clinicians, better patient outcomes. 

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