Engage-Rx
Background and Challenge
Hypertension disproportionately affects African-American men, increasing their risk of heart attack and stroke. Treatment gaps are worsened by systemic bias and medical mistrust. Dr. Fontil set out to change this. Working with developers, he created an algorithm that draws on clinic visits, lifestyle reports, and home blood pressure readings to deliver treatment recommendations, giving care providers a clearer path to effectively managing hypertension.
From the beginning, the vision was clear. “Doctors know how to treat hypertension,” Fontil said. “We just often forget.” Engage-Rx was designed to nudge providers when patients with high blood pressure come in for unrelated issues, ensuring treatment isn’t overlooked. SOM Tech partnered with him to bring this vision to life, with seamless integration into the EHR as the guiding principle.
Defining Needs and Motivations
We kicked off the collaboration by identifying patient and provider needs and motivations, then explored potential workflow scenarios.
Designing for Adoption
Participatory Design
From our findings, we created low-fidelity mockups and workshopped them with clinical providers to refine the interface—clarifying what was essential, removing what wasn’t, filling gaps, and aligning on the moments most critical to their workflow.
Cut-up exercise conducted with clinicians
Understanding the Workflow
Moderated Usability Testing
The mockups went through several iterations and were turned into a clickable prototype which we tested with clinicians to assess workflow fit, understand cognitive load, identify friction points, and validate key decision moments. Here’s what we heard:
“I would want to be able to, like hover over the medication and say, have a screen, like a window pop up that says this medication is, you know, good for these things. And these are the pluses and this is the minus.”
“And then it’s nice to have, if it’s in one screen, and I don’t have to be like clicking back to their lab screen and their visual chart and things like that.”
“I think the most convenient is when the [blood pressure] cuff just somehow communicates with the record. And I guess the second choice would be if the patient could input it themselves on my chart. And the last choice would be if the MA had to manually enter everything when the patient came in.”
Our Four Guiding Principles
1
Simplify: Make interfaces intuitive by reducing cognitive load.
“More usable, less clicking.”
Create more information-dense visualizations.
2
“Can you toggle between clinic & home graph instead of having two different sections?”
“Tell the story. Where are the failed meds?” “It would be really cool if it tells you what patient is taking when the lab was done.”
Provide just enough information to support confident decision-making.
3
“Relevant info in your face.”
”Say at top, ‘This would be what we recommend.’ Have the bottom panel closed completely and just show the best options at top.”
“Better job of sign posting.”
4
Surface the actions more clearly.
Integrated EHR Solution
The MVP’s integration into Epic surfaced a real challenge: doctors feared extra tasks and disruption. To solve this, we designed a dedicated tab that appears only when patients have high blood pressure. Recommendations are “suggestive, not disruptive,” arriving at just the right time in the workflow and helping clinicians consider treatment options quickly without added burden.
Clickable prototype
Hypertension isn’t just managed by primary care doctors. Nurses, physician assistants, and specialists all encounter it. “They may not remember how to treat hypertension. It’s not that hard, but they just haven’t done it in a while,” Fontil explained. The design had to work for all of them.
By designing for this entire spectrum of care and identifying all the real-world contexts in which blood pressure data might be collected, the team ensured the tool could effectively support hypertension care wherever it takes place.
Held co-creation sessions with stakeholders to create personas, scenarios, the value proposition and problem definition
Led participatory co-design workshops with clinical teams
Synthesized research findings into key themes
Wireframed and designed interactions
Built prototypes and iterated based on user testing
Created visual designs aligned with UCSF Patient Experience guidelines
Advised on presentation strategy
Developed style guide and collaborated with vendor on build
Coached UC Berkeley students on course-related project
My Work
Outcomes and Impact
Engage-Rx is now integrated with a patient-facing platform and being positioned for expansion across multiple health systems. The vision doesn’t stop with hypertension—future versions could extend into treatment recommendations for a range of conditions, reimagining how routine exams lead to faster, more effective care.