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UX Case study - Public healthcare, a wicked problem

Last week, my team and I have been assigned of a very complex challenge concerning the French Public Healthcare system 🏥.

Technology is changing the way we interact with each other. Many processes and tasks that required a long time to do in the past are now a matter of clicking a button and voilá ! As the public system incorporates technological solutions to big infrastructures, our experience as citizens should see that change too.

How Might We transform the end-to-end experience of access to public healthcare ?

🤔 Well, well, well … Where to begin ?

By “citizens” do we talk about improving the patients’ experience ? Or about the professionals’ one ?

What kind of healthcare do we talk about ? General medicine or specialist medicine ? Which specialist ? Other medical intervention like surgeries ?

Do we talk about liberal practitioners or public hospitals ?

Hmmm, maybe we talk about the administrative aspect, like the public health insurance (Sécurité sociale) ?

In fact the brief gave us a lot of questions. We understood why the project was qualified as a “wicked problem”.

a wicked problem is a problem that is difficult or impossible to solve because of incomplete, contradictory, and changing requirements that are often difficult to recognize. It refers to an idea or problem that cannot be fixed, where there is no single solution to the problem; (Source : Wikipedia)

In this case study, I’ll describe how our team applied the Design Thinking process, to identify and isolate an accurate problematic starting from a very vast theme, and also present you the ideation technic we used to imagine our solution.

Who are we ?

Before entering in the details, hereunder the presentation of my super UX Designers Crew 🦡

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Let’s begin … somewhere !

First, we began by carrying out a secondary research 🔍. Starting by gathering any kind of information helped a lot, as we didn’t have a clue of “where do we have to begin?” due to the vastness of the topic.

My teammates and I, each to her own, went browsing the web in search of any data and information concerning the “public healthcare in France” and noted everything we found interesting.

Being 5 UX designers coming from different backgrounds in this step was very useful, as our way of searching information was slightly different from each other:

  • Some were more focused on the digital innovations in the health sector,
  • Some others searched official data from public institutions like the French Government, Ameli.fr or Ipsos,
  • Some others looked in different news articles (Le Figaro, Le Monde …),
  • And some others found information concerning the sanitary crisis, etc, etc …

After gathering data alone, we did a brainstorm session to put all our ideas on post-its and categorized them into groups of topics.

Aaaah 😀 We begin to see a little clearer now.

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Our brainstorm board

The main insights we identified were the following ones :

  • Digitalization of the healthcare system
  • Fear concerning about the safety of data
  • Difficulty to access to information
  • Declining quality of healthcare
  • Inequalities in access to healthcare services
  • Difficult conditions of health professionals, in particular since the Covid crisis

Let’s deepen our insights !

Once that we identified some assumptions to validate, we built our user interview guide to prepare our meetings with the real users. For this step, each member prepared several questions on her side. Then we gathered all questions together to construct one team guide of 10 to 15 questions. By doing this exercise first alone, then assembling together, we were able to keep the most relevant ideas and refine.

We interviewed 6 different healthcare professionals :

  • Aged from 25 to 60
  • Coming from different small and big cities of France
  • Practicing different occupations : nurse, psychologist, ergotherapist, managers in administrative institutions …

The diversity of the interviewee profiles was really useful at this stage. As we didn’t know yet what would be the accurate problem to solve, it enabled us to have different points of view of various users of the healthcare system, and identify what’s the pain point they have in common.

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Presentation template by Slidesgo & images created by Freepik

The remote interviews were done in pairs and each member participated at least at 2 interviews. Each meeting was very instructive and plenty of precious informations. By asking only open-ended questions, they naturally talked us about their daily life and the problematics proper to their reality.

The challenges 💪 in this part for me was the following ones :

  • Do not forget to use some deepening interview technics like the “5-why” (asking “why” at the end of each answer to go further in the user’s thinking),
  • To keep all question “neutral” and avoid oriented question (“did you like ?” or “did you hate ?” instead of “what do you think about ?”),
  • It also sometimes was difficult to not react to their answers, as some of them were facing everyday the damage of the sanitary crisis on the healthcare system, which were already exceeded before.

Once all interviews were finished, we gathered the results by presenting to other members the information each one have noted, and the 4 others wrote them on post-its. Then we grouped the ideas per categories of affinity.

The difficulty of the exercise was that we had tendency to write post-its exactly “word for word” of what the speaker said. As we had 4 people writing for 1 speaker, we had many post-its in duplicate, instead of having 4 different interpretation of a same idea.

After having constructed our Affinity Diagram, we did a Dot voting to decide what topics we wanted to choose : each member had 3 dots of vote, that she placed on the selected post-its in silence. This technic enabled us to identify a clear trend quickly and efficiently, without spending 3 hours in infinite debates.

So, our team decided to work on the topic of “digitalization” as this topic was related to many of other themes. For example digital tools can be a part of solution for the lack of organization and communication, to solve the issues of access to healthcare by telemedicine, ...

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Presentation template by Slidesgo & images created by Freepik

Have you meet … Elisa ?

Based on our research, we finally found our perfect User Persona :

Elisa, a devoted but exhausted healthcare professional

Once again, to define the persona, our team first began by thinking individually, then we brainstormed together to keep only the most impacting elements. We tried to find a persona corresponding to different insights we got from our researches and identified in the affinity diagram.

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Presentation template by Slidesgo & Photo by Bermix Studio on Unsplash

Defining the persona in team and putting words on her goals, motivations, beliefs and frustrations, enabled us to clarify our mind and validate once again the direction that we were taking.

How can we help her ?

After “getting to know” Elisa, we were able to draw her user journey map. We decided in team to focus on the beginning of a work day at the hospital.

This moment seemed us to concern different healthcare professionals of a public hospital (doctor, nurse, health assistant, surgeon …) and corresponded to the issues linked to the lack of communication, organization and digitalization.

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Presentation template by Slidesgo & images created by Freepik and Eloïse Merian

Cutting out the task of into smaller steps and putting an emotion on each helped us to point out the worst moments of the journey and identify opportunity of improvement, which was in our case “Trying to decrypt the patients’ follow-up written by another colleague with a view to organizing her to-do for her day”.

Hereunder the problem statement which resumes our findings :

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Presentation template by Slidesgo & images created by Freepik

To each problem, there is a solution !

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Sorry for this bad drawings 🙈

As to develop our creativity and find solution, we used a technic called “Crazy 8's” 🎱. It consists in drawing 8 completely crazy ideas in 8 minutes (1 minute per idea).

I LOVED THIS TECHNIC 🤩🤪

Honestly I do not consider myself as someone being particularly creative. But with this technic, I was kind of pushed to think very quickly in a very short time-box, so I was compelled to put aside limits of feasibility and the result quite surprised me. I was able to find new ideas in few minutes only !

With the team, we did 2 rounds of Crazy 8’s session. Then from the results of our ideation sessions, we sorted out few best elements of different ideas, mixed them together to construct our final solution.

And here is the result : TADAAAAAAM ! 🎊

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Presentation template by Slidesgo & Storyboard by Eloïse Merian

The solution we proposed consisted in a collaborative digital tool inspired from the Agile method, including following features :

  • Getting an overview of the team’s to-do list and assign each ticket to a staff on the Kanban board
  • Prioritizing his/her own tasks by simple drag & drops on the Kanban
  • Quickly accessing to patients’ data (Numeric medical passport)
  • Voice controlling to change a ticket status into “done” or registering patients records vocally
  • Automatically transcribing the voice records into text and save times

What did I learn ?

Our project lasted 10 days and I worked in 4 other UX designers.

I think the 2 first day I was a little bit lost, due to the vastness of the brief. I was not sure where to begin and I didn’t have a clue of the solution we could construct at the end.

But going forward step by step and applying Design Thinking process and technics helped us to see more and more clear in a very natural way. Hereunder the UX tools used during the exercise (in chronological order):

  1. Secondary research
  2. User interviews
  3. Affinity diagram + Dot voting
  4. User persona
  5. User journey map
  6. Problem statement
  7. Crazy 8’s
  8. User flow
  9. Story board

+ And I think we used the brainstorm at almost each steps of the project 😅

Working in group was really helpful and supportive, as to be honest, I was a little bit worried of the fact that none of the team member knew the medical field very well, and also because we constantly hear a lot of alarming news concerning the sector due to the Covid crisis. But collaborating with my super colleagues, dispatching tasks, benefiting from strong skills of each member, and cheering up each other, made this a really nice experience !

Another constraint that we had was the very short time-box. 10 days to solve the totality of such a complex matter is in fact impossible. I think this context learned us to be efficient and act quickly, even if I finally think that we could optimize even more some hours that we spent in debating 😂 by using a little more the voting technic.

Thank you a lot for reading hope you enjoyed it, and don’t forget to wear your mask to support healthcare professionals.

from Giphy

Bonus

My super crew members’ Medium pages:

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