OnTrack

User Experience Design


Reducing preventable hospital readmission.

Project Goals

Create a patient-provider collaboration tool for hospitals to help patients understand and shape their own treatment plans, improving care transitions and preventing readmissions.

TEAM MEMBERS
Anna Malone
Diya Deb
Mike Szegedy
Tina Jose

CLIENT
UPMC (University of Pittsburgh Medical Center)

Problem

Readmission is a problem, where 1 in 5 Medicare patients are back in the hospital within 30-days of being discharged. Currently treatment plans are given to chronic patients but they are not made aware of how to integrate it into their lives. Poor communication and coordination between patients, caregivers, hospital staff and doctors about a patient’s life outside the hospital further compounds the problem.

Solution

Our tablet application supports a new service model for discharge planning, which takes into consideration a patient's routine, emotional needs, goals, motivations, and preferences as important building blocks in creating the final Care Plan.

Deliverables

Our end deliverables to UPMC included:

  • Service Blueprint
  • Functional Prototype
  • Product Pitch
  • Research Documentation
  • Design Documentation & Specifications

Research

Mapping a patient's journey from cause of readmission to their hospital stay, all the way to discharge and adherence at home.
In the process we mapped information flow, interactions, motivations and other environmental factors.

Internal Hospital Planning

During the discovery phase of our project, one of our primary goals was to understand the current discharge planning process from admission to discharge, which is largely hidden from the patient's view. We shadowed key stakeholders involved, including doctors, nurses, care managers and social workers. During our shadowing sessions, we noted information flows, pain-points and opportunities for improvement within the current service model.

Patient Discharge Interaction

To understand the patient interaction and involvement during the discharge process we shadowed bedside nurses to observe discharge orders being given. We also observed patient interaction with other key stakeholders as they were planning and preparing for discharge from the hospital.

At Home

At the hospital, we learnt that many patients were readmitted because they did not adhere to their care instructions at home. To identify causes for breakdows, we approached patients who had been recently discharged for diary studies, recording their thoughts, feelings and challenges they were facing. We also visited patients at their homes to gather insight into how they managed their medical regimens.

Synthesis & Ideation

Synthesizing Insights

We synthesized over 1,400 data points using affinity diagrams, sequence models and communication flow models.

Generating Design Ideas & Scope

Following synthesis, we generated 140 design ideas that we consolidated to 40. We later prioritized them with our client using an impact versus feasibility matrix. We held a visioning session with our clients to explore variations within the idea space to generate multiple product visions.

ENVISIONING POSSIBLE FUTURES

We used storyboarding and 'design speed dating' to determine the value of candidate ideas from both patients' and providers’ perspectives.

Prototyping

Knowing our target audience was older, we wanted to make sure they found the design easily accessible. We employed a full range of fidelity in our testing, from paper to code.

Lo-Fidelity Prototyping

We followed the design sprint methodology to design and test out our ideas and core design concepts.

Bodystorming Generative role-play was used to brainstorm and validate ideas for early prototypes and explore what it’s like to interact with a tablet device in the context of a hospital space.

Paper Prototyping and Product Idea Validation
We narrowed down to 3 prototypes, testing them with patients using the think-aloud protocol to validate how helpful and engaging our interface and interactions were.

Mid-Fidelity Prototyping

During our mid-fidelity stage, we explored mutliple app flows and navigations keeping in mind our persona's finer heuristic concerns. We tested the core features on the tablet device.

Interactive Wireframes using Axure We created an interactive tablet interface with basic drag-and-drop and click-through functionality. We used a think aloud protocol to test the application’s usability.

Wizard of Oz We used the Wizard of Oz to simulate certain features of our application that were not yet functional. We manually created responses intended for inclusion in the final design solution, testing patient’s reactions.

Participatory Design We worked with medical professionals to create domain-relevant content for the app.

Hi-Fidelity Prototyping

With the visual design completed, our app had high visual fidelity that was later developed with required functionality. We tested it in-situ at hospitals, to validate our proposed work flow across multiple stakeholders into the exisiting hospital workflows.

Functional Prototyping We built a prototype with high fidelity visuals and core functionality. We simulated a hospital setting and role-played as hospital staff to test the usability in a more realistic context.

Web-enabled Field Testing We worked with a care manager to pilot the application with 3 patients at a hospital and observed providers response to real data from patients.

*Due to NDA policies, high-fidelity product and process shots cannot be shared.

COMMUNICATING THE CONCEPT through Video

A short video was used to communicate our design concept quickly to other stakeholders in the organization. Through the film, we wanted to convey not just the big vision and concept, but also the personality and interactivity of the solution.