Improving critical communications for clinicians in a hospital setting
Lessons learned from establishing a design culture and redesigning a deeply embedded clinical tool with over 79k daily users.
Background
When I was brought on to the team in 2017, Mobile Heartbeat was a clinical communication tool used daily in 92 hospitals. Although the product had a deep userbase, the company had not prioritized design in its past and end-users reported that the product had grown dated, unintuitive, and frustrating. I was hired to build a design team, establish a design culture, and lead a full redesign of their existing iOS and Android applications.
My Role
Led all iOS, Android, and web design efforts and managed a team of two designers.
Tools
Sketch, Zeplin, InVision, Usertesting.com, Appsee, Jira
"Having worked in a hospital for over ten years, I see communication as the biggest challenge for clinicians. In many cases, care teams spread throughout the campus must collaborate, diagnose, and act within minutes. Shaving seconds off those processes can directly save lives."
Reevaluating our processes & determining our core user needs
The product roadmap was originally a classic waterfall consisting of new features and customer requests that lacked a clear direction forward. To resolve this, we created a cross-functional team to establish our product priorities and identify the core user needs. We chose to follow the Lean UX Canvas for the initial problem definition to help us maintain focus and establish measurable outcomes. Our main findings: physicians were rejecting the application because it didn't support their specific workflow and urgent communications were a burden. We validated these findings with extensive user testing.
Using qualitative analytics to measure success
We had very specfic KPIs for our redesign - to increase speed of critical communications and increase user adoption, especially with the physicians in our hospital systems. We used Appsee to record sessions, track usage patterns, and capture touch heatmaps. We experimented with the tool before conducting the product redesign to test out the product and use the opportunity to learn more about our existing user experiences.
Evangelizing user empathy
Our users had highly specific and complex workflows, and we needed to thoroughly research and understand them before beginning our redesign. Our research included shadowing, interviewing, focus groups & surveys. We built a variety of user personas from this research, presented them to the company, and printed them on walls in the office to increase visibility and adoption.
Establishing a design process
I worked to build a culture of highly rapid, transparent, and collaborative design and prototyping. We began with brainstorming workshops, low-fidelity sketches, wireframes, and then increased in detail as our vision became more defined. Additionally, we maintained a regular feedback loop with our users throughout the design process.
Solutions
We conducted extensive end-user testing to validate our solutions before implementation. This included in-person user testing via InVision prototypes. We conducted these tests in hospitals throughout the country and evolved our designs based on the feedback. As a result, we were able to begin development with confidence in our approach. After much testing, our UI was inspired by native iOS patterns, as they were most familiar and intuitive to our users. Often users would be interacting with our tool while running down a hallway with their adrenaline racing. Hospitals are noisy, mobile, and highly stressful environments - we needed to ensure our UI was as intuitive and familiar as possible.
Giving users a dashboard view of their day helped them coordinate care faster with distributed teams.
We added long-press and other power user functionality to help clinicians view and action on critical alerts faster.
Many physicians are moving between units and hospitals on a daily level - we made it easier for care teams to locate and communicate with them.
Not all care teams are unit based - we allowed users to favorite and build their own groups for easy access and collaboration.
We improved the visual design critical communications to cut through the clutter and ensure they're viewed and actioned on quickly.
We experimented with sound and toast design to ensure critical alerts are never missed.
Results & Learnings
Our improvements to the user experience helped contribute to a 30% user base growth in 18 months. Although users reported an increase in speed of urgent communications, our product team made the difficult decision to deprioritize the qualitative analytics which affected our ability to track this KPI effectively. Overall, my experience at Mobile Heartbeat consisted of a lot of firsts: building and managing a team, leading design on a company-wide level, and working within healthcare. As can be expected, mistakes were made and lessons were learned. I value these accelerated periods of learning in my career when I learn to be comfortable with discomfort and know when to ask for help and admit I don't know an answer.
Don't Expect Strong IT Infrastructure
We expected virtually zero downtime for critical communications, but hospital IT infrastructure is often underfunded and spotty. In the future, we must plan accordingly.
Integrate with Developers
A cultural divide between product and engineering formed that created a communication and creativity barrier. I now always push for integrated, cross-functional teams.
Push Back on Customer Leadership
We learned early that hospital leadership doesn't always represent the end-user. Large organizations can have competing priorities, and we can't assume that a single voice speaks for the majority.