MeasureCare
achieving fluid communication in the medical arena
the challenge:
Elevate our clients existing mobile application and desktop platform to enhance functionality and usability utilizing the principles of user experience and current design practices. Effectively streamline communication practices for medical personnel.
Given most medical professions are not at a specified desk all day, a mobile application that provides access to contact and schedule information of fellow medical personnel with emphasis on voice messaging and an ability to note the level of urgency of each memo.
the solution:
We know that communication in every situation and instance is the key to being most efficient effective. Even knowing that, the medical industry lags behind on various aspects of technology. By creating an environment in which staff can better communicate, patient care becomes elevated.
the impact:
RESEARCH
To learn all we could about the current communication systems available in the medical field we researched the medical space as a whole while also honing in on what tools are currently available. We learned that overall the health care system in American is highly antiquated, with many small practices still using paper filing systems. The medical industry is also unique in that there are HIPAA privacy regulations which enforce the standardization of the electronic exchange, privacy and security of patient's health information. This creates a design environment with strict perimeters, making for a great learning opportunity while forcing us to ask, 'how much have these regulations stifled the advancement of our medical industry?', though I suppose that's another discussion entirely. We found that there are a handful of companies who run the show of communication software in the medical industry. This led us to believe that breaking into the medical industry with a new and innovative product would be challenging, if not impossible. It would be best to play by the rules with this one.
What are the takeaways? Communication in the medical field between professionals is reliant on several large companies that consistently miss the mark. Regulations often get in the way.
Headline: "The Battle to Move U.S. Health Care From Paper to Digital Far From Over" - U.S. News 2015
"There remain enormous gaps in our broad understanding of the role of communication services in health care delivery." - nih.gov
"90% of hospitals will purchase smartphones in the next two years, less than 78% have a communication strategy" - Spyglass Consulting Group 2019
DISCOVER
Having reviewed and researched the communication factors in the medical field we set out to interview individuals within the medical field who would be able to give us a more thorough inside look into their daily communication practices. We interviewed radiologists who were in private practice as well as doctors and nurses within large hospital systems who are on 'the floor' in a face paced, critical environment each day. What we learned was pretty outstanding, for a nurse to communicate with a doctor directly about a patient, they often have to make several phone calls, are screened by gatekeepers who determine whether the severity of the situation warrants disturbing the doctor and then the nurse waits sometimes hours for a response. This game of phone tag occurs day in, day out for every single patient. Everyone we spoke to considered themselves "lucky" when they were able to track down a colleague and speak to them directly about a patient. In every other industry this would be considered an egregious waste of time and money, in the medical field there is the added layer of a patient's well being.
Some quotes from our interviews:
"Communication can be really impactful for care, it could delay care and patients could end up in the hospital for several more days"
"There's a rolodex at the front desk"
"Our unit is unique, nurses on the floor don't have doctor's numbers"
*someone on our team had never heard of a rolodex
"Face to face communication is best; text loses a lot of the details"
"If the doctor isn't in the building it's challenging to have to rely on phone or email to communicate"
Synthesis
While there are many different people in the medical field who are reliant on hospital communication systems our team had to be intentional when considering our target user. It is a complicated process and how could we best describe and visualize communication between medical professionals given there are thousands of possible outcomes. We decided to create two personas to guide us, Leighton an oncologist who would be in direct contact with a patient and Luke a radiologist who is integral to the patient outcome but not patient facing. We had to get creative when it came to our journey, how could we best display all of the steps involved in a practice that seems simple? So...we are following an image, from beginning to end. The image becomes necessary when a patient attends an annual exam, this is where we start. The experience concludes with the image being examined, finalized and then discussed with the patient.
our cancer expert Leighton
42 | Oncologist | New York City
Goals:
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Efficiently provide excellent patient care; minimize patient's time in hospital
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Support her team
Needs:
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Mobile communication access
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Timely responses from colleagues
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Fast test results
Frustrations:
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Communicating with colleagues through gatekeepers
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Redoing patient tests due to lag in patient flow
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Tracking down colleagues to speak directly, in person
our image guru Luke
56 | Radiologist | New York City
Goals:
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Deliver the most accurate reading of every image
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Provide quality and consistent treatment to patients
Needs:
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To communicate clearly with colleagues
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A way to present information that is critical as urgent
Frustrations:
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Not being able to easily reach a tech when there is an issue with an image
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Lack of integrated communication system
an ultrasound's journey
Goals:
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Be the most detailed image possible so doctors can deliver critical patient care
Needs:
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A quick way to be shared and discussed between medical professionals
Frustrations:
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Feels there's a lot of wait time; wants to be help the patient get better, faster
What's The Problem?
inefficient
Never ending game of phone tag, a chain of communication to get a response
antiquated
Medical systems lack the funding and strategy to move forward with communication technology
regulated
HIPAA laws create barriers for innovative technological advancement
consistency
Requires a standard form of communication; different organizations share one patient
So...How might we provide users within the medical profession a way to have access to each other that allows for system wide communication?
DEVELOP
On every level it felt best to keep the design and concept simple and easy. We realized that anybody utilizing the application would need it to be highly learnable and straightforward; medical personnel shouldn't spent a second of time dealing with a platform that has fluff features. We took the guiding principals of the iOS contact and messaging modalities and honed them as an internal system of communication. Users are able to quickly filter contacts based on speciality, organization and other options, view colleagues schedules and whereabouts as well as create groups for fast communication with team members. It's not a revolutionary concept however, it is highly functional in an industry that requires functionality above all else.
CREAtE
TEST
For testing, users were asked to maneuver through five tasks based on scenario prompts. These scenarios and tasks exhibit the features and functions of the product we are developing.
Scenario One: You're a new radiologist at Mount Sinai and want to see what other radiologist you will be working with. Task: Find the radiologists affiliated with Mount Sinai
Scenario Two: Within this new team at Mount Sinai you know you'll be regularly working with Dr. Luke Brandon and therefore utilizing his contact information.
Task: Tag Dr. Brandon's contact information for easy future access.
Scenario Three: You want to relay a quick but detailed comment to Dr. Brandon about one of your new patients.
Task: Send Dr. Brandon a speech message with urgency.
Scenario Four: You're approaching your work shift for the day and know you are examining one of Dr. Kelly Taylor's patients, you need to know when Dr. Taylor is available for consult throughout the day.
Task: Look up Dr. Taylor's availability for today.
Scenario Five: You've just started a new job and need to be able to easily communicate with your team.
Task: Add Dr. Brenda Walsh, Dr. Donna Martin and Nurse David Silver to a specified team.
Home Screen:
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Changed 'mContacts' to 'Directory' for clarity; added context description for each button
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Replaced 'Speech' with 'Messages for increased app usability
Directory Screen:
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Removed 'my groups' and changed the positioning of filter modality
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Added status indicator to each contact
Contact Card Screen:
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Removed images of group members to reduce screen clutter
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Replaced 'speech' button with contacts schedule
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When contact is 'pinned' the button appears negative
Filter Results Screen:
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The user is given carrots to note which filters have been selected
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Results of filter options are sorted alphabetically
Save Group Screen:
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Redesigned search bar to mirror iOS GUI guidelines
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Created shadow box to distinguish space for users to expect something to appear
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Changed arrows to "+" to note there will be an addition
Voice Memo Screen:
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Microphone icon placed in more prominent position and centered for easy thumb access
Group Screen:
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Communication features moved to top of screen
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Added '+ add' icon to allow users to quickly add additional members
Create Group Screen:
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Removed 'new group +' button and replaced with '+' button within group icon
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Removed 'mContacts: My Groups' as this was obvious and created redundancy
User's Contact Card Screen:
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Created forward facing contact card which allows users to notate when they are available, their contact info., location. Gives user access to their calendar and groups
EVALUATE
For continued exploration and eventual launch of product it would be ideal to evaluate a beta version of MeasureCare. This would allow the team to determine where there are areas that need to be changed or finessed and what parts of the application are well received. Again, any introduction of a product or platform to the medical field involves a lot of moving parts and it would be interesting to see how quickly medical personnel adapt to yet another communications system.
The biggest challenge of the design process was figuring out a way to easily filter hundreds medical personal efficiently, endless scrolling was not going to be an option and often searching names of individuals is impossible and not time effective. What may seem a simple task can quickly become a big question, which again points us back to understanding that the design process is fluid and continual, until the most delightful experience for the user is reached, we go back to the drawing board and begin again.
In Retrospect...
We are now in our eleventh month of navigating covid 19 in the United States. If it wasn't realized before it has become radically apparent that our medical personnel are essential to the fabric of our nation, when everybody hunkered down in their homes, safe in a bubble, medical staff ran towards the fire. They put themselves at risk and their families at risk for the betterment of the rest of us, they've been done all they can to keep the rest of us safe. With all that they do for us, shouldn't they be given top of line tools to help them do their jobs with maximum efficiency? We have the technology and products to take some of the tasks off of their plate, to help them out a little bit by making their daily operating easier. It all seems so simple. Several weeks ago the first vaccines became available for essential workers and yet this was simultaneously shadowed by how these doses would be administered, bringing us back to the beginning of the communication breakdown cycle of the medical industry.