DaVita Kidney Care
DaVita is one of the top kidney care providers in the United States. My work on the internal team at DaVita was centered around helping alleviate physician burnout and creating more enjoyable and efficient software. This case study is an overview of my work on improving patient charting in the software used by nephrologists as they are in the midst of dialysis treatment.
*Please note that some aspects and final UI cannot be shared due to NDA agreements
Problem Statement
Patient charts began as a table with a grid of individual cells. This is confusing to the eye, especially if there is a trend across visits.
Solution Statement
Charting will be improved when comprehension speed is increased, by using data visualization and updated levels of visual hierarchy
Project Overview
Role
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Analysis of current state
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Solutioning
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Redesign of UI
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Dev handoff
Tools
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Sketch App
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InVision
-
Confluence
Timeline
September -
November 2021
Previous Chart
Blood Pressure
Weight
Creatinine
Jun 1
May 25
May 18
May 11
May 4
Show More Results >
140/80 mmHg
140/80 mmHg
140/80 mmHg
140/80 mmHg
160/90 mmHg
160/90 mmHg
160/90 mmHg
210 lbs
210 lbs
205 lbs
205 lbs
205 lbs
205 lbs
200 lbs
200 lbs
125 μmol/L
125 μmol/L
125 μmol/L
125 μmol/L
116 μmol/L
116 μmol/L
116 μmol/L
116 μmol/L
Jun 22
Jun 15
Jun 8
Jun 1
May 25
May 18
May 11
May 4
140/80 mmHg
"quotation here"
"As a rounding physician, I need to be able to quickly digest and prioritize complex patient charting data ."
- "Dr. Efficient"
Nephrologist Persona 1
Approach
The charting was static and did not provide hierarchy, therefore physicians could not easily digest complex information quickly and easily. Below the design process is detailed, along with the steps to create a more usable and effective chart for nephrologists.
Step 1 -> Physician Advisory Board Feedback & Personas
Step 2 -> Breaking Down Issue (Overall Kidney problems, patient problems)
Step 3 -> Data Visualization Education
Step 4 -> Ideation
Step 5 -> Final UI Direction
Step 6 -> Physician Feedback
Step 1
Physician Advisory Board Feedback & Personas
The Physician Advisory Board is a collection of nephrologists that are assembled 3-4 times a year to be consulted to review new designs and advise on what is upcoming in the world of kidney care as well as what these changes will necessitate for DaVita's software:
demonstrations of new and updated
features are shown
new designs are created and prepared to be presented
PAB Process
physicians respond to questions and short surveys
designers digest feedback and
ideate solutions
Nephrologists communicated that they needed a clearer way to digest data than the existing tables that were static and lacked hierarchy:
Cell Hierarchy
80 bpm
80 bpm
80 bpm
80 bpm
80 bpm
60 bpm
60 bpm
60 bpm
80 bpm cells
60 bpm cells
difficult to ascertain pattern at a glance
Personas helped to inform the understanding of different doctors' (that may not have been represented on the board) pain points, and how they might benefit from chart updates:
Persona Range
Persona 1
Persona 2
Persona 3
concerned with patient's feelings (empathy focus)
concerned with recordkeeping
(efficiency focus)
concerned with quick rounds (speed focus)
Step 2
Breaking Issues Down
There were a few considerations taken into account before moving forward with the new designs.
I considered what I needed to address, and where solutions might come from:
1. Clearer cell display
-Consider how to represent trends more accurately
-Look at data visualization standards
2. Ordering of data
-Look to industry standards on kidney care
-Consider individual patient data for priority including out of range labs
3. Avoiding Visual Overwhelm
-Consider minimizing or hiding some less important data
-Look at progressive disclosure
Step 3
Data Visualization Education
Looked to industry leaders and learning platforms as resources for ideas and inspiration on incorporating data visualization
Options
- Visually link existing cells
- Indicate cell change
- Trending Bar
Step 4
Ideation Phase
1. Cell Display
Indicate Cell Change
80 bpm
80 bpm
80 bpm
80 bpm
80 bpm
60 bpm
60 bpm
60 bpm
Link Cells
80 bpm
80 bpm
80 bpm
80 bpm
80 bpm
60 bpm
60 bpm
60 bpm
Replace with Trending Bar
80 bpm
60 bpm
2. Ordering Data
Industry Focus
Based on general lab results that the industry looks to for assessing kidney problems i.e. blood pressure, creatinine, patient weight
Patient Focus
Display priority goes to individual labs from patients that are out of range i.e. any lab result within the set that is too high or low in value is highlighted and given priority as it indicates specific patient needs
3. Avoiding Visual Overwhelm
Minimize Non-Critical Data
Rows that are not critical can be accessed using the "Show More Results" functionality at bottom of chart
value
value
value
value
value
value
value
Show More Results >
Step 5
Final Direction (Low Fidelity)
New Chart UI
Blood Pressure
Weight
Creatinine
Jun 22
Jun 15
Jun 8
Jun 1
May 25
May 18
May 11
May 4
140/80 mmHg
160/90 mmHg
*
210 lbs
205 lbs
200 lbs
125 μmol/L
116 μmol/L
*
Indicates result outside of reference range
Show More Results >
-Trending bar
-Ordered on industry standards
-"Out of Range" indicators (*) with popovers that show recommended ranges
-Lower-priority results are minimized to avoid visual overwhelm
-More readable and can be scanned quickly and efficiently by rounding physicians
Features
Step 6
Physician Feedback
Updates were shared with Physicians who could interact with the new system and see how their ease of comprehension increased which will allow them to avoid physician burnout and provide better care to dialysis patients
