InstaEcho: Echocardiogram Interpretation Service

November 16, 2022

InstaEcho is an Echocardiogram Interpretation Service from Tricog that offers virtual tools and services for cardiac diagnostics, enabling doctors to diagnose heart conditions with accuracy, timeliness, and consistency. With the aid of artificial intelligence and medical expertise, Tricog's software has been used by over 5000+ physicians to treat more than 6 million+ patients, resulting in the saving of over 2 lakh+ lives. The platform also fosters accountability and motivation among its users.

Proposal

Tricog has designed an Echocardiography Viewer with the objective of facilitating the work of medical practitioners from any location and at any time. In response to the requirements of doctors, clinics, and hospitals, Tricog intends to introduce the Echo Viewer as a comprehensive product that provides end-to-end solutions.

Challenges

The following are the proposed modifications to enhance the viewer's workflow while conforming to IEC 62366 and 62304 standards:

  • Implement workflow improvements in accordance with IEC 62366 and 62304.
  • Introduce a new rule engine that automatically generates observation statements based on input from various standard guidelines, such as ASE, ESE, ACC, among others.
  • Make changes to the user interface of the image viewer, including the display of measurements.

Key objectives

The Echocardiography Viewer's existing capabilities will be improved, and observation statements and measurement workflows will be incorporated, necessitating the use of the rule engine.
 The objective is to provide swift and precise interpretation, regardless of the machine's origin or geographical location.

Solution

The ECHO Viewer has been incorporated into the current desktop application, featuring a fresh and sophisticated design suitable for web and mobile use. The interpretation model accessible via the web and mobile platforms enables medical practitioners to accurately diagnose cases at a high rate of speed using their desktop or mobile device.

Design process overview

All of my UX design sprints are focused on the double-diamond methodology, which emphasizes the importance of research and testing in delivering successful user-centered projects. Our iterative approach begins with low-fidelity wireframes and progresses to MVP (Minimum Viable Product) prototypes, with the aim of addressing identified pain points.

Ideation

The team and I explored problems within the diagnosing technology market. Due to my decade journeying in the marketing and product sphere, I was able to guide the conversation professionally.

After keying in on the problem statement in the market, we decided to explore and hunt for solutions regarding interpreting ECHO on the web viewer. Our solution was specific to interpreting the ECHO and considered how Tricog could find a way to give time and maintain accuracy and efficiency to the user.

Once we developed this intention, I drafted a UX Design Playbook. I proposed a timeline and strategy to help meet web viewer needs.

Research

My first step in this project was to learn all about Echocardiography and how it is used to diagnose the cases. Next, I conducted interviews with doctors, which was a bit different from the norm.

As for the doctors, they wanted to have a quick and accurate interpretation and an easy workflow with the customised viewer to help them assess their cases easily.

Style: Remote Testing via Google Meet Number: 7 Doctors interviewing Duration: 30 min

User interviews: Doctors

My empathize stage included interviewing the doctors individually, in order to get a better understanding of what they actually wanted. In order to do this, I chose a series of five questions that were qualitative and quantitative.

Instaechoo
  • How was the experience of using the viewer? Did you find any difficulties?
  • What is the most important thing you always look for when you diagnose a case?
  • How frequently do you use evidence while adding the observation statement?
  • What other functionality would they like to see which could help them to diagnose better? Or, is there any feature that we missed adding?

Problem statement

Dr. Aryan is a busy cardiologist and parent, who is looking for a solution that allows him to balance both personal and professional life. Without losing their accuracy of work.

Hypothesis statement

If Dr. Aryan use the Tricog Echocardiography viewer, he would have easily balanced their personal and professional life without losing their accuracy in diagnosing the case. He will be able to spend enough time with the family.

Interpretation journey

The experience of ECHO interpretation begins with an understanding that having an ECHO Viewer is a crucial part of diagnosing at Tricog.

Instaechoo

Throughout the journey, we educate doctors about the viewer and bring awareness towards their balance. We also guide them to use the viewer and avoid action.

Our key strategy is to encourage doctors to return to an accurate interpretation and ensure that doctors don't miss anything as they can't afford mistakes.

Legacy Echo

User flow

Instaechoo

Echo viewer

Instaechoo

Understanding the competion

As we move further away from the define stage, into the ideate stage, we can focus on the design ideation, and begin to brainstorm solutions to our problem statements. For this section, I have compiled my competitive audit report, gaps & opportunities.

Instaechoo

Gaps

  • How might we design a system that is fully automated to identify pathologies and prepare findings for the cardiologist or physician?
  • How might we help user to customise their workplace based on their preferences?
  • How might we help user to complete end-to-end diagnosis on the viewer itself?

Opportunities

  • The priority of this viewer is to structure and organise the easy workflow, so the focus will be on the diagnosis workspace. With this in mind, it could have customisation for the workspace.
  • Have an area where the users can add, remove or edit all the complex findings/observation statements without having any distractions.
  • Incorporate sections allowing users to review all the multiple instances of the measurements.

Echo Viewer Phase 1

User flow

Instaechoo

Wireframe

Instaechoo

Design FLEXIBLE WORKFLOW:

Instaechoo

We must ensure doctors will have flexible workflow to give more power to diagnose the case as per doctor’s preference.

AUTOMATED RULE ENGINE:

Instaechoo

Automated statements are based on the rules defined from standard guidelines such as ASE, ESE, ACC, etc for adding observation statements.

User testing

  • Confusion around navigation options: I don’t know why observations and summay is at two different places. I don’t know where to click and add all the information related to case.

  • Better resourcing for the final reporting: It would be good if Tricog could provide better resourcing for the reporting. It’s better to have it at one place of all the diagnosis information; otherwise, in the end, we can miss the diagnosis levels that is too risky.

  • Doctors are finding difficulties in switching the multiple tabs: I always confuse in switching multiple tabs while reviewing the case. Due to this, I often end up taking a lot of time for reviewing diagnosed case.

Key notes

Main Finding: Because of the lack of navigation and copying same component at multiple places, user finding it difficulties while reviewing the case.

Other findings include:

  • Doctors notes and comments are missing
  • On all screens, patient data is not much focused
  • Zoom and Pan features needs to be added
  • Echo reporting on Mobile

Echo Viewer Phase 2

User flow

Instaechoo

Wireframe

VIEW TAB

Instaechoo

REPORT TAB

Instaechoo

Design

CLEAR NAVIGATION

Instaechoo

We must ensure doctors know what they are navigating and how to get specific information. The clear message of any changes should reach the doctors.

DOCUMENTING INTERPRETATION AT ONE PLACE

Instaechoo

Interpretations provide means to document the diagnosis made out of the study to reflect the heart condition of the patient.

DOCUMENTING INTERPRETATION WITH TREE-STRUCTURE VIEW

Instaechoo

Tree-structured view for the automated rule engine simplifies the process for doctors to easily add observation statements.

Accessbility Consideration

I ran my colors through the color interface tool in Huetone.ardov Resources, and made sure that all my colors were passed by WCAG3 Accessible Perceptual Contrast Algorithm (APCA) guideline.

I made sure that my text, buttons, and icons were of an appropriate size to be easily legible, no matter what screen size a user was viewing and using the site.

Takeways: Imapct

I received positive feedback on both my usability case study and high-fidelity prototype. That reflects design of Echo Viewer is usable and meets the user's needs. So we onboarded 100 of customers from all over the world like Philippines, Africa, Malaysia & India.

Fully automated and pre-populated observation, it will help a lot to our doctors to diagnose the case faster and easier.

Takeways: What I have learned?

In designing Echocardiography Viewer for the web app, I learned that not only extensive user research - but also strict attention to design guidelines (IEC 62366) for different-sized screens, play a crucial role in the UX design process.

Business Imapct

INCREASE IN ECHO COLLECTION

  • This enabled the doctors to quickly interpret cases on the viewer, allowing truly remote diagnosis from anywhere.
  • 30% run-rate increase in the ECHO collections

DECREASED INTERPRETATION TIME

  • The new and improved layouts that show more details easier to access information.
  • Includes cases in India, and the Philippines.