Over the last few months Jacob Rader, Bhavini Patel and Scott Gerlach have been studying healthcare. Our research focused on the documents and records that patients interact with and how these artifacts affect their relationship with the medical industry as well as their understanding of their own health. Through contextual, qualitative research we had the opportunity to learn from a wide variety of people and identify many opportunities for design to make an impact in the healthcare system.
In talking to patients in at-risk communities we encountered a disconnect between the quality of care that people have access to and their perception of that care. Put simply, most people’s perception of healthcare is largely linked to the extent that their healthcare reaches out and meets them on their level.
Patients will not be proactive in their own care, they need the system to guide them and help them establish accountability.
Through our research we found that when healthcare was at its best was when patients were being proactively engaged by their healthcare provider; the provider would meet the patient on their level and would facilitate care for them. Even in situations where the technical care was good, if the system didn’t reach out to them, patients didn’t feel as stable. Whereas, people who have access to healthcare that addresses simple things like helping them schedule appointments and arrange transportation feel much more supported and cared for by their providers.
On the other side of this we saw that healthcare professionals are stretched very thin, pulled by both the volume of patients they care for and the bureaucratic demands of their work. Much of the time and energy that professionals have to expend is not directly perceived by patients.
Due to the technical nature of modern healthcare doctors have lost a common language for communicating with patients.
As modern medicine has developed it’s become increasingly complex and specialized forcing doctors and medical providers to develop a vernacular and understanding of the care their providing which is increasingly disconnected from their patients. Additionally, most professionals’ technical workflows don’t lend themselves to an understanding of the patient’s experience of healthcare: so problem areas like confusing or conflicting documentation don’t get addressed and become an additional obstacle that patients must negotiate.
When the two previous insights are layered together, we start to understand why miscommunication and misunderstanding so often develop in medical care. If we understand some of the factors driving poor communication between health actors, it becomes crucial to define what good health communication looks like.
Good health communication happens through interactions that meet the patient on their level. It gives patients small, understandable pieces of information as well as the time needed to process them. It gives patients actionable information and prompts when they need it. Ultimately good health communication helps a patient build understanding while encouraging self reflection.
Supporting Patient Recovery
Our goal is to leverage interaction design to help extend more support and clarity to patients without demanding more time and energy from professionals that are already stretched to their limit. In our research the most pronounced need for this sort of good health communication is in the transition from inpatient hospital care to outpatient recovery.
From the moment a patient enters the hospital, the hospital staff must be preparing for that patient’s departure. The high-volume nature of the hospital along with the reality that so many individuals in the hospital have a part to play in the care of each patient means that there must be very clear goals that create some alignment between all the professionals. Near the top of that list is ensuring that the patient can leave the hospital as soon as they are well enough to do so. The consequence: as they are leaving a hospital’s care, patients receive a condensed burst of information about their recovery.
Many of the doctors and nurses who participated in our research reported that the majority of patients who call during recovery are asking redundant questions that had been addressed with the patient through written or verbal instructions prior to them leaving care.
Clearly, patients are not processing the information they are being given in a way that is relevant to their recovery. This doesn’t just lead to confusion and redundant phone calls, it also leads to complications in recovery. Patients don’t understand or adhere to the treatment plans that doctors have in mind for them. They don’t heal properly, aggravating weakened areas which often forces them to be readmitted to the hospital. This causes extra strain on an overloaded system. Readmittance is a problem area that many hospitals are actively trying to problem solve, in part because of new guidelines in the Affordable Care Act.
The current system overloads the patient with a deluge of technical information at a single moment.
We propose taking all the information and sending it to the patient in manageable pieces over time via text messages.
We see a system that reinforces the education that patients receive while in care with timely reminders after they return home. What might this look like:
Patient is informed about the text messaging program as they’re preparing to leave care.
The patient starts receiving texts while still in care and the messages continue after care at targeted times that corresponds to the patient’s recovery.
Weeks out of care and the patient is still receiving helpful recovery information and appointment reminders.
We believe that a system like this will help on a number of levels. Firstly, it will connect patients with information at appropriate times in a formats they are more likely to digest and act on. Secondly, it will reduce preventable complications and readmissions. Finally, systems like this will encourage patients to think about their health on a more continuous basis and will help them feel more connected to their own health and the healthcare system.