Formative Testing: Accessing Inpatient Data in MyChart Mobile

Background

In February 2019, the Epic application MyChart Bedside released development that would allow patients to access inpatient information within MyChart Mobile. Previously, MyChart Bedside had existed as a tablet application that was only accessible if provisioned by a medical organization. With this development patients and patient proxies – such as parents or caregivers – would be able to access inpatient information from their own devices.


Problem

We did not know how discoverable and usable Bedside in MyChart Mobile would be with a new MyChart design. Soon after the Bedside development was released, MyChart started to redesign the MyChart Web and Mobile interfaces. Instead of static icons on a home page, users would now see action cards that would take them directly to activities that are most applicable to them at a given moment. At the top of the screen, they would find customizable quick links and a menu button that would allow them to access other activities. Previously, Bedside took over the MyChart Mobile homepage and outpatient icons were pushed to the bottom of the screen.

With the MyChart homepage redesign, Bedside could no longer take over the MyChart Mobile screen. We had to figure out anew how to integrate with MyChart or become obsolete with the May 2020 release. We designed a solution where users would enter the Bedside dashboard by clicking on a Hospital Stay card that would always stay at the top of the MyChart feed. We needed to know if this solution would work.


Research Approach

Benchmarking Task-based Study #1
Task-based usability study of Bedside development before the MyChart redesign
The Bedside inpatient dashboard took over the MyChart screen
Workflows in which participants are asked to find or complete information related to their hospital stay
Ex. “During your stay in the hospital, your doctor decides to run a test for the level of electrolytes in your system. You are told that your test results have been shared with you. Are your sodium levels normal?”
30 participants
Completion rates, error types and amount, ease of use, satisfaction (with SUS) analyzed

Benchmarking Task-Based Usability Study #2
Same study as the benchmarking, but after the MyChart redesign
The Bedside inpatient dashboard had to be access via a card in the MyChart feed
23 participants
Completion rates, error types and amount, ease of use, satisfaction (with SUS) analyzed

Iterative Task-Based Usability Study
Workflows in which participants are asked to find or complete information related to their hospital stay and workflows that required navigating between inpatient and outpatient contexts
20 participants
Completion rates, error types and amount, ease of use, satisfaction (with SUS) analyzed


Findings and Solutions

With the redesign, I found that only 50% of participants were able to complete the first task, compared to 100% of participants in the benchmarking study. The key issue was that users were not accessing Bedside to find the information they needed. Instead, participants tried to find the information they needed from the outpatient side of the application.

Auto-launching Bedside in MyChart Mobile Solution
Due to the results of the usability study, we decided to auto-launch into the Bedside dashboard when an admitted patient logged into MyChart Mobile. Patients or proxies would see a welcome screen the first time they logged in after admission, and then be on the dashboard. They would be able to access outpatient information through “home” buttons placed at top and the bottom of the screen. On the MyChart Mobile homepage, they would now be able to access Beside through the inpatient card in the feed and a menu item.
After designing this solution, we needed to determine how successful it would be. Moreover, the previous study results also raised another research question: how easily could participants navigate between inpatient and outpatient content?

Navigation post Auto-launch
After development, I ran another task-based study to determine how successful auto-launching was as a solution. This time, I also included tasks that required navigation between outpatient and inpatient functionality. Conducting the study with 20 participants, I found that all users were able to find inpatient information after being auto-launched onto the inpatient dashboard. Moreover, 16 completed the initial task “very easily” (per the facilitator’s estimation) and 4 “easily.” However, when users started navigating between inpatient and outpatient information, difficulties arose. When users had to navigate back to the MyChart Mobile homepage, everyone completed the task, but 5 completed it “with difficulty” and 1 with “a lot of difficulty.”
31% of participant, then, had difficulty navigating to the outpatient homepage after being auto-launched to the Bedside dashboard. Moreover, users voiced that they thought they should be able to access inpatient information directly from the MyChart Mobile homepage, without having to go to a different dashboard.


Outcomes

For the May 2020 release, we went forward with the auto-launch solution allowing users to continue accessing inpatient information with the MyChart Mobile redesign.

We recognized, however, that navigation was not ideal and neither was the stark separation between inpatient and outpatient information. Since then, new activities integrate better with MyChart Mobile, showing inpatient information from the outpatient side and vice versa. Moreover, on our future roadmap, we have plans to redesign Bedside in MyChart Mobile to provide a consistent experience with the new MyChart homepage and to give users more freedom and control over their experience.