Lessons from Designing for Healthcare
Support in a changing world
Scattered papers everywhere. On every surface that’s not covered by a cardboard medical supply box or prescription bottle, more papers. There’s a knock at the door. The wife walks over to answer it, cradling her wall calendar and at-a-glance organizer to her chest, pieces of paper sticking out of the organizer, mostly appointment reminders and handwritten notes. The nurse has arrived. The pharmacy calls while we’re there (the wife has been waiting for this call). “Just spell that name out for me one more time,” she asks, phone cupped between her shoulder and neck, one more note swiftly stuffed into the organizer. We are all chatting like it’s perfectly normal for the five of us to be in that house, in that room, watching the nurse expertly change her husband’s dressing, as we try not to look directly at the gaping hole in his foot.
This was America, up until a few weeks ago. As I am writing this, New York (where I am based) has just wrapped its fifth week of shelter-in-place, our hospitals close to capacity with COVID-19 patients. We are living in unprecedented times. Our healthcare system, which was already straining to provide care to millions of Americans with chronic diseases, is now faced with a global pandemic.
The urgency around the role of digital tools in healthcare has become paramount, almost overnight. Telemedicine services like Beam and Babylon are now the primary way most are experiencing healthcare. Hospital and clinic visits are only advisable for the absolute sickest of us. With millions of patients now physically on their own, healthcare providers should be asking, “what does support look like in our new digital world?”
Let needs drive solutions, not vice versa.
Companies in the healthcare space who were cautious about digital integrations are now being forced to transform into digitally savvy entities. They now need to be able to serve their patients through screens and devices. Although the urgency might be new, the request is not. We’ve worked with lots of companies who come to us with a very similar brief. It’s usually phrased as “we need an app.”
Our first question to clients who come in with this ask is: Why? Why an app? What problem are you addressing and why do you believe an app is the right solution for it? An app may be an answer, but apps are most effective when designed for a specific purpose based on clear user needs. Let us dig more deeply into your patients’ experiences, we ask. Let us see where the need really is, how we can solve some existing problems in new ways. Let us discover where the issues exist and then, as a collective, decide which touchpoints can help.
Patients and their caregivers are typically the ones with the most acute challenges, so we start there. We sit with them and we talk about what’s happening in their lives. We try to uncover what they are going through, what gets them frustrated about their care, what they would change if they could. We meet their nurses, their spouses, their children. Mostly we just listen.
Often, the main challenges patients experience are due to a lack of support. I don’t just mean how a patient is supported in their medical care, but how support is manifested in all aspects of the broader healthcare environment. What keeps the patient’s caretaker up at night? What does his nurse wish the patient was told at the beginning of treatment?
“Changing one moment in how the support ecosystem operates can have ripple effects on all parts of the experience.”
As an example, when working on a recent wound-care device project, we found vast inconsistencies in what patients were told about the role of nutrition in wound healing. Some were given an abundance of nutritional information at the onset of their treatment, while others only found this information through their own general investigation. Many patients expressed that they would have made changes to their diets earlier on in their healing journey had they known nutrition was tied to better outcomes.
This was a fairly glaring oversight — something that could have had a major impact on a patient’s healing and yet wasn’t consistently communicated to all patients.
Patients receive these devices in different settings and by different healthcare professionals. But surely there is a moment prior to treatment where all patients could receive the same nutritional messaging. Why hadn’t there been a simple nutritional pamphlet included with every medical device shipment? Perhaps this could be a perfect instance to use a digital platform as a means to reinforce and expand upon nutrition and other vital information.
We met the caretaking wife in the context of interviewing her husband, the patient, about — you guessed it — an app. Although we ultimately ended up building an app, we were able to move forward with a far simpler (and more useful) tool than was originally imagined. We also uncovered other opportunities to help provide support: A caretaking portal to help the wife manage the countless appointments and medications she was suddenly responsible for. A social network to connect her to other people dealing with similar experiences. These were all key moments to impact elements of the ecosystem that might have been overlooked had we not taken a needs-driven approach.
It was because of this approach that we were able to find the right digital solutions for the user. Instead of stereotyping our patients with presumptions, we led our conversations with humility and empathy. Truly listening let us learn what patients and caregivers needed, and allowed us to reframe the conversation to something more meaningful.
Shortcuts now lead to failure later.
Companies may find it appealing to release something quickly, a stop-gap app to show they too are reacting quickly to our new reality. But skipping the process of understanding users and their needs will lead to failure. Any time saved in the short term will likely mean more time and resources spent later on attempting to retro-fit features into a product that didn’t have a clear purpose to begin with.
Once the current wave of the pandemic passes, much of life will likely go back to some version of what it was before. But some things will inextricably change. People who are already sick will be less inclined to seek out in-person medical care. A greater emphasis will be put on self-service and self-monitoring, now that the world is adapting to virtual care opportunities. Given these shifts, it will be more critical than ever that healthcare service providers lead with principles of simplicity, privacy, self-sufficiency, and dignity.
Companies that take a broader, more human-centered perspective to support will be able to uncover the meaningful insights that lead to effective, long-lasting solutions. Solutions that will not only impact patients and caregivers but will also help to “future-ready” their businesses for a constantly changing world.