Electronic Health Care System
Service Platform
Memorial Sloan Kettering Cancer Center’s Service Platform was envisioned as a solution to unify over 400 disparate tools into a cohesive family of applications, creating a “data democracy.” While MSK appears to be well-funded, it is still a nonprofit organization, meaning resources are finite.
This reality became particularly evident in 2021 when MSK opted to implement SalesForces out-of-the-box HealthCloud solution. However, MSK is not a traditional hospital; it is a research center whose byproduct, fortunately, is the eradication of cancer. As a result, the HealthCloud needed significant customization to meet our unique requirements.
Fast-forward to 2024, where EPIC represents the realization of the Service Platform’s original promise.
Several factors contributed to this shift:
1. The “Build It Ourselves” Fallacy
Despite the best intentions, most organizations are not software companies. Senior executives often underestimate the complexity of software development, thinking, “How hard can this be? We can build it cheaper ourselves.” The reality, of course, varies greatly.
2. Funding Challenges
While we could have achieved nearly anything in Salesforce with adequate funding, the reality is stark: EPIC was a $100 million project. That scale of investment enables unparalleled capabilities.
3. Team Composition
The HealthCloud implementation team lacked seasoned developers. The so-called “developers” were primarily site-builders rather than software engineers capable of handling a project of this complexity.
To be candid, I support the implementation of EPIC over HealthCloud. It is a far more complete and robust solution that will ultimately benefit our clinicians and patients.
My Role in the Service Platform
Before EPIC came into view as the better alternative, I was tasked with designing a new Patient Intake Portal. Initially, I worked with Figma for prototyping. However, it quickly became clear that this approach would lead to “prototyping hell,” given the extensive and complex data required for testing and validation.
After some research, I discovered a GitHub project that implemented the Salesforce Lightning Design System within a prototyping framework called Nunjucks (new to me at the time). Within a day, I was up and running, building high-fidelity prototypes using this system. Although not directly tied to Salesforce, the Design System’s implementation was so complete that it proved invaluable.
Artifacts and Insights
Below are fragments from this project. For instance, I extended a Service Blueprint I inherited—an absolutely massive document that mapped the intricate workflows of the Service Platform. The version displayed here is a low-resolution sample for illustrative purposes.
Additionally, you’ll find links to the prototypes I developed. Initially, I waited three months for MSK to set up a server to host them, but when that didn’t materialize, I hosted the prototypes locally behind an .htaccess gate. While remnants of these prototypes remain accessible, many features no longer function as they once did for usability testing. Nevertheless, they offer a glimpse into the extensive scope of the project.
Roles and Responsibilities
- collaborated with developers to design more efficient implementations within the constraints of Salesforce’s HealthCloud
- coordinated with Project Managers to review the limitations of and expand the scope of Epic, Cadence, and Full Focus
- partnered with Product Owners, Business Analysts, Engineers, users, and leadership
- craft and elevate multidimensional user experiences at scale
- architected, designed, and hosted qualitative and quantitative user research sessions, workshops, and activities
- ensured products were beautiful and easy to use for patients
- collaborated with the design team to build out quarterly roadmaps, balancing team capacity with product needs
- established page layouts, information hierarchies, and pattern libraries
- explored custom solutions, weighing their value against time and resources
- participated in interdisciplinary workshops to frame problems and mine for business insights
- applied a broad range of product design techniques, including sketching, prototyping, information architecture design, and interaction modeling
- communicated conceptual ideas and proposed design solutions both verbally and visually
Data Model Map
And overview of a patient in the system – showing dimension dependencies.
Patient Intake User Journey
A small snapshot of the patient intake path at MSK
Care Provider Cases
Dashboard to reveal a care providers current charges
Recently Viewed
Summary of quick link to recently viewed. While seemingly banal, a page like this is a frequently hit screen in an EHR system.
“Live” Examples!
My Designs as Hi-Fidelity Prototype for User Testing
Users for testing, this was handbill by me in HTML/JS/CSS using SalesForce’s Lightning Design System. Click to see the remnants of the prototype.
One more thing. For most of the prototypes I made at MSK, I used Salesforce’s Lightning Design System – hand coded with data models!
Introducing Design Think to the Service Platform
UX and Design Think was relatively new to the team members of the Service Platform. My product manager and I put together this presentation to show the UX process. We used an example from the Service Platforms “International Center” project. Click to Download!
(With incorporating Design Think into the Service Platform sprints,) we went from frustration to collaboration within the team.
While we enjoy working together as a team, we often feel conflicted by the limitations of
the system and the needs of the customer — we realized that this is a shared experience
between business, development, and design.
From opposing viewpoints to shared sentiments, resulted in a 100% change in the
dynamics of the team.
Also, using robust user data collected from first hand research, we removed all of the
guess work that plagued previous projects.