Moments of truth: Designing for real-life patient experiences

Imagine rushing to the hospital with a life-threatening emergency and not being able to find the information you need to get there. Imagine having your child’s life hang in the balance as you pinch and zoom around your phone, because the hospital’s website is not mobile-friendly and doesn’t have directions to their emergency room. That’s exactly the types of patient experiences that Eric Meyer describes in Design for Real Life.

“I couldn’t find anything explaining what to do in an emergency,” Eric writes. “I kept looking for a box or banner or something that would tell me what to do, where to go, who to ask once we got there. I never found it because, as I discovered later, there was no such resource. There was no page to help. Our literal life-or-death situation was completely ignored.”

This is just the sort of “stress case” that Design for Real Life co-author Sara Wachter-Boettcher talked about in her Delight 2016 keynote presentation. And it’s far too common. Our Hospital Digital Experience Index (HDX) research, which assessed the websites of 15 top-ranked hospitals, found that even the best sometimes fall short when it comes to helping patients find the locations and services they need in an emergency.

As Sara and Eric write in their book, “If someone comes to a site or app in a moment of crisis, we bet they have a genuine need to be there—and that is the exact moment we don’t want to let them down.”

Sara offered a compelling argument for a more holistic, considerate and inclusive approach to experience design. Her approach rests on a belief that experience design cannot exist in a vacuum—that, in fact, users bring with them into any digital experience or interaction a hugely significant real-life context.

That got us thinking about some of the challenges we’ve faced when researching and designing patient experiences in healthcare. Should there be a different process for designing for environments such as healthcare, where real-life context must be taken into consideration?

A healthy concern for patient experiences

We encountered this very challenge on a recent project for a leading regional academic and research hospital. Having grown and evolved considerably over the years, the institution had outgrown its original location and expanded into a new site nearby. The expansion provided room for future growth, which they desperately needed. But it made life even harder for patients who needed to get to and from one appointment or campus to another.

As questions and rescheduling requests began to roll in, they reached out to us to help design a navigation system that would give patients a better means of finding their way.

Getting to the heart of real-life patient experiences

Our approach was grounded in primary ethnographic research, where we observed patients in their own environment and interviewed them about their experiences:

• We met people in their homes and rode along with them as they drove to the hospital, found parking, and walked to their appointments.
• We audited all of the institution’s sources and systems (digital or physical) that provided data related to locations, directions or navigation.
• We considered all the channels through which patients might encounter navigation assistance if our concept was implemented.
• Finally, we envisioned a robust, holistic wayfinding experience that would meet patients’ needs, achieve the client’s objectives, and be sustainable and scalable into the future.

Testing assumptions with real patients

Building on our ethnographic research, we designed for the various modes of interaction and inquiry that we had observed, allowing a variety of ways to interact with the physical environment. But as Sara’s talk at Delight points out, experience design shouldn’t stop there. Healthcare leaders and designers need to also consider the real-life context of a broader range of patients—including stress cases. To do this, Sara highlights a few key steps to take early in the design process:

• Challenge your vision and make space for real people. This is about identifying the underlying assumptions in your vision (everyone is able to hold a smartphone in their hand) and the biases (English language preference, unimpaired vision) that can make your design inaccessible to large populations of users. In the examples above, we could have explored how someone would use a voice-activation interface rather than a touch interface to find their way.
• Incorporate stress cases. Stress cases are worst-case, real-life scenarios that expose how aspects of your design and content can have unintended consequences. Using the examples from our work described here, would a parent or family member responding to an emergency stop at an interactive kiosk—a machine—to get directions? Would that just make the situation worse?

Designing for healthcare is unique in the closeness, emotion, and relevance of users’ real-life context. This puts us in a position to understand users’ context better than in other industries, where exposure to real-life context can be less immediate.

In looking to influence design or change within healthcare, designers should test their assumptions with real patients and ground their baseline understanding with the entire spectrum of experiences they may have. This not only brings a deeper level of compassion and humanity to our work but also carries far-reaching consequences for the organizations that rely on our work.