Sprint 3: Research, research, and pretotyping
After our initial dive into the problem space, we continue to dive deeper and deeper into understanding the problem space of physician burnout. Our last sprint ended with lots of guerilla research and a thorough literature review to gain more background about the problem space and identify areas where we could probe more deeply.
In this sprint, we focused on setting ourselves up for success by holding stakeholder interviews with Optum teams and related technology vendors, defining the questions we’re going to probe on with physicians, developing strategies for recruitment, recruiting physicians, conducting an affinity mapping exercise of initial research takeaways, and pretotyping!
Stakeholder Interviews
To understand more background about the problem space and Optum’s existing digital tools and technologies, we held stakeholder interviews with the Portals Strategy and EMR Strategy team. In these sessions, we gained more clarity about where the EMR fits into the physician workflow and the differences in the EMRs that employed versus contracted physicians at Optum use. This was immensely helpful going into physician interviews over the next few weeks where we will be speaking with physicians employed at Optum. These meetings also walked us through the physician portal (used by the contracted physicians) and discussed how that was integrated with EMR.
Lastly, these interviews served as initial conversations about the future of healthcare technology. We pondered the different levels of conversational ability in voice-to-text solutions and the opportunity for combining different data sources to create predictive analytics solutions that enable better preventative healthcare.
In addition to the Optum stakeholder interviews, we had an interview with an external technology vendor, DockHealth, a startup working on an integrated task management platform specifically for physicians. (Think Monday.com, Trello, Jira, but for healthcare!) This tailored and customizable solution is intended to plug into EMR systems. As task management is something we hope to probe on during interviews, the thorough workflows the DockHealth team had considered gave great insight into the physicians’ day-to-day tasks.
Exploring Research Themes
With the great background gained from the stakeholder interviews and our prior literature review, we began framing the questions we want to explore in our primary user research. To prepare for our upcoming interviews with Optum physicians, we defined 5 key themes we want to explore: 1) User Role & Context, 2) Understanding the Physician Workflow, 3) Exploring Digital Experiences, 4) Burnout, Perceptions & Emotions, and 5) Looking to the Future. We plan to start the interviews broadly to understand the physicians’ backgrounds before diving in more deeply with interactive Miro exercises to map the physician workflow and relevant digital systems and pain points. We also want to explore the emotional side of physician burnout.
Simultaneously, we prepared a guide for potential contextual inquiries that we are hoping to conduct in the future. Through these sessions we’d intend to see firsthand how physicians go about their daily tasks before, during, and after patient interaction. We’d also plan a “mock patient exam” to really understand the tasks the physician is doing in the exam room, and test our pretotype which we’ll touch on later.
Recruiting Physicians
On the less glamorous side of things, we’ve learned that recruiting physicians, especially amidst a global pandemic, is hard! Physicians are busy, overwhelmed, and, oh yeah, burned out! So getting some of their time has definitely been a challenge.
To be strategic in our approach, our team developed clear profiles for the target demographic profiles we’re hoping to speak with. For the Optum interviews, the bulk of our focus will be on physicians that are millennials given their high rate of burnout. We also hope to speak to some Gen X and Boomer physicians particularly to ascertain if Millennial physicians are more burned out due to generational differences or current situations OR due to stage in their career. Perhaps you have to take on more tasks as a younger physician? We’re also hoping to speak to non-physician clinical staff such as nurse practitioners and physician assistants. Our desired sample skews female as initial research into physician burnout suggests female physicians report burnout at a higher rate than male physicians.
If you’re reading this and you know any primary care physicians that would be willing to be interviewed or shadowed, leave a comment below!
Sense-making
With so much information coming at us and so many information gathering opportunities in the near future, we wanted to start making sense of what we were learning. The Optumists took to the wall to translate notes from guerilla research, the literature review, and stakeholder interviews into sticky notes, which were then used for affinity mapping.
This exercise helped our team brain dump all of the information we’ve been learning into core insights:
- There is a lack of quality patient-physician interaction due to copious amounts of data entry.
- A lack of interoperability across systems due to data ownership concerns, business priorities, and legal issues
- EMR systems effort to become more seamless has led to an “always on” mentality.
- Alert fatigue leads to information overload rather than actually drawing attention to key notices.
- There is a lack of shared ownership over health between physicians and their patients, which means primary care today is more diagnostic and reactive rather than preventative.
- EMR systems were originally designed for insurance and billing purposes, not for patient care.
What does the future of healthcare look like?
We don’t know the answer to that question… At least not just yet. But we’re beginning to think about what the future of digital healthcare systems may look like in the near and far out future. We drafted an initial project vision comprising three levels: 1) Baseline, 2) Automated, and 3) Predictive & Smart.
Can we see it in action?
No. We don’t have the future of healthcare completely redesigned. Again, not just yet… we’ll get there. But for now, we’ve started pretotyping what that future might look like in terms of automating the mundane and repetitive tasks of data entry. Our pretotype explored a voice-to-text solution that would passively input data into the EMR during a patient exam, freeing the physician up for the higher value task of caring for the patient. If you want to see this future beginning to come to life, view our prototype here:
Our pretotype scenario raised a number of questions for when we pretotype this with physicians:
Data Entry
- Will the physician need to manually shift between data input fields and prompt the system to fill in the preceding conversation, or will the system be able to do this intelligently? Would data categorization perhaps occur retroactively, such as using a color-coding system to assign phrases of text to input categories?
Patient Interaction
- Will the patient feel comfortable with this type of automated system?
- Would the conversation or tone between doctor and patient change (more formal, less formal)?
Feedback
- How would the physician and/or patient know that the system was on and recording? Would this system status need to be indicated through something like light indicators, for example?
- How would the physician be able to confirm that the dialogue is, indeed, being recorded?
The second part of our pretotype is research-focused to uncover reasons for physician burnout and understand their need. We’ve created an Instagram account @DrainedDocs where we’ll be sharing stories from fatigued healthcare workers as they come in (both from interviews and from an anonymous submission form on social media). Sharing these stories from across the field we hope will serve as a way to understand physician burnout, but also to advocate for this issue and create a safe space and community. If you know a healthcare professional that may have things to add, please send them to @DrainedDocs!
