AM+A

Kaiser Permanente (KP) is an integrated managed care organization, based in Oakland, California. Operating in nine states and Washington, D.C., Kaiser Permanente is the largest managed care organization in the United States. Kaiser Permanente has 8.7 million health plan members, 156,000 employees, 13,729 physicians, 37 medical centers, 400 medical offices, and $34.4 billion in annual (2008) operating revenues and $1.3 billion in net income.

In June of 2006, Kaiser engaged AM+A to analyze and test the usability of the Clinical Library (CL), a Web-based internal information resource. The Clinical Library makes a wide variety of clinical information available to physicians, clinicians, and nurses, both during actual patient care and at times when they are engaged in research or study. Through the Clinical Library, KP clinicians and nurses can find internally produced guidelines for medical conditions and procedures, find and print out patient handouts, reach other Kaiser Websites, access external resources such as journals and medical texts, and reach a wide variety of other resources of a operational or managerial nature.

Working with a team from CMI, AM+A drew up an interview script and interviewed sixteen clinicians and nurses in their offices in four KP regions: Colorado, Northern California, Northwest, and Southern California. Subjects were given a series of mostly medical questions, and asked to find answers using Clinical Library.

The Usability Analysis report resulting from this study detailed both the powerful potential of the CL to serve its target audiences and numerous severe usability issues currently limiting its effectiveness, particularly during time-critical periods of actual patient care. The report detailed 31 major “observations” concerning usability issues, grouped in four general categories such as “Search Issues” and “Navigation Issues.” A fifth category detailed observations of the effectiveness of “Clinical Tools,” a partial restructuring of the CL UI that had been implemented in the Colorado region. A table of priorities was prepared based on comments by the interview subjects. AM+A made preliminary recommendations for how each issue could best be resolved.

In the fall of 2007, Kaiser asked AM+A to propose a usability analysis and design project to address some of the issues discovered in the 2006 report. The proposal divided work into two Phases: Phase 1 was a rapid, two-month project focused on a “proof of concept” redesign of the most time-critical parts of Clinical Library, with four rapid tasks including a paper user test conducted by phone. Phase 2 was a six-month complete redesign, including the development of an interactive prototype and three user tests in the field.

AM+A completed its final work on the project at the close of 2008. Final user tests showed significant improvements in speed of navigation and user satisfaction. Based on the success of the project, Kaiser provided a letter of recommendation.