Nurse's passion for patient care brings critical eye to EHR design

In celebration of National Nurses Week, May 6 – 12, in the U.S., and International Nurses Day May 12, Allscripts User Experience team member Carin Mann, RN, discusses her journey to improve the lives of nurses.

 

I decided I wanted to be a nurse in the eighth grade. I knew that nurses worked hands-on with patients and helped them get better. That's what I wanted to do: Make a difference in people's lives.

This desire continued through high school and led me to Villanova's outstanding nursing program. I loved what I was learning and, after graduation, was excited to start working in the hospital ICU step-down unit. While on this unit, I became involved with the Clinical Practice Committee, which focused on how to improve the practice and processes nurses follow. This allowed me to examine how we can help nurses do their jobs better.

That became my next passion. 

I moved into a management role on an ortho/trauma/medicine unit and continued to look for ways to improve the daily lives of nurses, nursing assistants and medical clerks. Eventually, the hospital decided to implement an EHR. I was invited to join the decision-making team for choosing and implementing the new system.

After the decision for the new system was made, the hospital looked for nurses to be a part of the day-to-day decisions for implementation. This included tasks like reviewing security rights, order forms and order sets, patient lists and other features that clinicians need. This was my introduction to asking physicians and nurses how they wanted to interact with the computer and how it could help them. I served as "translator" to the people configuring the system. We also were a part of the testing process to ensure the system was working the way we expected. Eventually, we trained the users, too. 

Due to cutbacks, I left the hospital and started looking for other ways to use my passion to improve the workflows of clinicians and to continue to explore the power of EHR systems.  I was hired at Allscripts to help test clinical documentation, which included flowsheets and notes used by clinicians.

While working for an EHR vendor was a change for me, having a nurse on the Quality Assurance team was a change for the team. I followed test plans, and I also just used the flowsheets and notes as I would in the hospital. 

Along the way, I found bugs and uncovered new questions for my team. I also understood complex concepts such as drip calculations and "fanning out" information between flowsheets in a different way than non-clinicians would. Adding clinicians to the test team further enhanced the product experience. Within my first year, we had multiple clinicians testing on a variety of teams.

Since that first role at Allscripts, I have participated on the development teams in a variety of ways from design to product management. Our goal was always to deliver great features and talk to clients about what they need.

Some features were more successful than others, and I was always looking for a better way to get it right. Then entered the User Experience (UX) team.

I was introduced to the UX team after an Allscripts merger and discovered their User-Centered Design process. The more I learned about the process, the more excited I became. This seemed to be a great way to deliver products and features that improved the visual and workflow user experience. We could measure and test designs to find challenges before the release of the product. Thankfully, the UX manager recognized the value of having clinicians on the team and offered me a position where I have thrived.

My eighth-grade self didn't know about software and User-Centered Design theory. But she did start me on my journey, and that journey has taken me to places that I could not imagine then. 

Every day, I use my nursing experience as I am researching product requirements, talking to other clinicians, and "translating" among the users, designers and developers. 

Nursing brought me so many skills I continue to use now, including the ability to advocate for others, to be organized and to find time-savings. Nursing taught me that a good process goes a long way toward achieving positive outcomes. It also taught me that at any moment, chaos will reign, and you adapt accordingly. It taught me empathy for patients, other nurses and all who work with them.

I bring what nursing taught me to every design problem I solve.

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