Statewide Medicaid EHR rollout for IDD care coordination
Trained 2,000 clinicians and administrators statewide.
Context
State Medicaid agency implementing a new electronic health record system for intellectual/developmental disabilities (IDD) care coordination, including an embedded Level of Care Tool for clinical decision support.
Challenge
Validate that clinicians (LCSWs, RNs, case managers) could use the system effectively in real-world settings - home visits, group homes, community centers - while maintaining clinical fidelity and reducing cognitive load during documentation.
How we helped
Conducted ethnographic formative studies across multiple clinical settings. Performed task analysis on critical workflows. Identified use errors related to cognitive load and training gaps. Recommended design controls and an implementation strategy for statewide rollout.
The impact
- •Identified critical use errors in medication tracking and service authorization workflows
- •Recommended caseload cap (32 cases max) based on cognitive-load evidence
- •Reduced documentation burden from 50 to 20 items per quarterly visit
- •Supported phased statewide implementation with hybrid paper/digital transition
Methods
- Ethnography
- Contextual Inquiry
- Usability Testing
- A/B Testing
- Focus Groups
- Service Blueprint
- Cognitive Task Analysis
Tools
Specific tools are not listed for this engagement.
Standards & research foundations
- Ethnographic research
- Cognitive task analysis
- ONC SED §170.315(g)(3)
- NIST IR 7741
- HIPAA
- Medicaid Waiver Compliance
- DMH/BIDD Regulatory Requirements
