How my team is improving EHR systems to combat the opioid epidemic
My role: Product Designer
Timeline: 3 years
Disclaimer
This project is protected under a Non-Disclosure Agreement (NDA).
As such, specific details, contexts, and proprietary information have been generalized or omitted to comply with confidentiality obligations and privacy requirements. All information shared here is available publicly.
The opioid epidemic continues to be one of the most disruptive public health crises in US history, devastating families and communities across the nation. For patients struggling with opioid addiction, treatment often involves Opioid Treatment Programs (OTPs), which are (typically) standalone facilities that provide evidence-based care like medication-assisted treatment (MAT), counseling, and behavioral therapies.
These programs are critical for recovery, yet they rely heavily on efficient, modern software to manage patient care, track outcomes, and ensure compliance with complex and evolving regulations. Unfortunately, many existing softwares create barriers through outdated workflows or complex interfaces, hindering the ability of already-understaffed providers to deliver effective care to a rapidly growing patient population.
As leaders in the MAT (Medication-assisted treatment) software space, our team set out to improve Electronic Health Record (EHR) systems to better support OTP providers in their mission to save lives and enable recovery of those affected by the crisis.
First, a bit more background
Opioid Treatment Programs (OTPs) operate under some of the most stringent regulations in the country, requiring staff to navigate an intricate web of federal, state, and even county-level oversight. These regulations often overlap or conflict, making compliance difficult (and expensive) which directly impacts care delivery, staff turnover, and adherence to clinical best practices.
A cornerstone of OTP care is medication-assisted treatment with Methadone (the most commonly dispensed medication). Its regulated nature demands meticulous clinical record-keeping down to each milligram dispensed from every bottle of the medication. Even minor documentation errors can lead to regulatory penalties, legal challenges, and reputational damage.
Compounding these operational challenges is the stigma surrounding opioid addiction treatment. This stigma affects not only patients seeking recovery but also the healthcare professionals providing care, further straining staff and complicating recruitment and retention efforts.
As of May 2024, there are roughly 2.1 million known cases of patients with opioid use disorder in the US. Only 19% of them receive Methadone treatment.
We are failing to address this crisis as a nation, and there is an undeniable relationship of this failure to the policies, stigma, and now antiquated technology available to those on the front lines.
The industry is desperately in need of a modern, efficient, and tailored technology to help.
Forming the team
In May of 2022, a private-equity backed, multi-disciplinary team (including myself as the Product Designer) was assembled to build a new, modernized EHR that would be the successor to the company's two in-production legacy EHRs. While these systems were at the ends of their lifecycles (each over 20 years old), their functionality was robust and the products themselves incredibly impressive.
The goal was to preserve the best of these products while modernizing them with efficiency in mind and adherence to the modern regulations that had evolved so dramatically since each products' conception.
Starting by listening
With a project this large and complex, what better way than to start simply—listening to OTP staff on the front lines.
Myself and the Product team traveled to OTPs across the country observing staff during their day-to-day. It's hard to put into words the experiences we had, but the most striking thing we took away was the resilience of the human spirit. The staff in these OTPs were visibly tired, stressed, and burned out, yet their interactions with patients were kind, compassionate, and at times parent-like. It was sad, beautiful, and inspiring all in the same vein.
We visited facilities with less than 100 active patients, others with over 10,000.
We observed staff using the EHR during peak dosing hours when they had dozens of antsy patients in line for treatment at any given time, and at nights when they would prepare take-home medication for patients scheduled to dose the following day.
We observed pain points of the industry and its people in all dimensions—inside the EHR and out.
Breaking ground
This is the part where I'm unable to get too detailed due to my NDA, but I'll share what I am able to.
- Talk about personas
- Talk about segmenting the application into different clinical use cases (which roles use which portions)
- Talk about nuances of some roles (overrides, and county legal differences)
Building & scaling
This is the part where I'm unable to get too detailed due to my NDA, but I'll share what I am able to.
- Talk about maturing the design process
- Talk about project momentum
- Talk about democratizing and disseminating research
Acquisition
- Talk about growing the team more
- Talk RESPECTIVELY AND PROFESSIONALLY about "opportunities"
Current state
- Talk about current progress, that you're able to. Keep this very high-level