For some,
staying healthy means DIY.
We asked research participants to map their health ecosystems. I made this asset to help our team and stakeholders relate to one of the personas we developed.
Context:
Sutter Health is one of the nation's largest nonprofit healthcare systems, serving over 3 million patients in Northern California. Sutter's leadership approached our internal Design & Innovation team in early 2017 with a big ask. It felt like someone said, "we know primary care isn't working. We know we need to deliver a financially viable human-centered experience. Go."
This project was my focus for nearly three years. As one of three full-time experience designers on Sutter Health's Design & Innovation team, I wore every design hat imaginable. We launched a new primary care offering within 12 months of the project's inception.
My contributions:
The discovery phase of a project is easily my favorite. This was a collaborative and years-long project. During this phase, I took the lead on:
research planning
survey building
conducting interviews
synthesis
presenting to leadership
sketching/drawing
Defining the problem
The discovery phase of this project allowed us to define the edges of the problem space. Leadership knew they were asking a lot of our lean team, but they trusted us and our human-centered design process. It was up to our team to give shape to this work by telling stories of patients and medical professionals.
The modern healthcare experience does not meet modern consumer needs or expectations. One person seeing one provider (doctor, APC, etc) in a physical location isn't working. A sense of urgency grew as our early work uncovered several harsh realities:
40-50% — expected increase in demand for primary care demand in the next 10 years
50% — estimate of primary care visits that could take place outside the doctor's office
4 hours — the average for how long a person waits to be seen at an ER in the US
2300 — average panel size for a primary care physician in the US
We also knew that morale among primary care providers was low, and primary care visits were exorbitantly pricey. We weren't the first group within Sutter to redefine the primary care delivery model; we had about 20 other groups to learn from and to collaborate with, each in a different stage of their offering.
The competitive primary care landscape is also quite cluttered. Groups like Zoomcare, Carbon Health, One Medical Group (my alma mater) and Parsley would eat our lunch if we didn't pivot. Perfecting the current model wouldn't be enough; we needed an overhaul.
An overhaul
Later in this project, we would use our research findings to explore these four themes and develop concepts.
157 Survey Responses
62 Interviews
9 Expert Groups
Design Ethnography
Like good designers, we began by talking with as many people as we could.
I absolutely love design research and making sense of what I hear, feel and observe. I created the research plan alongside my design partner. I developed, launched and gathered insights from our initial survey, and used our interview script to conduct 30 interviews—often traveling to their homes to do so.
Interviews
We sought to understand people's context, their healthcare decision-making processes, and how they supported their health---with or without a healthcare system. Participants were generally open to talking about their health experiences, opinions and "health workarounds." I’ve found that people find me very disarming, and this help them open up. As an interview tool, we asked people to map out their health ecosystems, noting any relationships, technologies, challenges and goals related to their wellbeing. We used those maps to create PHI-free artifacts describing each interviewee's health experiences and ecosystems (displayed above).
Design principles and themes provided focus, purpose and direction.
Main takeaways
This stage of the process felt like we were boiling the ocean, but I am a master at design synthesis. We essentially locked ourselves in a room with thousands of Post-Its, a Google Doc, and markers. As a team, we needed to give a succinct and compelling story of what we heard. With the voice of the user as our compass, we aligned on design principles and “tensions” that incorporated the challenges we heard during research.
Healthcare providers and patients were in surprising alignment; the traditional health system could feel like a "necessary evil" for both parties.
Persona Development
I have mixed feelings about personas. In an endeavor as ambitious as this, it is impossible to design for everyone. That said, personas were a tool in our HCD toolkit, and we needed them to help distill what we learned in our research.
With mixed feedback, we developed four primary personas. I personally wrote the complex character-developing narratives behind each one of them (including the descriptors you see to the right). They helped us immensely, and were made in collaboration with existing marketing personas. Again, they could never do the job of representing everyone who interacts with the healthcare system, but they are a valuable tool.
This research is the foundation for the following service design phases of the initiative. My empathy game is strong, and my prerogative is to bring the user’s voice into every process and discussion. I never miss an opportunity to advocate for our users, and it’s easy for me to bring collaborators along.