Attachment_7_-_Product_Demonstration_Scenarios.pdf

RFP No. 140D0421R0050 Attachment 7

Product Demonstration Scenarios

Introduction:

This document presents a series of typical use cases for an Electronic Health Record (EHR) in the Indian Health Service (IHS). While it will not be possible for Offerors to demonstrate all of the capabilities during the acquisition phase that they will provide to IHS if awarded a contract, it is important that the Federal Government as well as IHS Stakeholders be afforded an opportunity to view and evaluate some key features, particularly from the standpoint of usability.

This document serves a dual purpose:

1) It provides instructions to Offerors on the content to be included in recorded scenarios for demonstration.

2) It informs Stakeholders viewing the product demonstrations of the specific processes the Offerors have been asked to demonstrate, and also serves as a scoring tool.

Instructions to Offerors:

The “Role” column in each table indicates the user who would typically perform the action described in the scenario step. Since it is possible that the application or user interface may vary by role, the Offeror shall demonstrate the interface appropriate for the role specified by the Government performing each step.

The Government recognizes that modern EHR solutions offer a high degree of configurability in business workflows and user interfaces, and that IHS has not specified detailed workflows for the scenarios outlined below. For the purposes of the product demonstrations, Offerors shall demonstrate the workflows and interfaces that provide the highest level of usability and user acceptance for these scenarios.

The Government has not provided all of the data that may be necessary to optimally demonstrate each scenario. Offerors shall provide appropriate clinically relevant content (e.g., vital signs, test results, medication doses, etc.) as needed to fully demonstrate the scenario, but shall not add steps or features not requested in the scenarios.

Offerors do not need to submit a written portion to accompany their scenario submission. Please see the RFP for more information regarding submission requirements.

Scenario #1: Complicated Outpatient The intent of this scenario is to demonstrate an ambulatory visit for a complicated outpatient from beginning to end.

56 y/o Male, Army Veteran, now works for tribal government. Covered by tribal health insurance (primary, but IHS does not bill tribal program) and Tricare for Life (secondary).

The patient has a 15-year history of uncomplicated type 2 diabetes, along with mild hypertension, dyslipidemia, obesity, and degenerative joint disease (DJD) of the knees (on appropriate doses of metformin, atorvastatin, and an over-the-counter non-steroidal anti-inflammatory drug (NSAID) prescribed through the IHS clinic and therefore part of the medication list). He presents to a rural IHS clinic for scheduled follow-up after a visit to a private-sector Emergency Department (ED) three weeks earlier. He has not been seen at the IHS clinic for over 6 months. The reason he went to the ED was because of pain and swelling in his left big toe. He states they told him he has an ingrown toenail that was infected and needs to come out. They put him on antibiotics – he doesn’t remember the name – and also did some lab tests. He states they told him his diabetes is not well controlled and there’s something wrong with his kidneys. He doesn’t have any paperwork from the ED visit.

Information from the ED visit is obtained by nursing staff through the Health Information Exchange (HIE). This shows the diagnosis of an ingrown nail with localized cellulitis, which was treated using cephalexin 500 mg TID for seven days, and Tylenol with codeine for pain (#12 total). A CBC in the ED showed borderline anemia, with no leukocytosis. A basic metabolic panel was normal except a random serum glucose of 273 and a creatinine of 2.3.

Provider evaluation shows an ingrown nail, lateral edge left hallux, good pedal pulses and capillary refill, resolution of local cellulitis described in ED note obtained through the Health Information Exchange, though still tender in area of ingrowth. An office procedure is performed – partial excision of ingrown nail left hallux using digital block and phenol to cauterize the affected bed, with a loose dressing.

The plan of care includes addition of a starting dose of insulin glargine to his medication regimen; this includes referral to the local diabetes nurse educator for insulin instruction (insulin is ordered but held pending education). Referral to a private nephrologist in the nearest off-reservation community is initiated for evaluation of suspected early diabetic nephropathy. Appointments are scheduled in three weeks for the treating primary care provider to recheck the toe, and with the visiting podiatrist when he is next available in two months.

The patient reports having had significant nausea with Tylenol #3, so this is entered as a medication intolerance to codeine. A small supply of Tramadol 50 mg is provided for post-procedure pain. The patient’s existing Rx for ibuprofen 800 mg BID for osteoarthritis is discontinued for now because of the renal concern. The dose of Lisinopril he takes for blood pressure is reduced from 20 mg daily to 10 mg daily for the same reason, pending feedback from the consultant.

Offeror Instructions Stakeholder Scoring # Role Demonstration Instructions

Offerors shall demonstrate each of the tasks described in this column.

Score 1 (least usable) to 5 (most usable)

Comment Stakeholders may provide comments to support their scoring

1 Patient Registration /

Check-in

Demonstrate how previous (pre-populated) demographics are reviewed and updated with new data. Patient not seen in many months, asked about gender identity / preferred name / pronouns, reports wanting to be addressed by middle name (cis male otherwise).

Demonstrate how pre-populated and unchanged insurance information is viewed including sequencing (primary/secondary).

2 Intake Nurse/MA Demonstrate how patient’s preferred name is readily apparent to clinical staff.

Demonstrate how clinical staff may access details of demographic, SO/GI, and insurance information.

Demonstrate how the patient’s completed check-in and availability for call-back are apparent to clinical staff.

3 Patient or Intake Nurse/MA

Demonstrate how the system supports initial patient input upon start of encounter. This includes documentation of routine age/gender appropriate screening questions, e.g., COVID-19 symptoms, tobacco use, alcohol use, “safe at home”, depression & suicide risk, and fall risk.

Offerors shall demonstrate their preferred proposed approach from a usability standpoint.

4 Intake Nurse/MA Demonstrate a review of pre-populated screening questions and documenting answers, documentation of chief complaint, recording of vital signs, medication reconciliation, and medication renewal requests.

5 Nurse/MA or Clinician

Demonstrate accessing recent ED visit documentation through HIE, viewing of C-CDA, including problems, medications, and labs.

Demonstrate reconciliation of new problem (DM type 2 w nephropathy) and medications (antibiotic) into EHR. Demonstrate review of ED labs including mild anemia, normal WBC, creatinine 2.1.

6 Nurse/MA Demonstrate documentation of point-of-care labs done by Nurse/MA: finger-stick glucose, HbA1C, urine dipstick.

7 Provider Demonstrate provider review of CC/vitals and other entries by Nurse/MA, including patient-entered/provided screening results from Step 3, and point-of-care lab results from Step 6.

8 Provider Demonstrate documentation of history, physical, and procedure. Use tools such as templates or forms as appropriate as documentation tools.

9 Provider Demonstrate medication renewal (metformin), dosage change (Lisinopril), discontinuation (ibuprofen), addition of new medication (insulin glargine), controlled substance tramadol, showing use of Electronic Prescribing of Controlled Substances (EPCS) and PDMP.

Add to Allergies/Adverse events: Codeine:

intolerance (nausea)

10 Provider Demonstrate lab order entry for complete metabolic panel (CMP), complete blood count (CBC) with differential, Hemoglobin A1c.

Demonstrate order set function as appropriate to submit bundled lab orders. Include how the indication for each test is documented.

11 Provider Referrals and scheduling:

Demonstrate communication to diabetes nurse educator for same-day in-house referral for insulin injection training.

Demonstrate external referral to nephrologist for evaluation of diabetic nephropathy.

12 Provider Demonstrate how provider requests staff to schedule an appointment with visiting podiatrist in 2 months.

Demonstrate scheduling a follow-up with PCP in 2-3 weeks.

13 Laboratory Demonstrate receipt and accessioning of lab orders entered by provider in Step 10.

14 Pharmacy Demonstrate receipt of the medication orders entered by provider in Step 9, and the processing of the new order for tramadol.

For Stakeholders: Usability Principles / Criteria

SCENARIO 1

Simplicity

• No information or visual elements are included that are not necessary to the task.

• Important information stands out, and function options are easy to understand.

• The application has clear, clean, uncluttered screen design.

• Functionality is limited to that which is essential to core tasks and decision making.

Comments (optional):

Naturalness

• The screen metaphors are familiar to everyday life, or commonly expected computer experiences for the clinician.

• Workflows match the needs of the practice.

• The application appears intuitive and easy to learn; training will not be an overwhelming process.

Comments (optional):

Consistency

• All the different parts of the application have the same look and feel, consistent placement of screen elements, etc.

• Terminology and data entry fields are used consistently. Understanding how one screen works helps you understand how other screens work.

Comments (optional):

Forgiveness and Feedback

• It is hard to lose data or destroy time-consuming effort with a wrong click or wrong choice of buttons.

• If you make a mistake, the application helps you avoid it or the application provides a method to recover from errors gracefully (the system is “forgiving”).

• The system provides informative feedback to the user about actions they are about to take or have taken.

• Information is provided to the user when the system is processing, indicating what is occurring and how long it might take.

Comments (optional):

Effective Use of Language

• The application uses the same words that your clinicians use (while providing mapping to standardized codes and terms used for data retrieval).

• List or entry-form choices are clear and unambiguous.

• Sentences read like natural English (or the selected language).

Comments (optional):

Efficient Interactions

• The application minimizes the number of steps it takes to complete tasks; appropriate defaults are always provided.

• The application provides navigation options such as shortcuts for use by frequent and/or experienced users.

• Navigation methods minimize user movements such as scrolling and switching between typing and mouse clicking.

Comments (optional):

Effective Information Presentation

• Information on screens includes sufficient white-space and large enough fonts to be read easily with high comprehension.

No information should be in all upper case.

• Colors are used to convey meaning (e.g. red to indicate medical urgency), not just for visual appeal.

Comments (optional):

Preservation of Context

• The application keeps screen changes and visual interruptions to a minimum during completion of a particular task.

Comments (optional):

Minimize Cognitive Load

• Information needed for a particular task or decision making is grouped together on a single screen rather than requiring the user to mentally integrate information from multiple screens in the system.

• Alerts presented to the user are concise and informative with clear actions, and are appropriate in number.

• The application performs calculations automatically for the clinician so that they do not have to manually perform the calculations.

Scenario #2: Uncomplicated Admission The intent of this scenario is to follow a patient through a brief hospitalization that begins in the Emergency Department (ED) and includes a period of Observation.

30 y/o Female presents to IHS ED with flank pain, vomiting, and low-grade fever. She has a history of urinary tract infections, became symptomatic with dysuria a few days ago and took some antibiotics she had left over from before. She did not get better and now has pain for a couple of days and is unable to keep anything down. She didn’t want to come to hospital earlier because of COVID concerns. She is initially evaluated in the ED, placed in Observation to see if she can begin taking fluids and be sent home.

She does not improve and she spikes a fever so she is admitted, treated with IV fluids and antibiotics until symptoms subside and urine culture is returned. She improves and is discharged on oral antibiotics suitable for the culture and sensitivity. She is scheduled for follow-up in clinic in two weeks.

Offeror Instructions Stakeholder Scoring # Role Demonstration Instructions

Offerors shall demonstrate each of the tasks described in this column.

Score 1 (least usable) to 5 (most usable)

Comment

1 Nurse Demonstrate documentation of nurse triage, chief complaint, vital signs, medical screening exam.

2 Patient Registration Demonstrate process for ED check-in after initial triage.

3 Provider Demonstrate documentation of a focused history and physical (H&P) exam by the ED physician.

4 Provider Demonstrate entering lab orders for: urine culture and sensitivity, CBC, C-reactive protein, and complete metabolic panel.

5 Provider Demonstrate entering a Chest X-Ray order Provider Demonstrate entering an order for an IV antibiotic for presumed pyelonephritis.

Pharmacist Demonstrate how the system supports pharmacy-managed Antibiotic Stewardship protocol. The pharmacist reviews the antibiotic order and makes adjustments to medication order and dosing as needed.

6 Provider Demonstrate process for transition of care from ED to Observation status, including review/rewrite of orders and medication reconciliation.

7 Provider Demonstrate a view of ED management tool (ED dashboard) including this patient’s status of Observation, pending orders, etc.

8 Provider – Nurse – Pharmacist

Demonstrate sign and release, nurse verify, pharmacist verify for IV fluids and IV antibiotics

9 Nurse Demonstrate eMAR barcode scanning for 5 rights before antibiotic infusion.

10 Provider Demonstrate admission to include review of EHR including lab results and writing admission orders.

11 Provider Demonstrate how admission H&P is viewed in the EHR (may pre-populate)

12 Nurse Demonstrate documentation of shift assessment at end of a shift.

Demonstrate nursing note documentation during shift.

15 Dietician Demonstrate registered dietician documentation of nutritional assessment and plan

16 Nurse Demonstrate nurse entry of Input/Output (I/O) flowsheet

17 Nurse Demonstrate how two-nurse verification is documented for high-risk medications or transfusion.

18 Provider Demonstrate entry of progress note by attending physician which includes decision for discharge.

19 Provider Demonstrate prescription of discharge medications by attending physician.

20 Provider – Nurse – Pharmacist

Demonstrate how interdisciplinary (physician/nurse/pharmacy) medication reconciliation documentation occurs at end of stay.

21 Nurse / Case Manager Demonstrate care plan with discharge instructions and follow-up of patient.

For Stakeholders: Usability Principles / Criteria

SCENARIO 2

Simplicity

• No information or visual elements are included that are not necessary to the task.

• Important information stands out, and function options are easy to understand.

• The application has clear, clean, uncluttered screen design.

• Functionality is limited to that which is essential to core tasks and decision making.

Naturalness

• The screen metaphors are familiar to everyday life, or commonly expected computer experiences for the clinician.

• Workflows match the needs of the practice.

• The application appears intuitive and easy to learn; training will not be an overwhelming process.

Comments (optional):

Consistency

• All the different parts of the application have the same look and feel, consistent placement of screen elements, etc.

• Terminology and data entry fields are used consistently. Understanding how one screen works helps you understand how other screens work.

Comments (optional):

Forgiveness and Feedback

• It is hard to lose data or destroy time-consuming effort with a wrong click or wrong choice of buttons.

• If you make a mistake, the application helps you avoid it or the application provides a method to recover from errors gracefully (the system is “forgiving”).

• The system provides informative feedback to the user about actions they are about to take or have taken.

• Information is provided to the user when the system is processing, indicating what is occurring and how long it might take.

Comments (optional):

Effective Use of Language

• The application uses the same words that your clinicians use (while providing mapping to standardized codes and terms used for data retrieval).

• List or entry-form choices are clear and unambiguous.

• Sentences read like natural English (or the selected language).

Comments (optional):

Efficient Interactions

• The application minimizes the number of steps it takes to complete tasks; appropriate defaults are always provided.

• The application provides navigation options such as shortcuts for use by frequent and/or experienced users.

• Navigation methods minimize user movements such as scrolling and switching between typing and mouse clicking.

Effective Information Presentation

• Information on screens includes sufficient white-space and large enough fonts to be read easily with high comprehension.

No information should be in all upper case.

• Colors are used to convey meaning (e.g. red to indicate medical urgency), not just for visual appeal.

Comments (optional):

Preservation of Context

• The application keeps screen changes and visual interruptions to a minimum during completion of a particular task.

Comments (optional):

Minimize Cognitive Load

• Information needed for a particular task or decision making is grouped together on a single screen rather than requiring the user to mentally integrate information from multiple screens in the system.

• Alerts presented to the user are concise and informative with clear actions, and are appropriate in number.

• The application performs calculations automatically for the clinician so that they do not have to manually perform the

Scenario #3: Prenatal Care (abbreviated scenario) The intent of this scenario is to demonstrate those features of the proposed solution that are specific to the delivery of prenatal care services. The elements to be demonstrated are limited to those specific to prenatal care. Elements of an outpatient visit that are common to other types of ambulatory care encounters have already been demonstrated in Scenario #1 and do not need to be re-demonstrated here.

The patient is a 35 year old female, G3P2A1, with a prior history of overweight and polycystic ovary syndrome. Menstrual periods are irregular, and the patient is not sure when the last one was. She lost her last pregnancy 3 years ago at 12 weeks (spontaneous).

She believes her provider said something about gestational diabetes back then but did not follow up on it after the miscarriage.

She is not using birth control and thought with her polycystic ovarian syndrome and her age she couldn’t get pregnant again. She had some “flu” symptoms with nausea and vomiting a couple of months ago but that resolved. In the past few days she’s had nausea again and noted some swelling in her ankles.

On exam the fundus is palpable at 12 weeks size, fetal heart tones present at 160 BPM.

Because of distance, the practice at this facility is to provide prenatal care through 26 weeks, at which point patients are referred to providers 50 miles away. A visiting OB/GYN physician comes once a month to see the higher-risk OB patients in addition to general GYN services.

Offeror Instructions Stakeholder Scoring # Role Demonstration Instructions

Offerors shall demonstrate each of the tasks described in this column.

Score 1 (least usable) to 5 (most usable)

Comment Stakeholders may provide comments to support their scoring

1 Nurse Demonstrate nurse intake for first prenatal visit, including referrals such as public health nurse, WIC.

2 Nurse Demonstrate Nurse-Initiated Protocol (NIP) for first prenatal labs and vaccines.

3 Nurse and Provider

Demonstrate longitudinal prenatal flow sheet functionality and data entry for: blood pressure, dipstick urine protein, nitrite and glucose, fundal height, FHT, edema, cervical exam.

4 Nurse and Provider

Demonstrate how the system supports review and updating of pertinent historical factors such as: vaccines, family history, attitudes, cultural values, etc.

5 Provider Demonstrate prenatal risk assessment with scoring (ACOG)

6 Provider Demonstrate ordering of obstetrical ultrasound

7 Provider

The patient has two subsequent visits at 16 and 20 weeks, then returns for a visit at 24 weeks. Demonstrate how the prenatal record shows all data to date (this data may be pre-populated for demonstration purposes).

Demonstrate how the prenatal record can be exported as part of the referral process.

For Stakeholders: Usability Principles / Criterion

SCENARIO 3

Simplicity

• No information or visual elements are included that are not necessary to the task.

• Important information stands out, and function options are easy to understand.

• The application has clear, clean, uncluttered screen design.

• Functionality is limited to that which is essential to core tasks and decision making.

Naturalness

• The screen metaphors are familiar to everyday life, or commonly expected computer experiences for the clinician.

• Workflows match the needs of the practice.

• The application appears intuitive and easy to learn; training will not be an overwhelming process.

Comments (optional):

Consistency

• All the different parts of the application have the same look and feel, consistent placement of screen elements, etc.

• Terminology and data entry fields are used consistently. Understanding how one screen works helps you understand how other screens work.

Comments (optional):

Forgiveness and Feedback

• It is hard to lose data or destroy time-consuming effort with a wrong click or wrong choice of buttons.

• If you make a mistake, the application helps you avoid it or the application provides a method to recover from errors gracefully (the system is “forgiving”).

• The system provides informative feedback to the user about actions they are about to take or have taken.

• Information is provided to the user when the system is processing, indicating what is occurring and how long it might take.

Comments (optional):

Effective Use of Language

• The application uses the same words that your clinicians use (while providing mapping to standardized codes and terms used for data retrieval).

• List or entry-form choices are clear and unambiguous.

• Sentences read like natural English (or the selected language).

Comments (optional):

Efficient Interactions

• The application minimizes the number of steps it takes to complete tasks; appropriate defaults are always provided.

• The application provides navigation options such as shortcuts for use by frequent and/or experienced users.

• Navigation methods minimize user movements such as scrolling and switching between typing and mouse clicking.

Effective Information Presentation

• Information on screens includes sufficient white-space and large enough fonts to be read easily with high comprehension.

No information should be in all upper case.

• Colors are used to convey meaning (e.g. red to indicate medical urgency), not just for visual appeal.

Comments (optional):

Preservation of Context

• The application keeps screen changes and visual interruptions to a minimum during completion of a particular task.

Comments (optional):

Minimize Cognitive Load

• Information needed for a particular task or decision making is grouped together on a single screen rather than requiring the user to mentally integrate information from multiple screens in the system.

• Alerts presented to the user are concise and informative with clear actions, and are appropriate in number.

• The application performs calculations automatically for the clinician so that they do not have to manually perform the

Scenario #4: Well Child Care (abbreviated scenario) The intent of this scenario is to demonstrate those features that are specific to the delivery of well child care services. This scenario consists of demonstration of growth charts, immunization functions, and anticipatory guidance.

Patient History: The patient is a 6-month old infant who was born at a private-sector hospital in an adjacent state, received initial Hepatitis B vaccine (HepB #1) before discharge (at the private-sector hospital). Had a well-child visit at this IHS facility at 2 months of age, and received three vaccines (Hib #1, DTaP #1, and IPV #1). However, at that visit the parents declined the others that were offered (HepB #2, RV1 #1, and PCV13 #1) because they felt that was too many shots. The child missed the scheduled 4-month visit and related immunizations.

At this 6-month well-child visit, the nurse notes that the EHR does not show the HepB #1 that the parent reports the patient received after delivery, so consults the state Immunization Information System (IIS) and records the information about this vaccine into the EHR. The clinician then uses the EHR to review the infant’s growth, expected development milestones, and view age-appropriate anticipatory guidance for the parents. The system’s capabilities to support immunization status review, current recommended vaccines, and immunization forecasting to inform scheduling of the next well-child visit are also demonstrated.

Offeror Instructions Stakeholder Scoring # Role Demonstration Instructions

Offerors shall demonstrate each of the tasks described in this column.

Score 1 (least usable) to 5 (most usable)

Comment

1 Nurse / Provider Demonstrate age-specific growth chart with longitudinal view (pre-populated with scenario-appropriate data).

Demonstrate adding new data and how the growth chart is updated.

2 Provider Demonstrate age-appropriate patient/parent education and anticipatory guidance.

3 Nurse / Provider Demonstrate immunization history for pediatric patient.

4 Nurse / Provider Demonstrate how a user would document an immunization received elsewhere, e.g.

incorporating the HepB #1 information discovered on the State IIS.

5 Nurse / Provider Demonstrate how the EHR shows immunizations due, taking into consideration the vaccine received elsewhere. This includes catch-up guidance for delayed immunizations and forecasting next doses.

6 Nurse Demonstrate obtaining consent electronically for immunizations (integration with signature device).

7 Nurse Demonstrate documentation of one of the indicated immunizations, including CVX code, lot number, VIS, etc.

SCENARIO 4

Simplicity

• No information or visual elements are included that are not necessary to the task.

• Important information stands out, and function options are easy to understand.

• The application has clear, clean, uncluttered screen design.

• Functionality is limited to that which is essential to core tasks and decision making.

Comments (optional):

Naturalness

• The screen metaphors are familiar to everyday life, or commonly expected computer experiences for the clinician.

• Workflows match the needs of the practice.

• The application appears intuitive and easy to learn; training will not be an overwhelming process.

Comments (optional):

Consistency

• All the different parts of the application have the same look and feel, consistent placement of screen elements, etc.

• Terminology and data entry fields are used consistently. Understanding how one screen works helps you understand how other screens work.

Comments (optional):

Forgiveness and Feedback

• It is hard to lose data or destroy time-consuming effort with a wrong click or wrong choice of buttons.

• If you make a mistake, the application helps you avoid it or the application provides a method to recover from errors gracefully (the system is “forgiving”).

• The system provides informative feedback to the user about actions they are about to take or have taken.

• Information is provided to the user when the system is processing, indicating what is occurring and how long it might take.

Comments (optional):

Effective Use of Language

• The application uses the same words that your clinicians use (while providing mapping to standardized codes and terms

Efficient Interactions

• The application minimizes the number of steps it takes to complete tasks; appropriate defaults are always provided.

• The application provides navigation options such as shortcuts for use by frequent and/or experienced users.

• Navigation methods minimize user movements such as scrolling and switching between typing and mouse clicking.

Comments (optional):

Effective Information Presentation

• Information on screens includes sufficient white-space and large enough fonts to be read easily with high comprehension.

No information should be in all upper case.

• Colors are used to convey meaning (e.g. red to indicate medical urgency), not just for visual appeal.

Comments (optional):

Preservation of Context

• The application keeps screen changes and visual interruptions to a minimum during completion of a particular task.

Comments (optional):

Minimize Cognitive Load

• Information needed for a particular task or decision making is grouped together on a single screen rather than requiring the user to mentally integrate information from multiple screens in the system.

• Alerts presented to the user are concise and informative with clear actions, and are appropriate in number.

• The application performs calculations automatically for the clinician so that they do not have to manually perform the

Scenario #5: Population Health IHS takes a population view of health care. Its clinicians are accustomed to asking questions of the EHR. Some of these queries are standard and planned, but many are done on the fly, or the user may wish to vary the standard query in some way. For each of the use cases below, demonstrate how the general user (not a super-user, informaticist, or IT specialist), would execute the query in your system, beginning with the decision to run the query (i.e. do not just show the final view/report).

Offeror Instructions Stakeholder Scoring # Role Demonstration Instructions

Offerors shall demonstrate each of the tasks described in this column.

Score 1 (least usable) to 5 (most usable)

Comment Stakeholders may provide comments to support their scoring

1 I’m an Eligible Clinician participating in a CMS

QPP.

a) Demonstrate how I can see the current reporting period status for all of the eCQMs I plan to report, comparing to last year as well.

b) Demonstrate how I can drill down into the patients who are contributing to those measures and find those that are impacting my scores and need follow-up.

2 I’m a Nurse Case Manager working with four primary care providers, planning for the week ahead.

Demonstrate all of the patients on those providers’ schedules for the coming week, flagging all patients that are due for immunizations or screening (e.g. colon cancer screening, pap smear, mammography).

3 I’m a Public Health Nurse. a) Demonstrate how I can pull up all patients with a diagnosis of a Sexually Transmitted Infection (STI) in the past three weeks so I can follow up with them.

b) Demonstrate how I can pull up all patients discharged from our Emergency Department or Hospital in the past week so I can call and see how they are.

c) I’m doing an immunization clinic in a small community next week; demonstrate a list of people in that community due for shots that I can contact.

4 I’m a medical director and I’m curious how we are doing on post-COVID functional status.

a) Demonstrate how I can find out how many patients in our practice age 50 and over had a COVID diagnosis in the past two years, and how many of those have had post-COVID functional status assessed.

b) Give me a list of those with no assessment in the past 6 months so I can ask case managers to follow up.

5 I’m a primary care doc and I’m curious about my patients with diabetes.

Demonstrate how I can identify all of my patients with a diagnosis of Type 2 diabetes whose last Hemoglobin A1c was 9.0 or greater, and who do not have a scheduled appointment.

SCENARIO 5

Simplicity

• No information or visual elements are included that are not necessary to the task.

• Important information stands out, and function options are easy to understand.

• The application has clear, clean, uncluttered screen design.

• Functionality is limited to that which is essential to core tasks and decision making.

Comments (optional):

Naturalness

• The screen metaphors are familiar to everyday life, or commonly expected computer experiences for the clinician.

• Workflows match the needs of the practice.

• The application appears intuitive and easy to learn; training will not be an overwhelming process.

Comments (optional):

Consistency

• All the different parts of the application have the same look and feel, consistent placement of screen elements, etc.

• Terminology and data entry fields are used consistently. Understanding how one screen works helps you understand how other screens work.

Comments (optional):

Forgiveness and Feedback

• It is hard to lose data or destroy time-consuming effort with a wrong click or wrong choice of buttons.

• If you make a mistake, the application helps you avoid it or the application provides a method to recover from errors gracefully (the system is “forgiving”).

• The system provides informative feedback to the user about actions they are about to take or have taken.

• Information is provided to the user when the system is processing, indicating what is occurring and how long it might take.

Comments (optional):

Effective Use of Language

• The application uses the same words that your clinicians use (while providing mapping to standardized codes and terms

Efficient Interactions

• The application minimizes the number of steps it takes to complete tasks; appropriate defaults are always provided.

• The application provides navigation options such as shortcuts for use by frequent and/or experienced users.

• Navigation methods minimize user movements such as scrolling and switching between typing and mouse clicking.

Comments (optional):

Effective Information Presentation

• Information on screens includes sufficient white-space and large enough fonts to be read easily with high comprehension.

No information should be in all upper case.

• Colors are used to convey meaning (e.g. red to indicate medical urgency), not just for visual appeal.

Comments (optional):

Preservation of Context

• The application keeps screen changes and visual interruptions to a minimum during completion of a particular task.

Comments (optional):

Minimize Cognitive Load

• Information needed for a particular task or decision making is grouped together on a single screen rather than requiring the user to mentally integrate information from multiple screens in the system.

• Alerts presented to the user are concise and informative with clear actions, and are appropriate in number.

• The application performs calculations automatically for the clinician so that they do not have to manually perform the