Gathering Insights In Healthcare With Responsive User Research
How might we improve communication between physicians and patients during the visit? How might we help educate patients about their condition? How might we simultaneously relax and educate patients?
These are just some of the exciting and important questions I get to tackle in my position as the Lead UX Researcher at Outcome Health. Yet, uncovering and understanding these users’ needs, goals, and pain points is not as simple as asking our customers to call us to share their feedback. Rather, at Outcome Health we employ a design-thinking approach, also referred to as the double diamond (originally developed by the British Design Council and updated by Hyper Island), to help us ensure that we are “designing the right thing”.
As the lead UX Researcher at Outcome Health, I am responsible for bringing the first phase of the double diamond to life, that is, designing and executing research that helps improve the user or customer experience with our products and offerings at the point of care. At Outcome Health, our customers are numerous and diverse. They are patients, caregivers, healthcare professionals such as physicians and nurses, front office staff, and administrators at healthcare systems to name just a few. While the theories and methods we, as researchers, learn in our training serve as an excellent base for talking with our users, in practice, we need to be more nimble and empathetic when designing and conducting user research.
Operational Considerations
On the surface, the obstacles I face when designing, recruiting, and conducting user research look similar to the challenges faced in B2B research. For example, we have customers that are professionals and may not be familiar with user research methods pertaining to product development. Additionally, our customers may not have time in their professional roles to participate in our research activities. This got me thinking, “How might we operationalize testing our products in a way that meets our customers where they are at?”
Healthcare Considerations for User Research
I quickly realized that I also had to find ways to overcome the many challenges inherent in the healthcare space such as healthcare regulations, prohibitions against the use of third-party software, personal characteristics of healthcare professionals, and our own internal policies.
Healthcare Regulations and Outcome Health Internal Policies
At Outcome Health, our Code of Conduct, company policies, and procedures for conducting this type of research are structured to comply with the complex laws governing the field of healthcare, such as the federal Anti-Kickback Statute (“AKS”), and the Health Insurance Portability and Accountability Act (“HIPAA”). For example, we never collect or store PHI (such as patient names or medical record number) or PII (such as images of participants) on our servers or devices, and we do not store identifiable responses or collect sensitive personal information about user research participants. In addition, whenever we show our customers or partners Outcome Health products and offerings not yet released, we request that our participants sign a nondisclosure agreement (“NDA”), which states that neither party will disclose details discussed in the interview. While ensuring compliance with complex healthcare and privacy laws and regulations can introduce time constraints and planning obstacles, following these guidelines demonstrates Outcome Health’s commitment to the highest ethical, legal, and compliance standards, and ultimately improves the quality of our research.
Third-Party Software Permissions
Many healthcare systems restrict employees from adding browser extensions to company laptops or from downloading apps on to company-issued smartphones. Unfortunately, many user interface testing platforms require research participants to either install a browser extension or download an app to run the testing software. While this may not be an issue when conducting research with the general public, this continues to be a hurdle for participants working in healthcare.
Characteristics of Healthcare Professionals
While many healthcare professionals regularly complete surveys, I’ve found that many are less familiar with user research and usability testing. As a result, some upfront time during recruitment is needed to explain the process. In addition, many healthcare professionals are stretched thin, especially during COVID-19, and have limited time for additional activities. It is important when scheduling research to remember that my deadline is not my user’s priority. They may not be available when you want to conduct the research or they may not have time to install testing software before the interview.
So what is a researcher to do?
Given these many challenges, I have found solutions in what I like to call responsive user research. What is responsive user research? To me, responsive user research is designing studies so that people can participate regardless of their personal characteristics (e.g. lack of time) or environment (corporate policies such as no third-party software). The concept of responsive research has its roots in cross-cultural anthropology. It intentionally addresses “the participants’ cultural values that affect recruitment, participation, retention, and distrust in the research process.”(Seponski & Lewis, 2017). I also like to think that responsive user research takes a cue from our design colleagues, wherein their designs are responsive, that is, they adjust so they are viewable regardless of the users’ different screen sizes.
Responsive User Research In Action
Let’s assume we want to test a prototype of a website redesign by conducting a moderated usability test with a UX testing platform. Through this approach we can capture a blend of qualitative (e.g., prompted and unprompted user feedback and reactions) and quantitative (e.g., where users make errors, what paths users take to complete activities) feedback as we observe users interacting with and providing feedback about the prototype. Using a digital UX research platform to conduct testing (such as User Testing, Lookback.io, or User Zoom) streamlines many tasks for the researcher (e.g., using a single tool to host a session, display the prototype, capture notes, create clips of key sections in the interview, analyze feedback, and observe the research session). However, what works well for the researcher does not always work well for the participant. While the platform does provide the participant with a single link to participate, it does not work if users can’t install and use the platform or can’t commit to a scheduled interview time. Since many of our participants have challenges that prevent them from participating using this approach, we developed three adaptations (and a fourth wild card option) for conducting research with the participant when the first approach (moderated usability testing with a UX platform) is not feasible. Our approaches include:
- Adapted Usability Testing
- User Interviews with Screenshots
- Survey with Screenshots
- Independent Third-Party Research Firm
1. Adapted Usability Testing
The first option, adapted usability testing, is the most similar to the traditional usability test.
2. User Interviews with Screenshots
The second option, user interviews with screenshots, shares many similarities with traditional usability testing while lowering technology barriers to entry.
3. Survey with Screenshots
The third option, survey with screenshots, gets us furthest away from the traditional usability test, yet still allows us to capture valuable user feedback.
4. Independent Third-Party Research Firm
Finally, I would like to offer a fourth ‘wild card’ option, different from the preceding options. If you don’t have the bandwidth or expertise to either recruit participants or conduct research in-house, an independent third-party research firm is an option to consider. Third-party research firms employ teams that can help you quickly get a project off the ground. They can handle time-intensive logistics (such as recruiting and scheduling participants and signing NDAs) and can provide staff and access to research platforms for data collection. In addition, such firms often manage proprietary panels of diverse healthcare professionals. The firms often incentivize (and handle compensation of) their panel members for participating in a research activity. However, the cost of using such a firm can sometimes be cost-prohibitive.
Let’s Get Started
As a researcher it is easy to get caught up in theory and methods. I often find myself asking, “Is my sample large enough? Is it representative of our target audience? Is my design rigorous enough to stand up to scrutiny?” These are valid and important concerns. At the same time, I recognize that designing the perfect study can become the enemy of the good. Because without user research, we would not have evidence for our design decisions and may design the wrong thing. As we have learned at Outcome Health, when we meet our customers where they are, we are rewarded with their insights. Customers generally want to be helpful and appreciate the opportunity to help improve the products they use daily. Responsive user research has helped us identify customer needs and validate solutions. I hope you give it a try!
Angie Eckstein is the Lead UX Researcher at Outcome Health. She is responsible for end-to-end customer-centric research across a variety of customer touch points with Outcome Health’s products and offerings. You can often find her behind the scenes trying to understand what makes people tick.
Outcome Health’s content and experience platform provides healthcare professionals and health systems with relevant health information, up-to-date resources, and tools to support and strengthen the HCP-patient relationship. HCPs across the country leverage Outcome Health’s platform in their waiting and examination rooms, and infusion areas to enhance the patient experience. We bring empathy, education and engagement to every moment of care at your practice.
