Driven by Real Needs: The OpenMRS Dictionary Manager Web App
Imagine you are setting up a Medical Records System at a new location. This new site may have 10, 50, 100, or more forms. Every single question and answer needs a code, so that clinical information can be stored correctly – e.g. “Asthma” might be coded by the computer as A1234. You feel overwhelmed thinking about the hundreds or thousands of codes you will need for just this one site. There are also many other new locations waiting to go-live. How would you get started?
User Centered. One of the OpenMRS Community’s core values, being user-centered means that we come together to design solutions that will solve real problems faced by OpenMRS implementers and users.
As a community, OpenMRS built a new product for and together with implementers: the Dictionary Manager Web App. This web application was built with the support of different stakeholders, implementers, and content management experts.
To make sure that the Dictionary Manager Web App addressed the real needs of its users, the OpenMRS Dictionary Manager Squad decided to dig into who our users are and what they want.
As a part of user research, we conducted user interviews with seven different users from a variety of organizations. The results of these interviews were used to develop User Personas for the Dictionary Manager Web App, including each person’s motivation to use the app and their pain-points.
Users Top Pain Points - And What They’re Looking For in a Solution
Implementers voiced two major interests and concerns:
Easy Implementation: Users want to have ready-to-use, consistent resources that are more reusable and can be shared across all their sites. They also mentioned that they want to customize concepts without continuously reaching out to the CIEL team. One of them said: ”I do not want to re-work on the same content that another organization has already worked with. I believe in sharing resources.”
Trustworthy Standards: Users want to be able to reuse existing content or contents from other, trusted organizations. We were pleasantly surprised to learn how strongly these users believed in following standards. They want to use a standard set of concepts in their EHR so that they do not need to always work on a reporting module for every single site. Using standards early-on means that future data collection and reporting will be easier when new concepts are needed – and then re-work on legacy codes can be avoided. One of the implementers mentioned that “I want to avoid re-work or complexity across our many sites. Having a standard set of concepts I can rely on saves me time with each new location, and allows me to focus on work that makes our users’ experience better. Otherwise I have to spend my time re-doing concepts and reports for each implementation.”
How Teams Are Set Up to Manage Content
From the interviews, we identified three different team set-ups common among OpenMRS users:
Limited Resources Set-Up: This is the most commonly found setup. Only one person looks after concepts for the organization. This includes all the steps from content creation to validation and, form creation to reporting. Most often, the person is a developer.
Some Resources Set-Up: This type of setup has a content manager, who looks after content in addition to a developer.
High Resources Set-Up: The setup is found among the large organization where they have a Content Management In-charge in addition to content manager and developer.
We found that all the organizations lack in-house terminology experts. They often seek support from other organizations, like CIEL, to decide on correct terminology.
What's Next?
The Dictionary Manager Web App has given our implementers a single place to manage codes. We continue to improve the product based on our discussions with real users. We determine what users have the most difficulty with, so we prioritize our tasks accordingly. We now maintain a mini-roadmap that focuses primarily on the most required feature: supporting reuse of concepts and dictionaries which can be pulled from all public content.