Application design in health care domain

30 Oct 2007 - 10:07am
8 years ago
4 replies
977 reads
Grady Kelly


I was a designer in the Health Care industry for three and a half years,
with two different medical companies. One of which provided an EMR
(Electronic Medical Record) applciation, and a PHR (Personal Health
Record). The other provided applications to Physicians that facilitated the
viewing and ordering of Lab Results. Each had users numbering in the
thousands with both patients and medical professionals. When it came to the
UI, I would use best practices to create the applications where needed, and
innovated where I could. And there are lots of places where you can be
innovative. The same is true of the interactions. What was the most
cumbersome was getting user acceptance or buy off on functionality, because
most had very drastic differences in their opinions of what they wanted to
do what and how. Because of that, we made the application very flexible or
customizable so that each user could have the application do what they
wanted. This was not the case for bigger pieces of the application, such as
reporting, etc. In those cases, most users had similar needs that we were
able to design around. In regards to Accessibility, we did not have any
strict requirements from any customers that I was ever aware of. This was
again a place where we would use best practices in design with css/xhtml,
etc to allow for the best possible experience, font sizing, screen
resolution, etc.

As for the Microsoft Health Common User Interface, when I first saw that,
I chuckled. There is nothing there that is new. Sure, maybe you could use
it as a starting point, but I can almost guarantee that groups of Physicians
or Medical professionals will not like the way that they have done things.

So to answer your questions ...

Is there any Samples or Guidelines available for health care domain?
I have never seen any good guidelines or samples. The various companies
that are solving problems in the Health Care industry are all doing it
differently. The are not unified. There are some websites for the various
EMR vendors that will show demos of their products. You may get some ideas
there, if nothing more that a starting point to come up with a better

What are the major attributes or details which have to be kept in
attention while designing?
My suggestion would be to use best practices in web application design
and go from there. Talk to customers and design around their needs.

Any example available which has the least number of mouse clicks?
You can think about mouse clicks, but in some cases it does not matter.
For instance, if a Physician wants to run an ad hoc report off of some
medical data, the steps that are required in choosing the data, how it is
sorted and displayed can take many clicks. Sure you want the least amount
possible, and you want the task to be easy to accomplish, but I would not
set yourself a limit on something like mouse clicks, it will vary.

Hope that helps.

Grady Kelly
grady at


30 Oct 2007 - 12:32pm

I worked with United Health Group/Ingenix on their billing/claims
adjudification software, which delt with identifying and matching
proceedures and modifiers, with contractual obligations, inorder to identify
payment discrepencies.

Ingenix is the leading source of medical procedure codes and their
modifiers. The issue we found with identifying and subsequently matching of
procedures from providers, (hospital groups), and payers, (insurance
companies), is that, (as was stated in an earlier post), most providers have
their own codes and almost all payers have their own different codes. Also
procedures are "bundled" in different means between the two organization
types. Basically it's a complete mess in identifying a "lingua franca" for
what is done to patients in hospitals and the subsequent billing issues.

There are standards which are leading the way such as HIPPA/HICFA/Medicare.
Along with all of this there is vested interest in NOT changing the system,
as most contracts would have to be re-negotiated, which would cause risk to
cash flows.

So lots of reasons why things are not easy in US Health Care, some of the
best solutions, (amazingly), seem to come from the US gov.


5 Nov 2007 - 10:24am
Grady Kelly


With the patients permission, you can share data. At my last employer,
we had set up the state of Delaware with a system that allowed Physicians to
view lab and other data across all participating hospitals and clinics.
There are also precautions in place so that if a Doctor looked at data that
they should not be allowed to see or share, that the system tracked those
actions. In some cases, a Doctor may need data without being able to get
the patients permission, like they are unconscious, for situations like
that, we called it "breaking glass" like you would have to do to set a fire

One of the biggest things right now in that space is sharing data. If you
think about it, it is a must. The design just needs to help them be
responsible with the data.

Grady Kelly
grady at

On 11/5/07, Lorraine.Carter at <Lorraine.Carter at> wrote:
> Hi,
> I understood that HIPAA prevented nearly all data sharing. Is that not
> the case?
> Lorraine
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Grady Kelly
grady at

5 Nov 2007 - 12:06pm

HIPAA does allow for data sharing, (at least it is being done). What you
can't share is the patients identity, thus you can identify male 32 has XYZ
issue, possibly you can also identify location.

Alot of this sharing was in a legal grey area, not sure what the decisions
are now.

On 11/5/07, Lorraine.Carter at <Lorraine.Carter at> wrote:
> >
> >
> > Hi,
> >
> > I understood that HIPAA prevented nearly all data sharing. Is that not
> > the case?
> >
> >
> > Lorraine

5 Nov 2007 - 5:36pm
Scott Green

HIPAA Privacy regulations do allow for the sharing of PHI (Protected
Health Information) between providers who participate in the "chain of
care" for a patient. For example, if a general dentist refers a patient
to an oral surgeon for a wisdom tooth removal consultation, the general
dentist can safely share all information relevant to the patient for the
medical need at hand. In my example above, this could include things
such as allergies, prescribed medications, previous medical conditions,
reason for referral, name, address, city, etc., as long as the referring
provider has a BAA (another HIPAAism for Business Associate Agreement.)
This is a standard document that simply states that two or more provides
in the chain of care are sharing relevant patient data.

- Scott

Scott Green
Product Analyst
PracticeWorks, Inc.

Tel: (770) 226-3254
Fax: (678) 742-9567
Mobile: (770) 335-6612

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