Rethinking Power Dynamics of Health Information
Crate is a mobile and web app that improves and innovates on current provider-patient communication by allowing patients to take control of their health through curation of relevant health information.
My Role
Product Designer
My Team
Chaebin Park — Product Designer
Jeonghye Yoon — Product Designer
Project Duration
3 months
TLDR
Cognizant's healthcare division came to our Healthcare Design Studio class with a curated set of relevant healthcare industry problems they wanted us to explore. My team was initially interested in exploring the broad area of the doctor check-in experience, but as we did more research, we came to uncover deeper root causes of a bad check-in experience and how it disproportionately negatively impacts those with chronic conditions.
Investigating the Doctor Appointment Experience
While we had selected a problem area given to us by our sponsor, my team knew virtually nothing about the space save for what we knew as patients ourselves. We set about conducting both secondary and primary research to better understand what the current state of the doctor's appointment experience was for patients of varying backgrounds and health journeys.
Patients with Chronic Conditions
Patients with No Chronic Conditions
Something that became clear to me early one was that sentiment varied greatly between patients who suffered from chronic conditions vs patients who did not.

Patients with chronic conditions had much more polarizing sentiments on their healthcare experience. In order to investigate this, I talked to patients with chronic conditions about their healthcare journey.
Insights From Talking to Chronic Patients
1

Telehealth Skepticism

“There have definitely been instances where, during the pandemic, I only had the option to be virtual. And that was really challenging, because there were symptoms that I felt required actual examination, right? ...They literally told me ‘take your phone and can you shine it in your mouth. So we can see?’ You're not gonna get as accurate as an in-person appointment.”
2

It’s a Fulltime Job

“I had to steer my own ship. I kept a long Google Doc of all my symptoms, treatments, medications, recommendations, and I would pull it up whenever I went to see a doctor.”
3

It Takes a Team

“I see 3 or 4 doctors regularly.”“My main doctor is my integrated medicine doctor, but I also have a PCP, a neurologist I was seeing for awhile, and a couple others.”
Source
Why is the System Failing Patients with Chronic Conditions?
We now knew intimately how thoroughly the current American healthcare system was failing patients dealing with chronic conditions.

But, what did people working in the system think? What systemic problems exist that place so much of the burden of care on patients dealing with their chronic conditions?

I talked to a group of healthcare subject matter experts to figure out what was happening on a larger scale in healthcare.
Insights From Talking to Subject Matter Experts in Healthcare

Acute vs Chronic

The current healthcare system model is not designed for chronic conditions, rather it takes an “episodic” approach - come in, get treated, then come back when something crops up.

Industry Trend Towards Unity

The healthcare industry is starting to move towards integration and unification across systems. A big barrier to this is lack of market incentive.

Disruption vs Optimization

A better appointment process may mean completely bypassing or rethinking the entire current experience. Other areas may benefit more from incremental optimization.
How Do Doctors Feel?
The last piece of my research consisted of talking to doctors to figure out how they navigated patient care.

Observation

Doctor’s have too many tasks and too little time

Design Implication

Consolidate communication + information channels that a doctor and patient must manage.

Observation

Doctors aren’t always compensated for the extra work they do to care for patients.

Design Implication

If we can’t decrease the tasks, we need to make it easier for patients to manage extraneous tasks and communicate this to doctors.

Observation

Newer technology has enabled faster, more dynamic communication but can sometimes be a friction point during appointments.

Design Implication

Make health info easier to access and navigate  across appointments.
Information is a Double-Edged Sword
A common theme arose from talking to the patients and providers.

Patients were overwhelmed trying to keep track of all their health information, this was made worse for patients with chronic conditions who must go to the doctor more frequently (which means more doctor's notes, more medications, and treatment plans) and across multiple doctors.

Providers talked about how modernized digital EMR systems allowed them to input more information about their patients during their appointment. Unfortunately, this meant that doctors had more and more tasks relating to information maintenance. These tasks were things they were not compensated for as they did not directly relate to the care of the patient.

From here, I saw a more specific problem my team could tackle: the modernizing of healthcare record systems has led to a collective inability to manage all of the information in a meaningful and effective way.
Design Goals
We established 5 primary goals we wanted to accomplish through our design. These goals focused on enhancing communication between doctors and patients as well as helping patients understand their own health information with minimal effort.
Creating Modules

Patients can create modules where they can add notes, messages, tests from across their providers to create packages of health info that makes sense to them.
Organize Floating Information

Save health information that is typically not made for looking back at into modules in order to fuel your health insights.
Prioritize What's Important

Prioritize how accessible your health information is and surface pieces of information that are important for you.
Curated Timeline

Timeline breaks up key information from EMRs into a historical record - users can access medical information directly this way.
Combine Timelines For Personalized View

Integrate different timelines by selecting multiple single views into one to get more holistic picture of healthy journey touchpoints.
Health Information Integration

Access relevant medical information directly from timeline by selecting specific elements.
Schedule Future Events on Timeline

Take actions like scheduling follow-up appointments directly on the timeline through app suggestions.
The Module
Ultimately, my team chose to refine our Health Module concept based on a few key considerations.

1. Our subject matter experts and patients showed a lot of interest in the module, citing its novelty and potential usefulness as its major benefits.

2. We saw an opportunity to refine the health module and continue solving for this health information problem by flipping the script on traditional EMRs by giving patients more direct autonomy and control over their own health information.
Refined Health Module


Creating Modules

We designed our platform so that users could create new health modules easily on the main page. Users freely can decide module’s icon and name. Also, documents can be added when creating the module.
Homepage View

We tried to provide users comprehensive view related to their health. The  homepage includes crucial infomation the users need such as calendar, documents, modules, and pinned modules.
Adding Content to a Module

Based on our interviews with patients, we learned that conversation with doctors plays important role for them. Therefore, we designed that users can add messages with doctors in modules easily.
User Testing
After refining our health module designs, we tested our designs with patients who we interviewed during the beginning part of our research.
Takeaways

Module Interaction

Less steps to take certain key actions like creating a module

Make key actions easier to identify on screen (i.e. hover not the only state where action is accessible)

Ability to drag documents around in module

Sharing Info

Ability to share individual items from module as opposed to entire module

Add method of sharing within module page

Add way to attach personal notes when sharing modules

Info Layout

Make individual page layouts more distinct so they don’t blend into each other

Change icon to share icon

More color so the text doesn’t look so overwhelming
Refinements
New Homepage
Our testing participants were confused about the module’s categories. Therefore, we created categories for modules that allows users to fuller control over how they'd like to organize and label their health modules. We also expanded the space by reducing calendar space. Also, the calendar and document space are changed based on users’ feedback.

New Message
Previously, adding a message to module feature shows up when users hover over on the message. We learned that it's not that intuitive to users because they often didn't realize the option existed until they accidentally would hover over a message. Because it was a priority for us that users be aware that they can also add non-traditional pieces of information such as messages into their modules we added a visible button for each message and improved the feature so that multiple messages in a conversation can be added at once.

Final Design
Modules

Modules are customizable collections of health information. They can be organized themselves into larger groupings (i.e. Diagnoses, Personal tracking, etc.) Modules can also be pinned and each can contain a mix of documents like doctor’s notes, patient notes, test results, and medication notes.
Viewing Modules

Modules can be grouped together and adding groups and individual modules are easily accessible through the homepage
Recent Docs

Recently uploaded docs, notes, and test results can be quickly viewed through this section of the dashboard
Calendar

Access a calendar with medication updates and appointment history as well as upcoming appointments
Adding a New Module

New modules and module groups can be easily created at the home. Based on the usability test feedback, documents and appointments can be selected when creating a new module.
Editing Modules

Pin specific items from module in pinned area

Accessing Edit mode allows users to drag and reorder items within the module


Sharing Specific Content From a Module

Patients can share specific information from a module with doctors, therapist, or caregivers.
Adding Content to Module

Modules are customizable collections of health information. They can be organized themselves into larger groupings (i.e. Diagnoses, Personal tracking, etc.) Modules can also be pinned and each can contain a mix of documents like doctor’s notes, patient notes, test results, and medication notes.


Mobile App

Considering the convenience of patients, especially when visiting their doctor in person or writing notes outside, we created a mobile version based on our desktop version.
Admin View For Providers

Providers can view and manage their patient communications through the admin view.


Admins can upload documents or write notes to specific patient profiles.


Revisiting Design Goals
How does our final design translate into the design goals we set out to meet?

At the center of our design, modules make health information accessible and personalizable to patients, allowing them to see their own health information in ways that make sense to them and tell a clear health journey story. The ability to save and access multiple forms of communication often forgotten by existing EMR systems such as instant messaging allow health nuggets through these conversations to be preserved and acted upon.