UX Research · Rheumatology EHR
Redesigning a Joint Examination Workflow for Rheumatology Clinicians
I led UX research for an EHR module used by rheumatology clinicians, helping the team understand where the existing workflow added complexity during patient care.
- Role
- Lead UX Researcher
- Focus
- Research Strategy · Workflow Evaluation · Usability Recommendations
- Context
- Rheumatology clinical workflows
- Research
- Interviews · Onsite observation · Rapid usability testing
- Output
- Released redesigned joint examination experience
Project Overview
Simplifying a clinical documentation workflow
The Joint Examination Module supported rheumatology clinicians as they documented joint exams during patient care. After previous feedback suggested the experience had become overbuilt, the Product team brought in UX to investigate the workflow and recommend improvements.
Project Snapshot
ProductEHR module for documenting rheumatology joint examinations.
Why UXPrevious feedback suggested the module had become overbuilt and misaligned with clinician workflows.
My ownershipLead UX research and recommend usability improvements to the existing design.
The Challenge
Balancing complete documentation with faster clinical flow
The Joint Examination Module supported rheumatology clinicians as they documented joint examinations, but clinicians reported that the workflow had become overbuilt.
The product required interactions and documentation that did not always match what clinicians needed during an exam.
UX needed to determine which information and interactions supported the clinical workflow, and which created unnecessary effort.
Research Questions
Which information and interactions are most important to clinicians during a joint examination?
Do preset intensity values such as mild, moderate, severe, and numeric values support how clinicians actually document joint conditions?
How should joint counts, disease activity calculations, and previous exam information fit into the clinician's workflow?
Research Approach
Combining earlier insights with contextual evaluation
Clinician interviews clarified workflow needs and informed prototype updates before the onsite visit.
Onsite observation showed when documentation happened during real patient care.
Rapid testing helped evaluate the updated prototype against core clinician tasks.
Earlier clinician interviews informed updates before the onsite visit.
I traveled to a rheumatology practice in Florida for an onsite study over two days. I observed clinicians during real patient examinations and followed their workflow through the care environment.
On the second day, I conducted rapid usability testing with approximately five participants using the updated experience. Participants completed core joint documentation tasks, including selecting joints and documenting joint conditions and intensity values.
Reference review
I reviewed existing joint examination tools to understand common interaction patterns for documenting tender and swollen joints.
RESEARCH FINDINGS
The workflow was telling us what clinicians actually needed
Interviews and contextual observation revealed a consistent pattern. Clinicians needed faster access to the information most relevant to patient care.
Finding 01
Clinicians created workarounds to keep documentation moving
I observed clinicians recording joint counts, tender joints, and swollen joints on sticky notes during the exam so they could enter the information later.
Make core joint documentation faster and easier to complete in the EHR.
Finding 02
Tender and swollen joints mattered more than additional intensity values
Clinicians focused on tender and swollen joint counts, while preset intensity and severity values added effort that did not consistently support their workflow.
Prioritize the joint information clinicians used most.
Finding 03
Clinicians needed important information before and during the exam
Previous tender and swollen counts, prior notes, injections, and relevant disease activity information helped clinicians understand patient history.
Surface relevant historical context where clinicians need it during the exam.
Finding 04
Speed shaped how clinicians interacted with the module
Clinicians needed common actions, important information, and disease activity calculations to be quickly accessible during patient care.
Make frequent actions and calculations easier to reach in the module.
“I just need a number of swollen joints and a number of tender joints.”
FROM INSIGHT TO DESIGN
Translating clinician behavior into design decisions
Improving the experience was not about adding more functionality. It was about prioritizing the information clinicians used most and reducing unnecessary documentation.
01 SIMPLIFY JOINT DOCUMENTATION
Clinicians focused on tender and swollen joints while unnecessary intensity and severity values added friction.
I recommended removing unnecessary intensity values and prioritizing the joint conditions clinicians used most.
02 MAKE THE HOMUNCULUS THE FOCAL POINT
Clinicians preferred the homunculus because it was faster to scan than the table.
I recommended making the homunculus the primary interaction and surfacing Total Joint Count, Total Tender, and Total Swollen near it.
03 BRING DISEASE ACTIVITY CALCULATIONS INTO THE WORKFLOW
Clinicians needed quicker access to disease activity calculations, and some tracked CDAI elsewhere in the EHR.
I recommended adding CDAI and DAS28 calculators and connecting relevant joint count information to them.
04 SUPPORT FLEXIBLE DOCUMENTATION AND HISTORICAL CONTEXT
Clinicians needed previous exam information and sometimes used temporary documentation workarounds.
I recommended providing flexible notes and surfacing relevant previous visit information, including joint counts and applicable disease activity scores.
Interaction recommendation artifacts
Recommendation artifacts documented the joint state color coding and legend used to clarify condition states.
These recommendations became the foundation for the next design iteration and gave the team a clearer direction for simplifying the Joint Examination Module.
DESIGN EVOLUTION
From an overbuilt workflow to a more focused examination experience
Research helped the team identify which parts of the experience supported clinicians and which created unnecessary effort. The module evolved through several iterations as those findings were incorporated into the design.
ORIGINAL EXPERIENCE
PROTOTYPE EVALUATED
RELEASED EXPERIENCE
IMPACT
Research helped reshape the joint examination workflow
The redesigned Joint Examination Module was released with key recommendations from the research, including an interactive homunculus and integrated disease activity calculations.
The shift was especially meaningful because many practices had previously avoided the table based experience. After release, the homunculus became a more usable part of the joint examination workflow, with informal feedback pointing to fewer complaints and an easier experience.
RESEARCH INFLUENCED THE RELEASE
Findings and recommendations directly influenced the interactive homunculus and disease activity calculator.
A PREVIOUSLY AVOIDED WORKFLOW BECAME USABLE
The experience moved away from a table many practices avoided toward a homunculus clinicians were actually using.
POSITIVE FEEDBACK AFTER RELEASE
Informal feedback indicated the redesigned experience was easier to use and generated fewer complaints.
Formal benchmarking after release was not conducted, so impact is based on what shipped and informal clinician feedback rather than quantitative usability measures.
REFLECTION
The workflow matters more than the interface
This project reinforced the importance of understanding how clinicians actually work before deciding what an interface should prioritize. Observing the joint examination in context revealed needs that were difficult to uncover through screens alone.
The strongest recommendations came from connecting what clinicians said with what they did: where they focused, what they skipped, and where they relied on workarounds.
Research was most valuable when it moved beyond identifying usability issues and helped the team decide what belonged in the workflow in the first place.