Design Thinking: A UX Framework for Healthcare Apps

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UX design has a direct correlation to user adoption, time to complete a task, reduction in errors (thereby decreasing the risk to patient safety), a decrease in support calls, and an overall increase in user satisfaction.

One of the most prominent issues facing clinicians and patients when trying to use a healthcare-related application is their inability to use the product efficiently or effectively (not to mention any patient-safety impacts).

In this post, we’ll explore the challenges of improving the design and usability of healthcare apps, and offers a solution to these problems with a five-step process called the Design Thinking Framework. This framework emphasizes that the keys to great design include iteration and collecting user feedback throughout the whole cycle, not just at the end.

Challenges of Designing a Better Product

The key challenges or barriers that healthcare vendors and hospitals face in terms of designing a better product (or improving the design and usability) usually fall into six main categories:

• The timing of UX involvement in the design and development process. Often UX is an afterthought (‘we’ll do summative testing at the end”). In order to be effective, UX methodologies and processes need to be applied from the beginning.
• UX expertise and resources in-house and/or ability to bring in UX expertise quickly as needed.
• Usage of appropriate techniques and deliverables to obtain and understand user input and capture UX design solutions (that solve a real problem).
• Leadership and culture in the vendor company/hospital. How well the leaders and company/hospital as a whole appreciate the value and necessity of UX design from a business perspective. The degree to which UX processes are
• The degree to which UX processes are connected and integrated with other corporate processes that enable individuals to work together to create the user experience of the product(s).

The Design Thinking Framework

When followed correctly the Design Thinking Framework helps clinicians and patients gain insights into the User Experience (UX) design process and ensure end users experience simple and meaningful interactions with the product. The framework focuses on these five components: Learn, Define, Ideate, Build, and Iterate.

Build

At the build stage, designers/developers should be ready to use the feedback from users to iterate on the solution that worked best for them to create a prototype, test it with users (again) and start coding.

Iterate

Iterate the process, adjust when necessary and then advance to the next challenge. Check back with your users frequently throughout the design cycle, NOT just at the end, to make sure you are designing the “right” solution. This is a repeatable process that can be integrated with any product development process, regardless of the size of your organization.

Methodologies, Activities, and Deliverables to Consider

For each of the five principles, there are different methodologies, activities, and deliverables to consider.

1. Learn
   • Activities/Methodologies: discuss the different types of design and user requirements research methodologies (e.g., on-site observations, interviews, workflow analysis)
   • Deliverables: personas, usage scenarios, task flow or hierarchical task analysis, journey maps
2. Define
   • Activities/Methodologies: participatory design sessions with stakeholders, requirements definition, and validation
   • Deliverables: storyboards, workflows, usage scenarios
3. Ideate
   • Activities/Methodologies: defining information and interaction design (via wireframing), formative testing
   • Deliverables: information architecture, concept designs, annotated wireframes, visual design and usability test report with recommendations
4. Build
   • Activities/Methodologies: prototyping, detailed design, validation or benchmark usability testing
   • Deliverables: user validated product
5. Iterate
   • Repeat the process and adjust when necessary and then advance to the next area or issue.

Usability Standards and the Design Thinking Framework

The Design Thinking Framework is based on two important standards related to usability: ISO 9241-11 and ISO 9241-210. ISO 9241-11 defines usability as “effectiveness, efficiency, and satisfaction with which the intended users can achieve their tasks in the intended context of product use.” The ISO 9241-210 standard provides guidance for designing for usability.

In addition, the Design Thinking Framework supports the Meaningful Use requirements for safety enhanced design and the test procedure for evaluating conformance of complete EHRs or EHR modules to the certification criteria defined in 45 CFR Part 170 Subpart C of the Health Information Technology: Standards, Implementation Specifications, and Certification Criteria for Electronic Health Record Technology, 2014 Edition; Revisions to the Permanent Certification Program for Health Information Technology, Final Rule.

Tips for Following the Design Thinking Framework

• Do your research first. Ensure you understand your users, the problems they face, their goals and tasks and the context in which they are achieving and completing those goals and tasks.
• Iterate on design. You won’t get it right the first time – so be prepared to iterate on your design multiple times (and before writing a single line of code) using stakeholder and end user feedback.
• Use/hire UX resources with the appropriate experience, skills and education.
• Test early and test often. Test with your target users as soon as you have design ideas down on paper, then keep testing through the cycle. By the time you’ve built the product or are ready to release, the validation test should be about measuring against UX goals for the product (e.g., 100% of users should be able to complete task A within a specified time period).
• Educate the entire team on user experience design, whether they are a designer, product manager or a developer. “Design thinking” is a team responsibility.

Benefits of a UX Design Process

By following a UX design process, such as the Design Thinking Framework, healthcare vendors, and hospitals can realize business value and ROI. UX design has a direct correlation to user adoption, time to complete a task, reduction in errors (thereby decreasing the risk to patient safety), a decrease in support calls, and an overall increase in user satisfaction.