Case Study: Improving the Doctor Patient Communication Experience
This UX research and design project came about from a combination of experience taking my kids to the doctor and a product design exercise suggestion from Artiom Dashinsky’s weekly newsletter (which you should totally subscribe to!) His challenge was to redesign the check-in experience at the doctor. I wanted to go beyond just checking in and look at how a patient’s communication with receptionists, nurses and doctors are recorded and shared (or not) and how that could be improved.
Summary
- Personal Project in the medical space
- Objective: Look at how patient communications with staff from appointment booking through the doctor’s evaluation and follow up are recorded and shared and find ways to improve and streamline the experience.
- Process: Interviewed staff at three medical offices; conducted a survey of people who had visited the doctor in the past year two or more times; document current experience, comparing each doctor’s office; read secondary sources from CDC; design new experience.
- Deliverables: User Journey Maps, research report of findings, wireframes of new digital interactions and screens for medical professionals.
Gathering Data and Synthesizing Information
Speaking to three different receptionists at three different offices, I came away with a fairly uniform process of setting appointments and gathering information about the patient, the reason for their visit and their symptoms. For existing patients, it’s a matter of pulling up their information based on a couple of key identifiers like name and date of birth. After that is a mini triage to determine the urgency of the appointment. If it’s too urgent, they direct the patient to go to the emergency room. If it’s serious, but not life threatening, they may be squeezed in sooner, but if it’s something that can wait, they will schedule them to be seen at an open time slot that works for the patient. They take notes, sometimes able to select common conditions from a drop down or list, other times, just writing the information in the appointment notes. These notes are saved for nurses and doctors to reference when seeing the patient.
Nurses may see the reason for the visit, but there is a chance they won’t. In either case, they will ask questions of the patient, usually letting them tell the whole situation so they can get an understanding of what is going on without guiding or biasing the patient’s retelling of what is going on with them.
I couldn’t speak to any doctors, but I was able to get a picture of how those interactions went by speaking with people who had visited the doctor at least twice in the past year. I spoke to five people; two men and three women. From them, I found that three out of five had the doctor ask them about specific things they had spoken to the nurse about, but still had to mostly retell what they had told the nurse. The other two said they had to retell everything they had said to the nurse with the doctor only asking what was going on.
User surveys of people who self identified as having visited the doctor two or more times in the past 12 months showed that the majority felt like they missed telling the doctor something, or felt rushed. Several mentioned that they felt like they had to repeat several steps each time, from giving insurance and verifying personal information to repeating reasons for their visit.
I wanted to research information about medical appointments in America and found that some interesting stats:
- 84.3% of adults and 93.4% of children had contact with a health professional in 2016
- 883.7 million physician visits in 2016
- 277.9 visits per 100 people
- 54.5% of visits were to primary care physicians
—CDC National Center for Health Statistics
Ambulatory Care Use and Physician Office Visits
Synthesizing information from interviews, surveys, and secondary data from the CDC, I posited that 883.7 million visits means that patients had to share their symptoms over 3.5 billion times.
The State of Telemedicine
Could patients providing information digitally decrease the number of visits to doctors? Meaning, could doctors offices triage patients prior to arriving, giving out prescriptions or medical advice digitally where appropriate?
Services like Teledoc, Connect Care, Kaiser etc show that virtual doctor visits can work in certain situations.
How might a doctor’s office adopt a hybrid model to better serve their patients?
Starting Point
The information I gained from interviews, walking through the process of getting an appointment myself, and survey data led me to map out what the current experience looks like for Carl. Carl is a dad who periodically takes his kids to the doctor. He also sees a sports MD to help with some injuries and like the rest of us, occasionally needs to be seen for an illness.
His time is valuable to him and he likes to feel that his interactions are authentic but also productive. This is especially true of appointments where he’s checking to see if he has an infection because he just wants to get well so he can go back to being a fun dad who can be active with his kids.
Mapping a New Experience
Based on the picture I was getting from the research, I decided to map out a possible new experience.
The main goal of this user experience was to make patients feel that they were being heard, that staff was on the same page, and that they could easily refer back to doctor’s orders.
I wanted to also wireframe some screens the patient would interact with.
Next Steps
Using the prototyping tool in Figma, I am going to have users test out this appointment confirmation experience. Is this an improvement over having to fill out paperwork at the doctor’s office? What process needs to be in place to ensure a consistent communication experience between nurses, doctors and patients? How can information be best displayed for them in the most readable, at-a-glance way?
Takeaways and Learnings
The original challenge from Artiom Dashinsky was just to improve the check in experience. To me, and many of those I interviewed and surveyed, that required further improvements to the way information is gathered and communicated to healthcare professionals and back to patients. This ended up being a lot to bite off for a single exercise that should have taken around eight hours. I’ve put around 12 hours into this project, and foresee at least twice that amount left to fully investigate, design and test all that should go into it. As someone who works 40 hours a week at a J-O-B, that is going to take me a long time. But I plan on continuing as my findings intrigue me and have awakened my passion for improving an experience that is both digital and human.
