Case Study: Public Healthcare(Booking an Appointment).
🇺🇸version
Design Thinking
It is difficult to tackle the subject without first making a small mention, when we talk about Health today everyone looks back thinking about what we have gone through in the last year with the COVID19🦠and although things are improving, life has given us a turnaround, at times it has made us reflect and perhaps in some way all this has caused us to put the brakes on our lives, in my case I would say that it has been a period to get to know myself a little better, to be more positive and focus on those things and people that make me happy. I think we have all gone through many phases, but I especially remember the one I call resolute, which consisted in making do with everything we had at home, whether it was wearing a haircut courtesy of the most crafty of the family or opting for the comfy look / tracksuit for every day and that finally became fashionable even to wear on the street, I must say that in a way this led us to lose that shame and even to laugh at ourselves without caring about the opinion of others and what’s more I think that this historical event has brought to light the naturalness and vulnerability of people something that we always ran away from or hid for fear of being hurt or excluded from society, it was in that period of space and time where we were all affected by the same thing and that undoubtedly has marked a turning point in our lives and it is true that with it we make history and those who will come will read it in books but I believe that the best story will always be the one you tell them.
Although the subject is very interesting and we could write a book about it, today I have not come to talk about the pandemic or health professionals, but I can say that in a certain way it has something to do with it and without going any further, the reason why I approached my project could be called a coincidence. It all started because I recently changed medical center and to be registered in the new one I had to give all the data of my health card, that included my full name and the two lines of numbers impossible to memorize. As always I usually keep my card in my wallet along with the rest of the documentation, but such was my surprise that it was not there which was quite strange to me, let’s say that it is not something I use very often and at that moment I could not explain why it was not there, the fact is that I started looking for it without any sense opting for places that I knew it would not be there and after having exhausted all the possibilities of finding it I could not think of what else to do so I decided to search on Google.
The thing is that I wanted to know what procedures I had to apply for to get a new health card, while I was looking for this information I discovered to my surprise that the Galician Health Service, or as we call it here SERGAS, had a new mobile application for appointment system, I was shocked, moreover I thought that appointments were still made through the website or at most by phone but I see that no. I was very surprised, that times have changed, so for a moment I forgot about the card issue and I was more interested in that application, so I decided to download it to my mobile and try it, it is curious and with this I make a parenthesis, but the simple fact of dedicating myself in the future to this profession makes that every day I wake up more and more in my interest in things like this, but I do not want to bore you with my reflections …. I just want to tell you that my briefing was ready to enter the operating room. Let’s start!
As if it were a virus, I had exactly two weeks to get this patient to safety, so I started by organizing my tasks by means of a calendar in which I set out the whole evolutionary process until he came out of quarantine.
- Research
As in any process you have to be guided by a series of guidelines to do a good job, the research phase is key to help us develop everything else, in this particular case I want to find out why there are so many problems to request a previous appointment?.
According to users, the vast majority constantly complain about the errors that occur during the application process either by using the website, or through the mobile application, it always ends up being a lottery if that day you are lucky so seeing what happens people prefer to resort to the phone call, the latter option becoming a real odyssey. Therefore and knowing the big problem we have had for years, it is time to put a little order. Let’s see what conclusion we draw from all this. Following the established and with the time against us we will launch several questions that will add possible hypotheses, for this we will do a little desk research.
As shown in the table, these are the 5 why’s, which in themselves gather the necessary information to continue with the research.
User
- What does the user look for when requesting a medical appointment?
- How long does it take to make an appointment?
- How can the user know if the appointment has been made correctly?
- Why is the web site so difficult to use for the user?
- What is more useful for the user a web site or a mobile app?
- What is wrong with the actual mobile app?
- How useful is a digital card for the user?
Health public service
- what a mobile application should have?
- Why when requesting a medical appointment through the web only give the option of a telephone or face-to-face appointment?
- Why isn’t there a health card that can be used for all of Spain?
- To what extent does a nurse do more administrative work than his or her own job?
- Why are telephone appointments so difficult to manage?
- What problems are there when living abroad with the health card?
Medical appointment request
- Why does the mobile application redirect you to the web to make an inquiry?
- Why is there no appointment confirmation notification?
- Why are personal data not saved every time we request an appointment?
- Why some of the app buttons do not work?
- Why isn’t there a calendar to check the days and hours free to make an appointment online?
Private Insurance
- Why does the user end up going to private medical clinics?
- what service does private health care guarantee?
- To what extent is it worth paying for a private medical consultation?
In view of the above table, these are the 5 why’s, which in themselves gather the necessary information to continue with the research.
5 why’s
- Why is it that every time the user logs in to the web or the app it does not recognize him/her as a user?
- Why does the user have to go through so many steps to request a medical appointment?
- Why is there no appointment calendar?
- Why do many medical appointments get missed?
- Why does the user have doubts when requesting a medical appointment online?
Great guys!!.we already have enough clues to start elaborating and in this order, the survey, interviews and in my case a Focus Group.
Let’s start then with the survey, in this case and counting with the 5 key questions it is very easy to elaborate a questionnaire to know a general opinion, is it true that there are so many problems or there are only some isolated cases? is it so chaotic to ask for an appointment? These are some of the doubts that we have to answer, let’s see what they tell us.
Survey
- Have you lost your medical card? No 94,7% / Yes 5,3%
- Have you found it difficult to obtain a new medical card? No 43,1% / Yes 56,9%
- Would you find it more useful to use a digital medical card? No use 11,7%/ Of little use 4,1% / Very useful 84,2%
- How do you request a medical appointment? By phone 91,5% / By mobile app 4,8%
- Do you have difficulties using the mobile app? Yes 88% / No 12%
- Do you have difficulties using the web? Yes 42,4% / No 57,6%
Relevant data obtained from 145 respondents.
We already have enough gossip to share with my interviewees, for this occasion I have summoned a nurse and I want her to openly give me her point of view in both cases, one as health personnel and the other as a patient, I want her to tell me first-hand how she lives her day-to-day work.
Interviews
Insights from María
“The lack of organization on the part of the hospital administration staff leads to many missed appointments by telephone.”
“Many times nurses neglect their duties to perform administrative functions that are not part of their job.”
“Nurses do not have access to the medical appointment schedule so we often do not know whether the patient will be seen in person or by telephone.”
I loved the interview with Maria, not you?without mincing words she told very interesting things, for example the ordeal with her grandmother’s medical appointments, since many times for elderly people the system has not designed a reminder of appointments, this I quote here has been a complaint of many others?it will have to be taken into account.
Let’s continue with the interviews this time I have gone a little further I have crossed the pond literally and we are facing the interview of a foreign person, I am curious about his point of view, you do not ….
- “The website is very cumbersome, there are many steps to cover a medical application.”
- “One of the most common problems I have here in Spain is that in bureaucratic matters the documents are slower, you have to be very patient.”
- “I am annoyed that every time I make a medical application through the mobile application I do not recognize my data being already a user.”
Another fantastic point of view and it is that our interviewees have been in everything.
Let’s see how the Focus Group turns out, in this case I wanted to gather a group of four very talkative women, hehe, people of the world I would say so as I want them to explain themselves we are going to take them by surprise and we bring up the subject as if it were a surprise and as they talk more than textbooks, let’s see what conjectures they come up with. Warning for navigators, the wine does its tricks…
Focus Group
“I think the hospital facility should be more attentive to the patient, there are a lot of population who are elderly and go to the doctor every week. They need to be reminded when they have their appointment.”
“Being a mobile app that they have recently improved, I still see very big bugs, your process is slow and crashes. Sometimes you end up losing patience, I do not want to imagine a person who is not very accustomed to technologies what they will think.”
“Continuing problems with the registration of medical appointments creates confusion for medical professionals who often do not know the reason for the patient’s visit and creates discomfort for the patient.”
“It should be convenient to access the mobile application, just with your name or that your card is not physical, but digital like many others. It would be more convenient for elderly people and even people who are in charge of others.”
“There should be an improvement in the control of appointments, nowadays a lot of time is wasted in making the management of appointments.”
As you can read the time invested has paid off, the topic has been able to fit very well, even details that obviously always escape us made me take note of them. They all agreed that the Galician community has a high percentage of aging population and for this reason they are the ones who most frequently go to the medical center for check-ups and medication, another thing that was also very interesting and that came up is the issue of prescriptions, some people in the surveys named it and is that they do not know the medication that the doctor prescribes and although they write it down on paper is not enough the patient wants to have access to it at all times.
2. Analyze
Well!!! we are on the way to close the first diamond, we still have many interesting things to discover until we get the idea but we are doing well. In this new phase we are going to synthesize and categorize the information, that is to say, what information has more weight and what less? For this we are going to use User persona, empathy map and as a finishing touch the famous Key Facts.
User Persona and Empathy Map
If we do a little memory during the research process we have known the opinion of different people, they have explained from their point of view how they see the situation when making an appointment, we emphasize that many of the people who go to the doctor are elderly, a clear example and that of Maria’s grandmother (nurse). Therefore, and in order to be able to gather all the points, I have created the character of Juan José, a 78 year old retired man who will give life to our user person, with him we will answer through the empathy map to the questions: What does he say? and What does he do? and What does he think? and What does he feel? and What does he see? and What does he listen to?.
What does he say?
- I would like to be able to access the application or website easily.
- I would like to see my medical history, check my prescriptions and a medical appointment reminder.
What does he think?
- Very lengthy application process, have doubts if they will improve the appointment system.
What does he feel?
- You often prefer to pay for a private medical consultation because you can be sure that you will get an appointment quickly.
What does he hear?
- That users complain, that the elderly are the most disadvantaged.
What does he see?
- Lack of organization by management.
- Medical appointments out of control.
What does he do?
- Many times he asks his daughter for help, he tries to access from different devices to the medical appointments page and other times he goes to the health center to ask for an appointment.
Journey Map
Reflecting the user persona we are going to simulate how a person of this age faces the process of requesting the already famous appointment, the resulting paint points will give us more than enough clues to draw out the inner insights.
Experience vs expectations
Our user has to make a medical appointment, it turns out that when accessing through the web he does not get the page to open correctly and therefore decides to ask to help his daughter, she recommended him to use the application of the health center itself, he manages to enter but you have to enter many data and does not know how to do it, ends his daughter to help him although the process was very long and slow. Finally she manages to make an appointment, but does not receive any confirmation notification.
Key Facts +Insights Cluster
We will cluster and break down each phase and highlight those things we consider important. These facts are the clear summary to improve the user experience during the whole journey.
Web site access
- The user cannot keep the record of his data each time he accesses the site to request a medical appointment.
- The user cannot access from his mobile because it does not recognize him as a registered user.
- Health card numbers are to be entered at all times, they should be recorded.
Complex procedure
- Many steps to make an application
- The user does not know what day of the week the appointment is because there is no calendar.
- User wants to see prescriptions to order medications at the pharmacy.
Intuitive web app
- The user does not recognize what many of the CTAS of the application are for and what function they do.
- The user needs to be informed at all times of where he is at any time.
Security
- The user needs to know that his application has been made.
- Notification of the appointment.
3. Devise
We have just jumped to the next diamond without a blink of an eye, it’s time to contribute our skills in (design, usability, creativity…) we are going to capture everything we have learned in the two previous phases and improve it.
Current scenario:
Before we move on to the plan itself we need to put the ideas in order, simplify the information, think about what is the best solution and what we want to achieve with it. Now we can say go ahead with the idea.
Problem
The biggest problem lies in the access to the appointment request, being the internet the most problematic and the easiest to solve.
Registration every time you access.
Compulsory card application.
Confusing appointment notification.
Lack of appointment calendar.
Solution
In view of the fact that the majority of respondents make more use of the mobile than the computer.
In view of the fact that the majority of respondents make more use of the mobile than the computer. The idea would be to work on the mobile device.
Digital card
saved user data
Availability of an appointment calendar
Prescription consultation
Notification of appointments
Objetive
An easy application adapted so that all users can make use of it.
As the box above indicates in the middle column the most comfortable solution would be to improve the existing application, but first and before we go crazy and look for design ideas I think it would be appropriate to make a heuristic evaluation of the existing SERGAS App.
This is the image of the application, as we can see at first glance there is a lack of consistency in the design, starting with the mix of colors, typography and buttons with information and design somewhat confusing. In general aspects this application lacks a good information architecture, if its main function is to request a medical appointment then we will have to create a linear process in which the user feels safe at all times. Next we stop with more detail on the key points that will be relevant for the design of the app.
Dashboard 1- Hamburger menu, it slides to the left cutting the image of the main menu by default, if we check the functions between the two menus coincide in name some buttons.
Dashboard 2- Icons and functions, we observe that we find ourselves again with another menu, already at first glance the size of the icons is disproportionate, they do not start from the same design style and the shapes are irregular and unrepresentative of the function they indicate. There are unnecessary buttons (current events, applications…), they do not contribute anything to the user and therefore we can omit them. Nor can there be buttons without icons, there must be harmony in the design.
Dashboard 3- Backgrounds, a health application has to somehow reflect a clean and clear image with representative colors of the sector, in this case the blurred image of two women would not fit with what we are looking for.
Value proposition
SERGAS by appointment, needs its application to have 3 important pillars to arouse the user’s interest.
Reliable
We seek that the application generates confidence to the user, being more effective fulfilling all the functions to be performed.
Accessibility
we want the user to be able to access the application comfortably without entering too much data and for the process to be short.
Usability
We emphasize that it is the main factor for all of the above to work. Any user, young or old, can understand it.
Why
Sergas appointment is the system of medical appointment, with which we have throughout the Galician community.belonging to the public health service its function is to attend and care for the patient.our idea is simple, improve communication in this area.
How
Digital card
The patient’s registration data will be automatically recorded.
Other improvements
Generate greater convenience for the user to find everything they need.
What
Organization
Notifications, recipes, specialties.
Comfort and Safety
All at your fingertips for greater peace of mind
Information architecture
Starting from the basis of all the information we want to include in the dashboard, we must focus on prioritizing which is the most important and which steps we should include and which we have to remove. To do this, we will organize the app’s behavioral tasks on a scale from most to least important.
- Workflow
Once we are clear about which functions will be part of our design for each dashboard, we will organize them through a sitemap, which will help us to better understand the real behavior of our future prototype.
- Wireframes
At this point my favorite hobby begins, giving creativity to our idea without losing sight of the stipulated design models by which we must be governed, we do not have to invent anything … just stick to what already exists and give it a correct use.
As you can see the flow created goes through different functions, let’s take a closer look at the request process.
Appointment request
We have a home image that takes us directly to the main menu where the user can select the card with which he/she is going to request an appointment and then make a clear and easy request among other functions.
4. Prototype
How little we have left! It’s time to launch and give life to our MVP, perhaps for me the revealing phase of the whole process in this project, hopefully if everything goes as so far we can improve the app, anything can be, but we must continue. Here we show you the final result of how the SERGAS home dashboard would look like.
In order to understand why certain changes have been made in order to improve usability and accessibility, let’s see which main functions have been a claim by users during the research phase.
Application process
This image represents the before and after of the same dashboard, as we can see in the image on the right the user can visualize his health card without having to go through several steps. Below is a small demonstration of the appointment request process.
With the new appointment request function, the user performs the entire process from the application without being transferred directly to the web as was previously done.
Additional functions
We also want the user to have access to their recipes, so we have incorporated a RECIPES button in the toolbar where the user can consult their history.
New card
Taking into account that many of the people who visit the doctor frequently are elderly, we have included a section where the user can add other cards, in this case those of their family members, so they can request an appointment for those who need it and keep track of their check-ups.
Last but not least, as SERGAS includes several medical centers, the user will be able to search for the location of the nearest center according to his area.
Design System
To make the design of the prototype more in line with what would actually be an app, we made a small visual tour for inspiration but since most of them were very different from each other we ended up sticking somehow to what we call colloquially as simple and minimalist.
Fundamentals of design
Even the smallest detail is visible in a design, both color and typography are key to something as visual as a screen fits in the context of a standardized taste, something so to speak a universal theory.
Color starting from the premise that blue is the dominant color in the sanitary world, we create from it a range of colors going through a scale of possible blues that could somehow harmonize within the same frame.
Typography
it turns out that to choose a typeface as such is not predefined any, therefore and based on the device we are using as a viewer of Figma, we are inclined to choose an Inter typeface, which brings the final consistency to the design and projecting an image of comfortable reading for the user.
Grid, the mobile version works under the design of a grid of 8 centered on a column with a Margin of 15 on each side.
Effects ( Drop shadow)
application of the shading technique to give a floating card effect.
Prototype connections.
Visual layer of how the app would work with all its functions.
Components
As if it were a Lego, we think that each piece is key for the whole structure to work, so following the Atomic Design theory, the classification would be as follows.
5. Conclusions and Futures.
We have reached our end and in a satisfactory way, we can say that in summary we have fulfilled the wishes of many of our users and without exaggeration we consider that all the functions are necessary for a good performance of the app. On the occasion of having faced the improvement of the application we have considered among many other things the need for a card and how uncomfortable it is to have it always at hand, either and I put myself as an example that I have lost it and like me sure that many others, it would not be such a crazy idea to be only digital. Have you ever thought about it?
Continuing with the world of the cards, as future I would emphasize more than anything that there was a health card at national level, with which you could move around Spain without any problem, why do I say this? Because it has caught my attention that the simple fact of going to a health center outside your town the protocol to follow is different and in the hypothetical case that you have to have an operation takes a different procedure, so it would be more comfortable that any authorized doctor can access your report just by consulting your card, in this way we could reduce the chaos that generates all the paperwork and long waiting lists. What do you think? Would this be a good idea for the future? suggestions welcome.
Ohhh!!! goodbyes were never good, but in this case yes!!! we say goodbye to you the most patient patients hehe, the doctor discharges you.
See you in another one!!!!
In the meantime, best of health, my reader friends.
