Hospital Quality Reporting

App Development | Design | UX

Overview

In an effort to promote the delivery of quality healthcare services to patients at Medicare participating facilities, the Center for Medicare and Medicaid Services (CMS), maintains the Hospital Quality Reporting (HQR) system, which collects, processes and reports metrics on the performance of hospitals, care systems and ambulatory surgical centers.

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Strategy

As the Human Centered Design Lead, I coordinate UX efforts with product owners, delivery managers, and key stakeholders from CMS to establish strategic UX product objectives, socialize our DesignOps strategy, and refine our HCD process to work more
effectively within the Scaled Agile Framework (sAFE).

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Public Reporting (PR) Redesign

I personally lead the effort to redesign HQR Public Reporting, which gives providers access to cumulative quality metrics for their facility before being made publicly available through medicare.gov. This migration of query-based legacy reports into a dynamic, and 508 accessible UI, standardizes data formatting across all care-measure categories, provides access to historical trend data, allows users to quickly filter data in order to isolate areas for improvement. In addition, this work introduces solutions for accessing supplemental information in the context of provider data and easily navigating between facilities for those with multiple organizational affiliations. This initiative has received praise from the HQR community as well as from Kate Goodrich (Director, Quality Measurement and Health Assessment Group Center for Clinical Standards and Quality) as a new model for other compare websites within the CMS ecosystem to follow.

Design Audit

In order to review facility quality scoring data before it is made public, hospitals must run what is called a “public reporting preview report”. These reports take time to run and are only available in PDF format. A thorough design audit was performed and cross-referenced with user research in order to ideate on improvements to the system, with a focus of readability and flexbility of access to preview data.

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Ideation

In order to review facility quality scoring data before it is made public, hospitals must run what is called a “public reporting preview report”. These reports take time to run and are only available in PDF format. A thorough design audit was performed to evaluate how the readability of data could be improved.

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Wireframing

The redesign effort focused on eliminating the need entirely for preview reports as the primary way to access quality metrics for hospitals, and replace them with a dynamic UI that allows users to filter data, easily access supplemental information and historical trend data.

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Usability

Overall, users felt the redesign preview report UI was more accessible and easily understood than the previous report design.

Hi-Fidelity Designs

One of the most glaring issues with HQR PDF reports was the lack of standardization or design principles across all reports. Within the preview report alone, there were a dozen separate table formats. It was essential to establish patterns for tabular data that would last, not just for public reporting, but for the many other places tabular data patterns would be surfaced in HQR.

Establishing consistency in iconography, link styling, and even consolidating column naming conventions for like data types revealed that all data types could fit within a single data table paradigm, significantly reducing the complexity of the content hierarchy and increasing ease of use.

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Another key way we improved the readability of the public reporting UI was to utilize a progressive disclosure model for accessing supplemental information about measures. Nested data sets (tables within tables) were a signature reason why PDF preview reports were nearly incomprehensible.

Leveraging modals to display relevant, but secondary information such as measure definitions, footnotes or trend graphs, greatly simplified the overall UI and created a highly extensible pattern to be used elsewhere on HQR.
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User Feedback

“I think its an improvement overall, just getting to a current state where the rest of industry are with reports. This is really nice. It’s easy, there’s not too many clicks, I’m not getting lost in a whole bunch of submenus which is part of the hard thing about the QNet reports right now. So this is just more logical, more visually pleasing, it helps focus, easier to share. I love it. Yeah, it’s a huge improvement.”

“I think this format would be very helpful for organizational leaders that review preview reports, better visualization.”

“Well laid out with, clear headers, good font choice, clean look – no clutter.”

eCQM Submission Redesign

One of the main submission methods for HQR is Electronic Clinical Quality Measures (eCQM). These files, submitted currently as QRDA formatted XML files, are historically processed in large batches, and reviewed through query based PDF reports. This process was slow and cumbersome, and gave no real time feedback to submitters. We overhauled the this process to include a dashboard workflow for file upload history, isolating structural errors in files, as well as reviewing measure outcomes. The MVP of this functionality is currently in development.

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eCQM UI – Wireframes

The redesign …..

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Usability

Overall, users felt the redesign preview report UI was more accessible and easily understood than the previous report design.

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eCQM Report – Hi-Fidelity Designs

One of the most glaring issues with ….

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User Feedback

“[It’s] easier to view the files specific to measure outcomes.”

“The new way is a much more efficient way of viewing the data collected.”

“I think having the ability to see where the outcomes are falling, especially during test submission, will save us a lot of time by not having to submit to prod and then waiting to run the final reports to see what the outcomes are.”