CUA of the Month – June, 2007

Christina Chang
"My goal is to make sure all software by Purkinje gets usability tested. I am working with project management to integrate the user-centered design process into our software engineering lifecycle. I’m also working with Dr. Doerr on early prototyping of our next generation of EHR software."
Christina Chang
User Experience Specialist

Usability: Just what the doctor ordered

by June Oliver

The next time you visit your personal physician, you may have Christina Chang to thank for a shorter wait and more thorough treatment. Christina is a user experience specialist for Purkinje, a healthcare IT service and software provider created by doctors for doctors.

In contrast to the cutting-edge sophistication of most medical technology, medical records often linger in the “dark ages” of paper charts and handwritten prescriptions. Only a small percentage of U.S. physicians who work in solo or small group practices have made the leap from paper to electronic health records (EHR), despite efforts by hundreds of vendors. The reason: horror stories from early adopters about increased workloads, cumbersome applications, and even billing system dysfunctions.

Purkinje’s diagnosis: A usability deficiency. To treat the condition, Tom Doerr, Purkinje’s Chairman and Chief Medical Officer, brought in a usability expert.

“Dr. Doerr takes usability very seriously and understands the importance of institutionalizing it,” says Christina. “Also, our CEO Bryan Dieter expects every employee to go and visit our customers.”

Christina loves to meet Purkinje’s clients, despite the challenges of studying users in medical settings. “It’s difficult to do Contextual Inquiry in a clinic. We have to be very focused because doctors have extremely full schedules, plus we encounter all the patient privacy regulations. But we also talk with nurses, front office staff, and the people working in the labs. They enjoy having a chance to tell us what works in our products and what needs to improve.”

Christina’s comfort in the medical environment developed during a four-year stint at Elsevier, a leading medical publisher. She worked there on the user interface design of MD Consult, a searchable on-line database of reference books, journals, practice guidelines, patient education materials and drug information for physicians.

“At Elsevier, I gained experience in user-centered design throughout the project life-cycle,” Christina says. “Even though I was a senior software engineer, expanding my skills into usability seemed like a natural step. Now at Purkinje, I work closely with our engineers but also serve as an advocate for our users. You have to listen to them.”

Christina has accomplished a phenomenal amount since she joined Purkinje in August 2006.

“At the time, we were preparing to release our main product CareSeries,” she recalls. “It’s a very comprehensive software suite, including records of patient visits, test results, radiology reports, referrals, and scanned documents. CareSeries provides support for prescribing medications, checking drug interactions, and also handles scheduling and billing while generating administrative and financial reports. The software is customized to fit the needs of each practice. It even allows patients to access their personal records online or refill a prescription.”

Considering the scope of the product, it isn’t surprising that CareSeries contains 1600 screens. Christina’s first responsibility at Purkinje was to redesign, well, all of them.

“I was able to jump right into the user interface redesign project from day one, thanks to our VP of Engineering Mark Balbes. He is a great executive champion for usability,” says Christina.

She worked closely with Purkinje’s marketing and product management teams to develop a UI style guide and design standards for CareSeries. With these tools, the redesign was implemented in just a few months with the help of 45 developers in Purkinje’s Hyderabad office. The new version launched in February 2007 and was recently judged to be the best ePrescribing system in the U.S. market at this year's TEPR conference (Toward the Electronic Patient Record).

“When we introduced CareSeries at a trade show in Washington, D.C., many clients remarked it had the best user interface they had ever seen in an EHR product,” says Christina. “Since then, customers have told us that CareSeriestransformed their clinics. It’s very satisfying to get that kind of feedback.”

Christina is not resting on her laurels, however. “My goal is to make sure all software by Purkinje gets usability tested. I am working with project management to integrate the user-centered design process into our software engineering lifecycle. I’m also working with Dr. Doerr on early prototyping of our next generation of EHR software.

“HFI has been an indispensable resource all along. After taking HFI’s four certification classes, I was able to share much of the material with our engineers during our Lunch and Learn sessions in St. Louis. Soon I’ll be rolling out a Usability 101 course for our developers in India, something we can video conference over the Web. They are very eager to learn.”

CUA of the Month

Each month we highlight the successes and achievements of a different member of our CUA community. If you are a Certified Usability Analyst and would like to be considered for CUA of the Month recognition, please send a brief professional bio to

Privacy policy

Reviewed: 18 Mar 2014

This Privacy Policy governs the manner in which Human Factors International, Inc., an Iowa corporation (“HFI”) collects, uses, maintains and discloses information collected from users (each, a “User”) of its website and any derivative or affiliated websites on which this Privacy Policy is posted (collectively, the “Website”). HFI reserves the right, at its discretion, to change, modify, add or remove portions of this Privacy Policy at any time by posting such changes to this page. You understand that you have the affirmative obligation to check this Privacy Policy periodically for changes, and you hereby agree to periodically review this Privacy Policy for such changes. The continued use of the Website following the posting of changes to this Privacy Policy constitutes an acceptance of those changes.


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In the course of its business, HFI may perform expert reviews, usability testing, and other consulting work where personal privacy is a concern. HFI believes in the importance of protecting personal information, and may use measures to provide this protection, including, but not limited to, using consent forms for participants or “dummy” test data.

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Users browsing the Website without registering an account or affirmatively providing personally identifiable information to HFI do so anonymously. Otherwise, HFI may collect personally identifiable information from Users in a variety of ways. Personally identifiable information may include, without limitation, (i)contact data (such as a User’s name, mailing and e-mail addresses, and phone number); (ii)demographic data (such as a User’s zip code, age and income); (iii) financial information collected to process purchases made from HFI via the Website or otherwise (such as credit card, debit card or other payment information); (iv) other information requested during the account registration process; and (v) other information requested by our service vendors in order to provide their services. If a User communicates with HFI by e-mail or otherwise, posts messages to any forums, completes online forms, surveys or entries or otherwise interacts with or uses the features on the Website, any information provided in such communications may be collected by HFI. HFI may also collect information about how Users use the Website, for example, by tracking the number of unique views received by the pages of the Website, or the domains and IP addresses from which Users originate. While not all of the information that HFI collects from Users is personally identifiable, it may be associated with personally identifiable information that Users provide HFI through the Website or otherwise. HFI may provide ways that the User can opt out of receiving certain information from HFI. If the User opts out of certain services, User information may still be collected for those services to which the User elects to subscribe. For those elected services, this Privacy Policy will apply.

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HFI may use personally identifiable information collected through the Website for the specific purposes for which the information was collected, to process purchases and sales of products or services offered via the Website if any, to contact Users regarding products and services offered by HFI, its parent, subsidiary and other related companies in order to otherwise to enhance Users’ experience with HFI. HFI may also use information collected through the Website for research regarding the effectiveness of the Website and the business planning, marketing, advertising and sales efforts of HFI. HFI does not sell any User information under any circumstances.

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Information about Users that is maintained on HFI’s systems or those of its service providers is protected using industry standard security measures. However, no security measures are perfect or impenetrable, and HFI cannot guarantee that the information submitted to, maintained on or transmitted from its systems will be completely secure. HFI is not responsible for the circumvention of any privacy settings or security measures relating to the Website by any Users or third parties.

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If a User’s personally identifiable information changes, or if a User no longer desires to receive non-account specific information from HFI, HFI will endeavor to provide a way to correct, update and/or remove that User’s previously-provided personal data. This can be done by emailing a request to HFI at Additionally, you may request access to the personally identifiable information as collected by HFI by sending a request to HFI as set forth above. Please note that in certain circumstances, HFI may not be able to completely remove a User’s information from its systems. For example, HFI may retain a User’s personal information for legitimate business purposes, if it may be necessary to prevent fraud or future abuse, for account recovery purposes, if required by law or as retained in HFI’s data backup systems or cached or archived pages. All retained personally identifiable information will continue to be subject to the terms of the Privacy Policy to which the User has previously agreed.

Contacting HFI

If you have any questions or comments about this Privacy Policy, you may contact HFI via any of the following methods:
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PO Box 2020
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(800) 242-4480

Terms and Conditions for Public Training Courses

Reviewed: 18 Mar 2014

Cancellation of Course by HFI

HFI reserves the right to cancel any course up to 14 (fourteen) days prior to the first day of the course. Registrants will be promptly notified and will receive a full refund or be transferred to the equivalent class of their choice within a 12-month period. HFI is not responsible for travel expenses or any costs that may be incurred as a result of cancellations.

Cancellation of Course by Participants (All regions except India)

$100 processing fee if cancelling within two weeks of course start date.

Cancellation / Transfer by Participants (India)

4 Pack + Exam registration: Rs. 10,000 per participant processing fee (to be paid by the participant) if cancelling or transferring the course (4 Pack-CUA/CXA) registration before three weeks from the course start date. No refund or carry forward of the course fees if cancelling or transferring the course registration within three weeks before the course start date.

Individual Modules: Rs. 3,000 per participant ‘per module’ processing fee (to be paid by the participant) if cancelling or transferring the course (any Individual HFI course) registration before three weeks from the course start date. No refund or carry forward of the course fees if cancelling or transferring the course registration within three weeks before the course start date.

Exam: Rs. 3,000 per participant processing fee (to be paid by the participant) if cancelling or transferring the pre agreed CUA/CXA exam date before three weeks from the examination date. No refund or carry forward of the exam fees if requesting/cancelling or transferring the CUA/CXA exam within three weeks before the examination date.

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