Developing the Next Generation of E3 Patient Medication Management Technology

In 2017, Enclara Pharmacia launched a new app, E3 Mobile, to allow hospice nurses to profile and order patient medications from the bedside or anywhere else they might be. It was revolutionary in many ways, cutting time spent on phone calls by 60% and streamlining other time-consuming processes. Now, Enclara is preparing to revolutionize patient medication management again with the all-new E3 Pro. Coming in early 2022, E3 Pro will add new features and a reimagined user experience for both mobile and desktop users.

“We set out to provide a more powerful, intuitive product,” said Nicole Brnich, Director of Product Management at Enclara. “Staffing is a growing challenge for hospices. Nurses are spread thin and there is limited time to train new hires so we wanted E3 Pro to help with both. New features allow nurses to spend even less time managing medications, leaving more time for patient care. By applying emerging best practices in user experience design, we have shortened the learning curve so today’s new user is tomorrow’s expert.”

Built for Hospice Nurses

E3 Pro has been developed around the needs of hospice nurses at every step of the way. The Enclara digital product team started with a list of common feature requests and created personas including field nurses, admissions nurses, supervisors and prescribers. Then, using the existing E3 products, they worked through all the handoffs between those roles to find opportunities for improvement. “With every process, we looked for ways to reduce the number of steps and make common options easy to find,” said Erin Dwyer, Director of Digital Solutions Management at Enclara. “We reviewed ideas with our focus group participants to make sure we were on the right track.”

The twin goals of fewer clicks and at-a-glance visibility informed the basic design of the new application. Role-based dashboards provide one-touch access to common actions and the information each user needs to see. For a field nurse delivering patient care, that means showing action items such as pending electronic prescription requests right at the top. A supervisor’s dashboard shows clinical and financial metrics as well as census numbers and alerts.

The dashboard concept extends to individual patient profiles which display medication alerts and common actions in an intuitive layout. This can potentially decrease administrative delays on the hospice side, leading to fewer rush orders and greater utilization of mail order if desired. Related improvements to the medication entry process support safety, accuracy and formulary adherence.

In addition to an improved user experience, the new E3 Pro features enhanced functionality, particularly around local pharmacy utilization. The original E3 Mobile was developed around simplifying access to Enclara’s mail order program which overnights medications direct to patients nationwide. Over time, however, many hospices chose to take advantage of the application’s local electronic prescribing support, particularly as the spread of electronic prescribing mandates encouraged hospices to adopt the technology more widely.

“Our number one priority with E3 Pro was to integrate local dispensing as more of a core function, particularly for hospices where that’s the primary medication access model,” Brnich said. “We also worked to deliver a more unified mail order and local experience for hospices that rely on both.”

With E3 Pro, the nurse will have full visibility to all medications on one screen and, for hospices using an Enclara electronic prescribing partner, status of local pharmacy orders. There is also the ability to re-order medications without reentering the details, which essentially allows the nurse to “refill” local orders. A new map feature makes it easier to search for local pharmacies near the patient’s home and identify which ones are 24/7 operations.

Testing and Refinement

The E3 Pro development project is now entering the beta testing period with the participation of multiple Enclara clients representing a variety of use cases. Their feedback will help Enclara fine tune features and develop training materials. With the importance of E3 to a hospice’s day to day operations, there was some initial concern that it might be hard to sign up enough beta testers, but instead the hardest part has been keeping participation at a manageable level.

“As soon as they see it, they want it,” Dwyer said. “In our demos the clinical staff get really excited by the new look and feel, the dashboards and the new features, so even in beta it basically sells itself.”

Following beta testing, E3 Pro will begin its pilot phase with selected hospice clients in spring of 2022 with a full rollout later in the year. Support for the current E3 Mobile app and E3 Connect website will continue during the transition period.

Further Reading