Redesigning a universal disease tracking form for all
investigative documentation at LA County

Redesigning a universal disease tracking form for all investigative documentation at LA County

Redesigning a universal disease tracking form for all investigative documentation at LA County

OVERVIEW

OVERVIEW

Designed for reporting, Not for the people doing it.
Designed for reporting, Not for the users

Disease tracking & surveillance at LA County happens over 8+ platforms, and systems are optimized for number reporting as opposed to fitting the workflows of the staff. Often, this means that the nurses and investigators actually using these systems every day must navigate fragmented systems, duplicated documentation, with some staff still working on paper as they serve 10M residents. I joined to represent them and build the design foundations as the county integrates into one unified software for all disease tracking.

Disease tracking & surveillance at LA County happens over 8+ platforms, and is optimized for reporting needs. The nurses and investigators actually using these systems every day must navigate fragmented systems, duplicated documentation, with some staff still working on paper as they serve 10M residents. I joined to represent them and build the design foundations of the county’s modernization project.

How can we support field staff's documentation needs
in a system with limited agency?
How can we support field staff's documentation needs in a system with limited agency?
How can we support field staff’s documentation needs
in a system with limited agency?

GOALS & IMPACT

Establish a disease and role agnostic documentation form

If you’re a numbers person

40 Diseases

supported by the form. Shipped and live!

Standardize UX across
programs building forms in silos

28 Patterns

shared over 6 programs to standardize 40+ forms

Build a design culture in a civic tech environment

60 Members

Engaged with design docs and tools to propel migration

THE FORM

What is the case management form?

Case management information is the operational layer for field staff. This helps move a case along, allows supervisors to review all cases are closed out correctly, helps plan for staffing, and is important for staff licensure. This information was scattered across a platform due for sunsetting.

Scattered across platform “A”

Caters to only nurses

Current Form

Migrate to platform “B”, Focus on nursing side

MVP

Expand form capabilities to support non-clinical investigators

Post MVP

SOLUTION HIGHLIGHTS

A single form for all investigative staff to document

The previous form only accounted for nurses. We added team documentation across clinical and non-clinical staff; For visibility, credit, and reporting.

Tracking case progress across the team

The Progress Status fields capture the stage at which the case is currently. This is important for a supervisor to know the case investigation is developing within the appropriate timeline.

BEFORE

AFTER

  • The updated “Progress Status” section shows who added the status

  • Status options available for all roles.

Adding all contact attempts, not just the successful one

Contact attempts are important to document so the field staff can show that they followed protocol.
It also shows that they began the case within the priority timeline.

Contact attempts are important to document so the field staff can show that they followed protocol. It also shows that they began the case within the priority timeline.

BEFORE

AFTER

A table to document all contact attempts, method, and outcome

A separate notes section that works for all users

A running log for miscellaneous case notes to support field staff's habit of documenting everything to protect their license. The format supports all user's documentation style

SOLUTION HIGHLIGHTS

Trust as the biggest barrier in civic tech

Imagine waiting on a improved platform for more than a decade, while dealing with the realities of public health work. You’re bound to give up. Building trust was step 0 before we could begin migration.

Extending the form to multiple user groups

Post migration, our goal was to bring on the non-clinical investigators to use this form. We evaluated two paths: using an existing proposal which structured their notes differently, or our own form with additional fields.

EXISTING PROPOSAL

EXISTING PROPOSAL

Use a separate section; Different documentation style

Use a separate section; Different documentation style

ALTERNATIVE

ALTERNATIVE

Use the same form, add additional fields as required

Use the same form, add additional fields as required

Auditing both options

A three part process: understanding investigator workflows through interviews, auditing existing paper forms against both structural options, and running card sorting with staff to validate what level of structure actually made sense to them.

User Interviews to Map Workflows

20+ taskflows, 2 user journeys based on involvement

Comparing existing form requirements against both options
Card Sorting with users to align with workflows
Implementation Details

Investigators preferred less structure than the proposal assumed. The existing form, with a few additional fields, reflected how they actually worked. The form was extended to cover investigators and went live. It now supports the full field staff team.

We added fields to represent the full team, new contact attempt outcomes, and additional status options for investigator workflows. Additional changes also included splitting the form fields into multiple sections to make fields easy for staff to identify as something they need to fill.

USABILITY PATTERNS

Improving usability in a platform with scattered governance

Clinical forms at LA County are owned by six different disease programs, each building independently. Without governance over these forms, I could affect usability by creating a shared set of UX patterns and guidelines they could apply themselves.

Audited 14+ forms across 06 disease programs

28 UX patterns across field, section, and content levels

Usable across 08 platforms and 40+ diseases

28 Patterns across fields, sections, content

DOCUMENTATION

Building the documentation layer from scratch

Close to no documentation existed on the users, the stakeholders, or how governance actually worked. Understanding relationships and ownership had to be re-explained often among teams. As I learned, I documented these relationships and made them accessible to the whole branch.

Stakeholder Relationships & Governance
09+ Personas Documented
Service Maps highlighting roles of multiple stakeholders

These materials were presented to a branch of 60 people and are regularly referenced in meetings and larger stakeholder discussions to explain relationships and keep field staff needs visible

Bringing a design culture to civic tech

Inspired by Andy Matuschak's idea of working with the garage door open, I proposed making our design work visible to the whole branch in real time. The board became a shared resource across teams

THE GARAGE

We won the Promising Practice award at NACCHO, a national public health conference, for introducing human-centered design principles to center field staff perspectives. We're set to present this work at the conference to health departments across the country.

The painting brings together a group of women in motion, using bold forms, patterns, and repetition to capture everyday life and community. Public health similarly looks closely at everyday life to understand people’s needs and build systems that can respond to them.






Untitled
Manoranjan Chitrakar · Mixed Media

The painting brings together a group of women in motion, using bold forms, patterns, and repetition to capture everyday life and community. Public health similarly looks closely at everyday life to understand people’s needs and build systems that can respond to them.

The painting brings together a group of women in motion, using bold forms, patterns, and repetition to capture everyday life and community. Public health similarly looks closely at everyday life to understand people’s needs and build systems that can respond to them.

Malavika Doshi © 2026

Malavika Doshi © 2026

Malavika Doshi © 2026