And how to create paradigm-shifting products
We have countries running healthcare on paper — in 2021!
And we have countries running healthcare on software that suck the life out of the clinicians.
Healthcare tech at large has an ocean-wide void. And the curtains have long been lifted up the broken state of tech. What’s mind-boggling to think is that we have built currencies of the future, but the information that can save someone’s life floats on paper.
To put things in perspective, “Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S.” — Johns Hopkins Medicine
We’re talking “Errors”! And this is in the US, which has one of the safest hospitals in the world. Imagine what might be the case with other countries?
So why isn’t this changing?
In short, it is shadowed by political and corporate strongholds. And since it’s a systemic problem — it needs to be approached by systems thinking and design. So far, this approach has not been used at scale. Though, the ball has started to roll.
Now, here’s how well-designed systems can be created.
A designer designs for their users. In healthcare, we have primarily three types:
- Clinicians (Doctors, Nurses, Medical Assistants, etc)
Let’s straightaway address the elephant in the room, the EMRs and EHRs. People using these are mostly stuck into using these decades-old legacy systems.
And the others are glued to using paper.
Since most doctors practice at an institution as opposed to independent practice, they’ve to use what their institution provides. So if we want the clinicians to use a new piece of a software system, their institution needs to invest in buying and/or replacing their current system.
And if we want the paper folks to use software, well why would one wanna give away the habit, fluency, and ease of using paper and a nice fancy pen?
Either way, it’s challenging to make clinicians adopt new digital products. They’re not looking around to install a shopping or a social media app or browse at www.“how do I treat my patient”.com
Product Designers have to go way beyond putting together a nice, usable piece of interface for Clinicians.
Now that the challenge is established, let’s get to the solution. Phew! we got all that out of the way.
First things first, we need to give our designed product a name, let’s call it a Clinical Digital Assistant — CDA. (“Electronic Medical/Health Record” terminology should now be out of the window).
- Now, we don’t have to re-design another documenting system. We have to design an “assistant” in essence. A product that provides value back to the users — for all the effort they put into recording a ton of information.
- To provide value, a designer has to identify what kind of value their clinicians need?
For example, if your user is a surgeon, an insight such as “there’s an X% chance of failure of this surgery for the patient” would be immensely helpful in decision making. Such insights can be generated by baselining the patients and evaluating the historical outcomes.
- As you can imagine, deriving a value needs data, qualitative, well-structured, truckloads of it. Which either comes from another software (from all those monitoring machines plugged into the patient, labs, investigations, etc) or is entered by the users.
Now, here’s what the designers need to work on, make it damn easy to enter the data!
A user shouldn’t have to figure out their way around the interface. Rather, the interface should guide them through the flows and steps.
“How to determine the flow? And If I hide all the details, where do I put it?”
This is where design at its core needs to be exercised. A designer needs to understand the mental model of their users.
Sit with your users and observe their process, mental process, and physical process. When a doctor sees a patient, understand what the doctor tries to do from the moment a patient registers till they are treated. What type of questions do they ask? In what sequence? What do they look at? Why do they look at something? How do they eliminate possibilities? How do they gauge a problem? How do they define a care plan? On what basis? What goes on in their head?
You can draw a flow chart of the doctor’s thinking process to help see it clearly. At my company when it started, we put in the first three months doing just this!
Once you understand this, and the dimensions of decision making, it can be translated into interface flows.
When a software works in line with the thought process of its users and helps them in decision making, that’s when a digital assistant is born.
This is half the battle won. For the rest half:
- Identify the unsaid motivations of the users.
And design towards fulfilling those.
For example, the users might be highly motivated to see more patients in in less time. To help with that, optimize for speed, make the noncritical information progressively discoverable.
Or, the users might be driven to derive insights, they’d like to capture as much information as they can gather. To help with that, make it easy to record the details in a given context.
- Identify the problems and the needs.
This is obvious, ask your users what issues they face in their practice. How can a digital assistant help them?
- Design for Personalization.
This is best explained by examples:
Provide a quick access to each doctor to their own most commonly used set of labs, investigations, drugs, etc. So that they don’t have to search and add the details one by one every time the same sets need to be ordered.
All these principles adds up to creating a delightful product that not only hooks their users, but shifts the paradigm of the industry.
A clinical digital assistant is well designed when it doesn’t need any “training”.