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Reinventing the patient journey

A process for digital transformation in primary care

Elise Mortensen

Elise Mortensen

• 6 min read

Digital tools have transformed almost every aspect of our lives. With technology increasing access and efficiency, we’ve come to expect convenience and personalization in nearly every task. What used to require an in-person appointment or lengthy phone call can now be completed in a few taps of the finger. In sectors such as retail and personal finance, convenience and discretion have driven many consumers to prefer virtual services such as online shopping or personal finance to in-person services. Despite these leaps forward, the healthcare industry has been slow to adopt digital tools or—perhaps even more concerning—has introduced technology without considering the emotional experience of the end user.

To date, electronic health records (EHRs) and digital health interfaces have produced poor user experiences for patients and physicians alike. These shortfalls have led to skepticism about the value of technology in healthcare more broadly. According to the Kaiser Family Foundation, of the nearly 88% of patients that say their physician is using a computer-based medical record, fewer than half say that the move to EHRs has improved the quality of care they receive (45%) or the interactions with their physician (44%). And a 2018 study from Stanford Medicine found that though 63% of primary care physicians think EHRs have led to improved care, 59% think the EHR system needs a complete overhaul. Much of the failure of health technology can be attributed to limitations (time, budget, personnel, etc.) on technological development.

This vacuum creates a unique opportunity for healthcare providers to transform their service delivery with consumer-grade software. Healthcare can be the next frontier for digital technology that is seamless, responsive and powerful for both the provider and patient. Consumer-directed functions such as care coordination and care provisioning present clear opportunities—and challenges—for human-centered design.

3 trends paving the way for digital transformation

Digital transformation, as the name suggests, refers to the integration of digital technology to solve problems and strengthen processes. And while such broad terms may feel a bit daunting, the outcome of successful digital transformation is actually quite simple: software that is both simple and pleasant to use.

Technologies within the healthcare space have been evolving for decades, but three major design and market trends have laid a foundation for organizations to integrate digital tools more effectively and efficiently than ever before:

  1. Human-centered design frameworks
    Human-centered design is a creative process that puts the user—and their thoughts, feelings, and experiences—at the center of product design and development. Rather than relying on a core group of “experts” to decide how the audience will experience a digital interface, human-centered design involves a collaborative, iterative process using feedback from real users. The process provides a scalable, repeatable roadmap for designing software and validating it with non-technical users, such as patients and physicians who are used to working in a pen-and-paper world.
  2. Commoditization of the tech stack
    A more mature market has brought unprecedented commoditization of the technology layers, or “stack.” With countless specialized vendors available for each unique technology requirement, it is now possible to develop and deploy custom software in a matter of weeks rather than months or years.
  3. Out-of-the-box analytics
    Progress in data analytics and storage services has produced modular products which make advanced, out-of-the-box analytics possible for small and medium-sized enterprises. Even without an analytics or business intelligence expert on-staff, companies can track meaningful business metrics and make informed decisions.

The opportunity is clear and the resources are available, but what does this process actually look like? Drawing inspiration from the Plan-Do-Study-Act Model and the now ubiquitous design sprint, HTD’s approach to digital transformation leverages user research best practices and human-centered design principles to create digital experiences tailored to the unique needs and challenges of its audience. 

Approach: understand, ideate, prototype, implement, measure, repeat

Digital transformation starts with building an experience that patients and practitioners love. An engaging experience improves both physician performance and patient adherence. And in the case of digital health and care coordination, user engagement in turn creates valuable data about patient health and care delivery which can be processed to create enterprise value. The process is broken into the following phases:

  1. Experience design: The first phase of digital transformation is focused on understanding the human needs for which a digital interface must provide. For healthcare clients, this means identifying needs and challenges of both patients and physicians, prototyping an interface that meets requirements, and validating that interface with real users. Experience design consists of 3 sub-steps:
    • Discovery: In the discovery phase, the team explores the existing system and meets with key stakeholders (patients, nurses, physicians, etc.) to identify challenges and goals that will inform design. 
    • Ideation: During ideation the team generates novel solutions to remedy pain points discovered in the previous step. They begin to design solutions (both software and process) that address stakeholder challenges and help achieve stakeholder goals.
    • Validation: Finally, validation allows the project team to test their hypothetical solutions with real users. The evidence gathered at this step allows the team to identify those solutions with proven utility and efficacy.
  2. Value analysis: In the second major phase, the team evaluates back office goals and processes to draw connections between organization and user priorities. The goal of value analysis is to identify areas of untapped value within an organization and form hypotheses around the potential value (revenue, cost savings, quality improvement, etc.) of certain stakeholder actions.
  3. Implementation: As its name suggests, the implementation phase puts idea into action. The team deploys process changes in the clinical and back office environments while launching user-friendly interfaces that expose the right information to the right stakeholders at the right time. The value analysis hypothesis predicts how the impact of stakeholder adoption on business value and provides a benchmark against which to measure results. 
  4. Measure and Repeat: After the exciting launch of new digital processes, it’s easy for organizations to pat themselves on the back and focus their attention elsewhere. But this final phase of transformation is perhaps the most important. The team observes new tools and processes “in the wild” to confirm that hypotheses are proven and the user experience functions as designed. Measuring results not only allows for the team to tweak and optimize digital systems, but it also allows executives to decide how to allocate resources for the future.

Transformation in action

There is no one-size-fits-all digital solution in healthcare. The beauty of the digital transformation process outlined above is that it produces digital tools and systems tailored to the specific needs of each organization. Digital engagement applications are transforming patients’ interactions with their healthcare providers at every point along the care continuum:

  • One Medical’s medication adherence application supports patients managing chronic conditions through reminders, education, and easy communication with their physician.
  • Boston Children’s Hospital’s HIPAA-compliant mobile app has replaced entire preoperative and post-operative strabismus surgery visits for pediatric patients by evaluating each child’s eligibility and likelihood of success through surgical treatment. 
  • Wellopp Messenger extends the care dialogue beyond hospital walls to help patients stay motivated for rehabilitation after surgery.
  • Welkin Health powers condition management tools and coordinates communication across channels to improve the experience of both physicians and patients.
  • Oscar’s app offers direct messaging with a care team and care coordinator.

These examples represent just a few ways that digital tools are transforming primary care. As more and more providers shift toward alternative payment models, they are being held accountable for the cost of care. Such models incentivize investment in efficient care protocols with quality outcomes that can deliver higher shared savings. Digital health has the opportunity to catalyze such models. The designs of the future will give power to the patient, allowing them to take control of their health through digital and in-person experiences catered to their needs.

Elise Mortensen

Elise Mortensen

Elise is Director of Research at HTD. Coming from a background of social science and design, she specializes in user experience and behavior change.