On a recent project, our team spent some time shadowing a clinical pharmacist as she completed her daily tasks. During the session we watched her interact with no less than seven different systems to reconcile a single patient’s prescriptions. All seven systems presented similar medication data in different formats, with varying degrees of accuracy and timeliness. To speed up the reconciliation process, she created extensive work-arounds—involving several laptops, numerous printed medication lists and an elaborate coding system with multi-colored pens. The process took upwards of 20 minutes, before she started all over again for the next patient.
It was clear to us almost immediately that the digital tools which were intended to help her were actually crushing her productivity and generating more work. The system designs were failing her.
The health care industry has recently developed a taste for human-centered design, which we all know is desperately needed. But I find it interesting that this discussion has centered almost entirely around the patient. While I agree that this are critical to consider, I think we are too often interpreting human-centered design as exclusively patient-centered design, ignoring the other people in the equation: providers and clinical staff. After all, the feelings and behaviors of these individuals ultimately determine the kind of care patients will receive. How thorough, calm or empathetic can a provider be when their environment is continuously cultivating stress? Maybe one of the best things we can do for the patient is to have empathy for their provider.
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Most digital tools in use today were designed from an inside-out perspective, working from internal existing resources instead of end users’ needs, and it shows. The systems look and behave like developers and engineers built them while sitting in a conference room, contemplating the wish lists of their purchasers. I’m sure they had conversations with a doctor or two, but did they ever actually spend time gaining empathy for their real end users?
When I talk about gaining empathy, I am not referring to a client advisory group, surveys, phone interviews, and certainly not a focus group. I mean going into the field and spending time with people to understand what goes on in their natural environments. Only when you approach a problem in this way can you truly understand the needs of your users and design useful solutions for them.
As a patient, it’s easy to feel the effects of these design problems. How many times have you sat silent in an appointment while your doctor distractedly tried to navigate their EMR? Or take our pharmacist for example. When she’s forced to spend the majority of her day navigating a needlessly complex data system, how much time and patience is left for patient interactions?
We, as designers, have a responsibility to understand all the people who use the health care systems we create, and how their use affects the end patient. We need to realize the stressors and the challenges of clinical workflows and create useful solutions—not just extra work—so they can get back to focusing on providing exceptional care. It is time to start building health care technology for the people who actually use it.
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As a principal and Azul 7’s design thinking practice leader, Denny Royal’s background in design research, customer experience, brand, design and technology allows him to help clients solve challenges from a holistic perspective. He speaks regularly at health care and design industry conferences and events advocating for a human-centered approach to the design process.
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