Streamlining Epic's Staging Forms

 

DISCLAIMER: Screenshots cannot be included in this case study due to a non-disclosure agreement. This study has been reviewed by Epic employees to achieve a desired level of anonymity.

 

OVERVIEW

Epic is the world's largest electronic medical record and is used by millions of oncologists everyday. However, data showed not many of these oncologists were actually staging cancers with Epic's staging forms. Most were opting to stage cancers in electronic notes or paper. To make matters worse, there's a statistically significant percentage of caretakers who begin staging a cancer in one of Epic's forms and then abandon it midway through the process.

I worked with seven other cross-functional designers to create simpler, more streamlined staging forms that would be easier to complete.

SKILLS AND TOOLS

  • Heuristic evaluation
  • Design review
  • Cross-functional communication and strategy
  • Quality Assurance
  • Agile development

TEAM AND DURATION

This project required months of design meetings and over 500 hours of development. I worked on a cross-functional team of 20 with a primary focus on design review, heuristic evaluation, and quality assurance.


    SOLUTION OVERVIEW

    design principles.png

    We synthesized feedback from Epic's customer base to ensure the most important staging information was prioritized at the top of each page. Customers indicated more real estate should be given to the primary tumor (T), regional lymph nodes (N) and distant metastasis (M) fields at the top of each form.

    Our team developed a style guide to lead all other decisions and ensure consistency across the 104 different forms

    STRATEGY

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    Our strategy for this development balanced reactive problem solving with agile development. Thanks to their relationships with core customers, Epic has extensive qualitative data to support each design decision.

    From there, finer style guides were defined by the functionality that was currently possible within the system with the expectations laid out by previous releases.

    The AJCC cancer staging manual features a diverse array of information, written in equally diverse authorial voices and styles. Refining this information so it had a consistent style and voice without compromising information (all information is important when it comes to staging cancer) was a real challenge that required months of analyzing forms on a case-to-case basis.

    REVIEW STRUCTURE

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    Our core design review team consisted of myself, two other QAers, two developers, and a pair of tech service specialists with extensive knowledge surrounding the history of staging within the company's software, the company's relationship with AJCC, and general cancer staging vocabulary.

    After agreeing on a preliminary style guide, our team met for an hour each day for months to refine this style guide for every form. Light heuristic evaluations were run on every single form to ensure the decisions our core design group was making (dropdown vs. buttons; should we automatically display description or hide it and what does that mean for the view?; when should we introduce breaks in information? etc.) aligned for maximal usability, consistency, and feasibility.

    These forms were designed, developed, and iterated in an agile style.

    IMPLEMENTATION

    Development designs were only passed to QA once they got the thumbs up from every member of our design team. Development then went through two rounds of QA before being okayed for implementation.

    NEXT STEPS

    This project made the Epic staging forms easier to use, solving for the oncologist demographic who abandoned their documentation mid-way through a form. However, it does not solve for the oncologists who are unable to find the forms, or are unable to determine their next step after completing their documentation. The next step for Epic will be to widen the scope of this development to ensure the staging forms fit logically within their system's information architecture.