Listening to Real People is a Critical Step in the Solution Design Process - The Indian Health Service Health IT Use Case
The Department of Health and Human Service in partnership with Indian Health Services and the Office of the National Coordinator has embarked on a Health IT modernization effort that will affect the delivery of healthcare services to over 2.6 million American Indians and Alaskan Natives (AI/AN), and has identified Human-Centered Design as one of its objectives for future improvements to associated Health IT. The work with the IHS continued with the creation of design artifacts that captured a cross section of patient and staff experiences at AI/AN healthcare facilities.
In order to understand the unique care delivery needs of the AI/AN community, over the past year we conducted almost 150 one-on-one interviews with healthcare staff, Tribal leaders, and patients. We visited six sites in total and consulted with several AI/AN patient advocates from the community, including the NIHB for cultural and historical background, recruitment, content creation, and validation of work-in-progress deliverables.
"Listening to real people is a critical step in the design process. Purposefully embedding research processes rooted in empathy and equity into tech design helps ensure products help people; we strive to uncover insights from research that is inclusive and people-focused" - &Partners Human-Centered Design Expert
Telling a story about patient access to a telehealth specialist after emergency surgery in a rural hospital is more powerful than simply saying we need telehealth. These stories give a big picture of how different staff members work together and face challenges like the remoteness of rural AI/AN reservations, lack of internet connectivity, staffing vacancies, and difficulties recruiting doctors to these areas. Our focus had specific goals:
- Define modern Health IT needs
Identify the core concepts and functional needs of a modern Health IT system.
- Focus on uniqueness
Understand how healthcare facilities might provide better healthcare for patients, specifically in AI/AN communities.
- Develop a tech-agnostic rubric
Develop a rubric to evaluate all the possible Health IT options and construct these in a tech-agnostic way, leaving room for unforeseen innovations.
- Keep it human-centered
Use Human-Centered Design, design thinking, and qualitative and intensive user research to inform and accomplish all of the above goals.
Evidence-based, people-driven narratives is critical to improve health outcomes. Several in-person and remote workshops with the IHS health practitioners and patients add nuance, context and insight to the knowledge gathered in the field, and helped find the right focus and range to our user personas.
The personas developed are a blend of the many common health disparities affecting AI/AN community members (diabetes, high-risk pregnancy, substance abuse and more); many barriers they face getting the healthcare they need (poverty, distance from urban centers, etc.); and many unique aspects (eligibility, difficult access to referred care, and more).
We grounded stories on the patient's journey and attempted to capture a wide range of roles, processes, and situations learned from the field, and convey as many requirements as possible. Finding were synthesized into blueprints and illustrate a number of use cases that encompass the unique needs of AI/AN individuals.
A people-centered research process that incorporates HCD activity and approach can help the IHS continue to uncover needs and make improvements. Over the next couple of months we intend to highlight each of the personas, patients' journey, and blueprints associated with the health disparity identified.
Blog 1 - High Risk Pregnancy Journey map
Blog 2 - Guardianship of Children
Blog 3 - Suicide Ideation
Blog 4 - Injured in ATV Accident
Blog 5 - Recovering from Opioid Addiction
Blog 6 - Diabetes Comorbidities
Blog 7 - Caring for a Parent
To learn more about the methods and approach used to develop these findings, read Telling Complex User Stories: The Indian Health Service Health IT Case Study.