Design Solutions that Increase Access to Telehealth
Hello there! I’m Fabiola, the Lead User Experience Designer for our athenaTelehealth product. I have been working as a UX designer for about a decade, spending half of that time as a healthcare subject matter expert. I wanted to share some learnings on how I worked with my team of 10 developers to meet our product goals and provide a user experience that helps support, empower, and comfort users at a time that is often stressful to them.
It's early 2020, and due to the pandemic, telehealth visits have gone up by 50% in the United States. We knew we needed a telehealth solution, fast. So a team was put together with the goal of developing an MVP (Minimum Viable Product) that would be ready to launch in just a few weeks, ultimately enabling access to healthcare for thousands of US patients daily.
Most telehealth and video apps are native, but in order to integrate with our existing large EHR network and meet our time- to- market goal, we needed to stay on the browser. This negated the need to download a separate app or even create a login, conveniently, users could simply join via a secure link and even share the link on the fly with caregivers. However, we couldn't support all browsers, so in the worst-case scenario, a user would get a full stop error in the beginning of the flow. They could also run into device permission errors if they failed to allow their browser access to their microphone and camera.
The pandemic has accelerated the well- justified need for healthcare from the comfort of people’s home. We knew that we would need to facilitate this care for a wide range of users. People using the newest iPhones, the oldest PC's, and Chrome or Internet Explorer. People with new Bluetooth headphones, people with no privacy in their homes, people who have never made a video call. People who speak English as their second language, people with vision impairments, people with throbbing pain, people scared that they don't know how to support their mother or father from afar. So, how did we ensure that all these people get access to care while not increasing friction for our more experienced users?
To answer this question, I embarked on a series of research initiatives:
A lot of good insights came out of these research initiatives, but one of the main take-aways that emerged was the importance of empowering users to get into a troubleshooting mindset and holding their hands via custom content and a calming design.
Let’s get into how this research translated into our designs.
Step-by-step recovery paths in our modals
I worked closely with our copywriter and developers to pinpoint the full- stop errors that might occur and all the best user recovery paths we could offer. This ended up being a large body of work, as the recovery path looked different on every platform and browser.
Accessible help in all points of the flow
It’s certainly best practice to help users prepare their technology via sending informational emails in advance, but we recognized that users need help and information right there when they’re in a workflow, not in a separate message that they would need to go and find. We built a stand-alone device check flow that allowed users to live test and troubleshoot their technology before their telehealth session. We also embedded an extended help section in the device settings page so that users could access this guidance while staying in the workflow. They wouldn’t need to jump over to a separate browser page and lose context.
Visibility of system status via a transparent device check
A light competitive audit showed that most telehealth and video conferencing apps route users into the call and automatically pick the video, microphone, and speaker inputs/outputs without informing users of these choices. They assume that everything will go well, leaving users in the dark if something goes wrong. We wanted to take a different approach here, to avoid the common fallback approach that happens with many telehealth apps: the practice ends up using a normal phone call when technology fails, which can be risky from a HIPAA standpoint as PHI (protected health information) is often shared.
After multiple design iterations and user tests aimed at probing different solutions, we landed on a solution that lets the user know in real time what devices we picked for them. They can now quickly identify if the wrong headphones connected, for example, and edit that in their settings before the provider even joins, saving precious face time with their care team while automating most of the process.
A calming waiting room experience
Most patients do not enjoy the in-person waiting room experience. They’re often kept waiting for long periods of time, possibly with no explanation. Meanwhile, they may be stressed, anxious, frustrated, or even in physical pain. Telehealth lets users meet with their clinicians from the comfort of their own home, but we recognized that there could still be an unpredictable waiting period before the visit. We hypothesized that communicating a sense of calm via deliberate pacing of information, animation, illustration, and voice and tone would help guide users to actually read the tips provided, troubleshoot effectively if needed, and put them in a focused mode to have a productive conversation with their care provider. A breathing animation lets users know that the page is active and hasn’t frozen. It also encourages longer exhalations, which is proven to calm people down by stimulating the vagus nerve. We also worked hard on managing users expectations via the status indicators and providing estimated wait times when possible. User feedback confirmed that this approach was successful:
“I like the casual, friendly, warm, succinct vibe of these messages. I think these pages are intended to make me feel informed and patient while waiting for the doctor to join the call” — Male, 32
The pandemic has proven that there’s a real need for telehealth. It’s not going anywhere, and it opens up care to a lot of people. UX designers need to be aware of just how vast that range of people is. With careful thought, research, and deliberate choices, we can strive to design for increased access and allow even the less technologically proficient to have a good care experience. Good design is still quite rare in the healthcare space, but this is where the power of design can truly make a difference. After all, low stress levels and a distraction free environment can be life changing when it comes to making decisions around your health.
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I want to shout out my stellar UX team at athena — especially Camri Hinkie, who helped me design the in-call experience, and Jackie Sliwinski for all the help around the waiting room experience. Also a big thank you to Cathy Leamy, our copywriter, and the whole athenaTelehealth team.
