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Jenny Wang

Challenge policy to enable ease of prescriptions refill and renew for Veterans

Recommended design suggestions in the intersection of needs of stakeholders and users to improve the overall medications management experience.

Overview

Project summary

As part of the organization's goals for digital transformation and streamlining all tools for veterans, our team (in the health portfolio) plans to migrate everything from My HealtheVet (MHV) to VA.gov while improving the user experience of My HealtheVet (MHV). Prescriptions are a part of MHV. To improve the experience for veterans in viewing, managing, and taking actions on their medications, this project aimed to examine and identify usability and accessibility issues. Additionally, we want to understand the unique clinical logic behind the actions veterans can take and how this impacts what we display on the Veterans' interface.

Team: UX researcher (Me), Design lead (Coulton B.)

Design lead: Coulton B.

Duration: 6 weeks

The Problem and Goal

The biggest challenge is the amount of unknowns about the Medications.

Pharmacy is one of the four primary pieces of functionality within My HeatheVet (MHV). As the health team builds the Medications section of MHV of VA.gov, we wanted to understand what we can learn from the existing tools and what gap we need to fill. Today, Veterans and caregivers can digitally access and manage their medications from the Rx Refill app, MHV Liferay Pharmacy, VA Health and Benefits app, My VA Health Portal (Cerner only), Blue Button report, and Veteran pre-visit summary and after-visit summary. We seek to learn from these tools and understand the usability, medication functionality, and data requirements that will help our team improve the medication management experience and create a unified and Veteran-centric experience on VA.gov.

My Process

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Screenshot 2024-03-07 at 10.43.33 PM.png

Process overview

Process overview

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There are previous usability testings that show what Veterans struggle with when they manage their medications, which gave me a starting point in understanding their pain points. However, we know so little about the clinical process for refill and renew prescriptions, and what data is available about prescriptions, which is crucial to designs as well. I worked with the design lead in crafting the scope of the project and key questions we want to research:

Usability

How do Veterans manage their medications?

How do Veterans interpret VA pharmacy terms on prescription dates and statuses?

What actions Veterans do to refill and renew medications?

Functionality

What is the process for a Veteran to refill medications?

What is the process for a Veteran to renew medications?

VA medications vs. Other types of medications

Clinical

What are the different statuses and dates?

What are the use cases for showing allergies with medications list?

What is the process for medication renewal?

Data

What are the limitations of medication data from VistA (MHV’s data system)?

Patients’ pain points vs. Clinical processes

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Veterans' prescriptions refill and renew journey

Veterans' prescriptions refill and renew journey

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From talking with stakeholders and subject matter experts, I understood the the refill and new journey more and created a journey map to identify the pains points and gaps in the team’s knowledge. There were many findings came out of this journey. For this case study, I will focus on a critical aspect: the misalignment between the prescription management needs of Veterans and our current clinical processes, upon which the interface design is based.

It’s challenging and stressful to manage medications because patients need to pay attention to a lot of statuses and dates. On the medication management journey map, there are many touch points and tasks patients need to track to successfully manage their medications.

There are three main actions patients take regarding their prescriptions, which are request refill/fill, request renewal, and track prescriptions. If patients manage multiple prescriptions, it can get stressful and challenging because they need to keep an eye on the statuses and dates for each prescription in order to know when they should request refill and renewal and track their prescriptions. Some statuses and dates are clinical terms, which are not helpful for patients, such as discontinued and transferred (see the old medications interface on MHV screenshot). Based on past user research, patients find statuses and dates confusing and prefer statuses and dates that tell them what to do next.

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Old Medications Interface on MHV

Old Medications Interface on MHV

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What do the clinical terminologies (prescriptions statuses and dates) mean and how they associate with actions Veterans need to take?

I started questioning what the statuses and dates mean and how they help Veterans take actions and manage their prescriptions.

Through the action flow that is associated with statuses and dates (see the flow screenshot below), we could see what statuses and dates mean and what actions are associated with each. This gives our team an idea of actions Veterans need to do to get their prescriptions refilled and renewed in different statuses and dates.

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Status and dates of prescriptions in flow

Status and dates of prescriptions in flow

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This is where I started questioning if the current statuses and dates for prescriptions refill and renew make sense for users. Even though there is a VHA Directive governs what essential elements necessary to review, manage and communicate medication information, the terminologies for statuses and dates are not in the requirement.

Results

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Improved refill process with simple language

Improved refill process with simple language

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I created the flow (screenshot above), and we proposed to the stakeholders and subject matter experts to use simple language to communicate prescriptions refill and renew steps because Veterans struggles to understand the current terminologies and that don’t help Veterans to take actions accordingly. This is the low fidelity examples of the medications with simplified and actionable design.

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