Tuesday, November 06, 2018
Change Control
Related DocumentsDescription / Function / Location
Healthcare Plan (A)
Field Study Plan / Field Study Plan
Debrief / Recapping usability observations
Healthcare Plan (A) Notes from study / Collective notes
Healthcare Plan (B)
Healthcare Plan (B) Field Study Plan / Field Study Plan
Healthcare Plan (B) Notes from study / Collective notes
Healthcare Plan (B) Demographics / Results of the survey from users
Healthcare Plan (B) Interviews / Results of interviews
Quotes from Customers / Collection of quotes in my usability travels to customer sites
IT Problems Reported from an outside firm / Outside firm observations
Outside firm log description / We went over this spreadsheet in our meeting with Healthcare Plan (B) and outside firm IT problem logs
Healthcare Plan (B) Workgroup Session Results / 3 hour collaboration with user on three exercises
Number of Case Manager Users using CA / Spreadsheet with the total number of users by line of business
Healthcare Plan (C)
2009-2010 Call Handle Time / Call handle times in seconds
Master Quantifier / This document is an inventory of all Lean UM Quantifiers.
Training Notes for CM & UM / Notes taken while observing the CM & UM folks for the week.
UM Testing with Healthcare Plan (C) / Testing results with Healthcare Plan (C) done for UM 4.7 design
Change Record
Date / Author / Version / Reference
5/25/2010 / Kimberly Lovely / 1.0
6/04/2010 / Kimberly Lovely / 2.0
Contributors
Name / Name / Name
Kimberly Lovely / Colleague 1 / Colleague 2
Deliverable Review/Sign-Off Requirements
Role / Reviewer / Signed Approval / Date
N/A / N/A / N/A
2010 Usability Report / 1 of 71
TABLE OF CONTENTS
Clients Studied: Healthcare Plan A, B and C
the Field Study story
1. Understanding the users
2. Demograpic questionnaire results
5. Identifying usability issues & inefficientcies (findings)
6. results from the interviews of supervisors & Cms Healthcare Plan
Closing Remarks
Friday Workgroup session - notes
Value Captures – Reported IT problems
2010 Usability Report
Clients Studied: Healthcare Plan A, B and C
Details of the usability report.
Healthcare Plan A – March 29th – March 30th, Resumed on May 21st, May 27th and June 15th, Kimberly Lovely, Colleagues A, B & C
Healthcare Plan C – March 22nd – March 26th, Training, Colleague A observing UM training and Kimberly Lovely Observing UM and CM training.
Healthcare Plan B– April 26th – 30th, Colleagues A, B and Kimberly Lovely
the Field Study story
Healthcare Plan (C)
The Healthcare Plan (C) one week training I observed was a mixture of UM and CM supervisory roles. CM users were not extreme power users like UM folks. They really aren’t measured but soon will be they stated. They mouse clicked and took their time. Whereas the UM users were power users tabbing forward, backward, using the mouse right click, and the arrow keys to navigate from field to field. UM users are highly measured.
“It’s like going from a Yugo to a Beemer.” - CM student
“The product is over engineered in places.” – UM Student
“There are a lot of moving parts.” – UM Student
“To many places to look for the same thing.” – CM Student
Healthcare Plan A
60 Total Number of CM Users of Product at Healthcare Plan (A) Medicaid
The Healthcare Plan (A) site visit was with users in supervisory roles and care managers. First two users work in Content Editor and the third works in the product 50 percent of the time. The forth user works in the product and is a true end user. 8 Care Managers and two supervisors were observed.
“We tell everyone that they are forbidden to use the back button in the product.” –CM & Content Manager
“There are a lot of thing we don’t use or is completely useless to me. We may not be using the product like it was intended.” –CM Pediatrics
“It’s floats! It scales!” (She didn’t know the Member Overview icon floated)– CM
“It’s so easy to do something wrong in the product.” – CM
Healthcare Plan (B)
/ Out of these 366 users only21 of them are men.
366 Total Number of CM Users of Product at Healthcare Plan (B)
Healthcare Plan (B)was breath taking. A fortress up on the hill along the banks of the mighty TN river. Will these CM users be like the users observed thus far I wondered?It will be interesting to see the three lines of business Commercial, Medicaid and Medicare all under one roof and in one state. I have already met my users prior to landing. I received many demographics surveys and questionnaires back from them.
Our team started the week off with first Commercial, Tuesday Medicaid then Thursday a two person interview with Medicare. Medicare opted out of the observation part of the study last minute. In the morning Care Manger Supervisors came down from each line of business. The forum was round table discussions and a Q&A session. Next we split for observation of the end users. Thursday we met with an outside firm to go over their findings which were minimal and mostly resolved upon an upgrade to 4.7. The most exciting day was of course theWorkgroup session. This is where we discovered we had an innovative bunch of folks. We witnessed the birth of AWESOME 2.0.
Details of the work group session
We invited the users we studied to this session to gain the following:
1. To learn how they would ideally like to assign members.
2. To understand how they would ideally like to design a Care Plan.
3. To collectively understand what they would like to see on their personal Dashboard (Homepage).
Our team was armed with cards for them to work with. However they did the opposite. They took matters into their own hands. I guess by telling them that they have to create it from scratch ignited the flow of innovative thinking. They were told that nothing existed out there. There was no existing product in their world. It was up to them to create their “Blue Sky.”
What we learn was they like to spend Healthcare (B’s) money for touch screens and voice recognition technology.
Care Managers are like no other user I have ever observed before. They carry a heavy heart and it’s personal to them. They take on the member’s stress. They comfort families whom lost a love one. They are resourceful and make sure members are educated. They do not work 9-5 but 24/7. On the weekends they drop off toys for the children of the dying parent. These Care Mangers care for you and your family.
I think the reason why many or all of us are at the Healthcare IT company is to make a difference in the health care industry. This is a commonality we share with our Care Managers of our product.
1. Understanding the users
With that said I would like you to meet Patricia. Patricia out of all the users of our product struck me the most. Her confidence and style on how she works with her members caught my attention. Patricia is very computer savvy but set in her ways.
Patricia starts her day off by launching Outlook to check on her mail. She launches Word, Excel and two products owned by the Healthcare IT company. She has been using CCA for 1 ½ years now. Her role is dual, she does the UM case for members seeking bariatrics surgery, which is a process, they must meet several goals before the surgery is approved. Once they have the procedure, she follows them in a Care Management case long term to help ensure success of the procedure. She may have 2 years’ worth of data per member.
50 percent of her day is going on the hunt for the member’s phone number. She has her methods to hunt it down which varies from each user. But her main goal is to care for her member’s. She first tries product (F). No luck. So she launches a template for a form for missing phone number. She has to reach this member within 7 days according to the business process. Knowing that in 24 hours this maybe resolve is comforting to her. Reaching that member however is delayed one more day.
When she is creating a Care Plan it’s all in word. She copies from word to product CCA. She is more comfortable and productive in doing so she states. She is like many that I have observed in Care Management. Many feel they are doing the same task over and over for 30 minutes when a simple task should take less than 5 minutes. An example given was of something that is so simple but takes them time of having drop downs for a selection in alphabetical order. Condition list and medication list you can’t sort alphabetically. Another example was the ability to select multiple milestones at a time to import into a Care Plan.
In conclusion in observing Pat and the others we are seeing a pattern that is worth noting. The system is creating a behavior in the users. The behavior is one of trust. Many have lost important information and time entering in notes on a member when the system would quit on them (C). So they rely on a self generated paper base system or they record in notepad and or word. They enter in the information ONLY after they have captured the information needed of a member in these aids. This is duplicating the workload for the users and doubling the amount of time doing the tasks.
The users want to be as efficient as possible and feel the product wastes a lot of their time when not necessary. Time they would rather spend with more members.
Users expect technology to be integrated into the product to enhance their workflow. Our users are savvy and would love to use right click menus, drag and drop capabilities, tear off tabs to enable them to work on more than one member at a time.
“My job should be to work for the member not the documentation.” – Healthcare Plan (A), Care Manger
2. Demograpic questionnaire results
33 questionnaires have come back so far from our users whom are all female except for one. They will continue to trickle in. These results are from Healthcare Plan (B). A consolidation of those results can be seen below.
Education — level of schooling our users have completed.(33 respondents)
Users were asked: What level of schooling have you completed?
Education Level of Healthcare Plan (B)
Training on Product CCA
Users were asked: When were you trained on the product, what version of the product and for how long was the training?
What we learned from this question was that training varied. Healthcare Plan (A) and Healthcare Plan (B) users felt that they could use more training. The range of training was from 2.5 days to 2 weeks. Some training reported consists of PowerPoint Presentations or webinars for 1 – 3 hours. Mentoring also took place learning from others on their team the product. Cheat sheets where also created by Care Manager Supervisors to expedite efficiency in workflows and aid the users starting out in the product after training.
Job role length of time
Users were asked: How long have you been in this role?
The majority are seasoned in their current job role.
Length of Time in Job Role (Healthcare Plan (B)
Total years of experience our users have in the healthcare industry.
Users were asked: How many total years of experience do you have in the healthcare industry?
What we discovered was the majority of the users had ten plus years in the healthcare industry. So they are educated and very experience in their field.
Experience in the Healthcare Industry at Healthcare Plan (B)
User Self Rating in CCA product.
User Self Rating in CCA at Healthcare (B)
Users were asked: How would you rate yourself as a user of the CCA Product? Novice, Average or an Expert?
As we have discovered in previous questions these users have been using the product for a long period of time. Many factors come into play as to why they only feel that they are average users of the product. Lack of lengthy training as noted may be a key component. As observations were made of users in the product they seem sluggish in comparison to other products such as word or note pad. Certain tasks in the product were interrupted by resorting to tangible aids for task completion.
Tools & Technology used in our user’s work.
Users were asked: What tools and technology do you use in your work? (Please include any software tools, as well as phone, PDA, paper forms, equipment, number of monitors etc.)
Software/Technology / Paper Based Tools / EquipmentCCA / CM Checklist / (1- 2) 19” Monitors
Products (F) & (Q) / Paper Forms / Phone/Headset/Blackberry
Triage Log / Note Pads / Computer/Laptop
SharePoint (Triage) / Paper Forms / Calendar
Outlook / Folders / Keyboard/Mouse
Word / Facets Face Sheet / Modem/Comcast w/Nortel Box
Excel / Drug Handbook / Printer
Note Pad / Cover TN Handbooks / Scanner
Juniper / Transplant Forms / Desk/Chair
Thin Client / SharePoint Member Info / Fax
Right Fax / Paper Aids / Coping machine
CareGuide / Policies & Procedures / Calculator
Amysis look-back / Rolodex
CITRIX
MEDAI Database
HCS Provider Viewer
PeopleSoft Finance
Care Guide
Live Meeting
BC Member Appeals Automation
Carekey Bridge
PowerPoint
Language Line
FEP Direct
Report Manager
Next Gen CM
Genesys
CM Referral Database
XenDesktop
SnagIT
Personal Templates
Internet/ Browser IE
- MrDocMan.com
- Yellowbook.com
- Government Sites
- Access TN
- CoverKids.com
- EncoderPro.com
- CareGuide
- Intranet
- Healthwise
- Smart Neighbor
Intranet / Sites, Crossroads,
Windows
IH250, IH728 Main Frame
It was interesting to see that each Care Manager had a tangible folder on each member they cared for. This folder contains the product (F) Face Sheet, written notes, printouts etc. Many users went outside CA to sites that aided task completion. Medicaid users spend 50 percent of their time hunting down phone numbers. In doing so they went to yellowbook.com and some Googled the names. Other sites users went out to a lot were Encoder.com as a direct result of CCA not having a usable search for drugs and MrDocMan.com. Tools such as the calculator were used to do cost savings tasks. A widget would come in handy that they could use in this type of task.
Monitor Resolution and size.
Users were asked: What size are your monitor(s)? What monitor resolution are you viewing CCA?
The size of the resolution varied based on the setup in home offices and in the office. The physical size range of the monitors was 11” to 24” in size. Some users work just off their laptops. The recommended monitor resolution based off the user guide is 1024x768. What we found also is that even at the recommended size of 1024x768 the users were still scrolling horizontally which is causing strain on the wrist. This is an important point to make as WellPoint has a strict accessibility policy for workmen’s comp. Unfortunately not all users adhere 1024 also. Having the resolution at 1280 causes a void and waste of space. Majority of the users were viewing CCA in 1024 and 1280. There were some at 1154 and 1440. The screen layout should be liquid both horizontally and vertically.
1280 x 1024 Monitor Resolution
1024 x 768 Monitor Resolution – Even at the recommended size the tabs below are cut off and a scroll bar is added to the right. This also may explain why users are not using the tabs at the below. Keeping everything above the fold will reduce the scrolling. For many users they don’t have the top browser bar but have to scroll horizontally also which is straining them. Users are having problems with their wrist will all the scrolling.
1152 x 864 Monitor Resolution – Users have adjusted to this resolution perhaps because the layout shows the tabs below and eliminate the scroll bar to the right.
Loading all the tools also in the browser menu bar takes up time and adds to the visual clutter. The recommendation is for no browser bar at the top. Use open window method only. There is no value to the user having this at the top. In fact the browser back button is being hit. This causes error messages. Some users also are using right click back which also causes the same issue.
Right Click Contextual Menus & Tabbing
Users were asked: Do you right click with the mouse in applications? Example would be for menu items in Microsoft Word.They were also asked if they tab into fields with the keyboard.
The goal of this question was to see if contextual menus for the right click function would be intuitive to users of CCA. We discovered that most of the users surveyed use right click contextual menus for functions such as cut and paste except for 5 out of the 78 surveyed. They also added they can’t do that in CCA and would love to see that functionality integrated.
For the tabbing field to field only 8 out of the 78 surveyed said they don’t. So what this is telling us is that the tabbing in the product has to work and work logically to support this behavior in the user’s workflow. It is also an accessibility issue and with Healthcare Plan (C) a workman’s comp. compliance issue as I noted in the Healthcare Plan (C) UM testing documentation.
Ages of our users
Users were asked: There age range.
The majority of the users surveyed are between the ages of 36 years to 55 years. The youngest 13 users were 26 years – 35 years of age. The oldest 13 users were 56 years – 65 years of age. There was one user in the age group 18 years – 25 years of age.