Sizing Up a Mountain: Defining a Design Opportunity

Last week, our team shared a few principles and practices that’ve helped us map out a complicated world of electronic medical record (EMR) systems. I compared the process to that of discovering mountains to climb in an unknown land. This week, I wanted to go one level deeper into a seemingly basic question.

How do you actually define a design opportunity?

Unlike actual mountains, problems have very fuzzy edges.

One of the images in our office, taken by daphne tan

Let’s say you’ve been sleeping poorly the past week. You whip out a post-it and write the following:

“How might I wake up feeling more refreshed?”

Well, sure — but why did you sleep poorly? Turns out you drink way too much coffee throughout the day. You rewrite it as:

“How might I reduce the amount of coffee I drink throughout the day?”

Okay, but why did you drink so much coffee anyway? Perhaps it’s because everyone in your company gets up early, has meetings all day, and pulls all-nighters. Ah, you’ve nailed it now:

“How might I shift my company’s work culture to one which promotes work-life balance?”

You get the point.

You can uncover problems of ever larger or deeper scope by simply asking, “Why?” You shouldn’t design anything without asking “Why,” yet you also have to stop at some point and move onto asking “How?”

Integrating the how’s and why’s into the who and what.

We ran into this exact issue many times over the past few weeks. For example, Ishaan interviewed a client executive who was extremely excited about an idea she had.

This led us to apply the same approach to EMR software:

What if, instead of manually configuring EMR workflows, the software could automatically configure workflow based on actual usage data from clinicians?

If that didn’t make sense, here’s an analogy: Imagine you want to redo your home’s interior, top to bottom. There are endless decisions to make and it’s a lot of work to figure out. What if, instead of asking you to choose what you want, an interior design team could look at how you actually live in your current home and recommend a set-up based on that?

This was a very thought-provoking idea and we immediately wanted to brainstorm how to make it happen. That is, until we realized this was just a particular solution to an underlying problem.

One of our many brainstorming discussions.

From the beginning of our research phase to present, we’ve shifted gears from understanding healthcare as a whole to focusing on the implementation of EHR software across hospitals. At a high-level, we know that the current configuration process isn’t reliably capturing the needs of clinicians, in part because of low physician participation and in part because there is an inherent difficulty of imagining how real workflows work in complex software.

On top of this, we also learned that, as a whole, the current implementation process of EHR software simply is not fostering buy-in across their wider team before rolling new user workflows out. In theory, physicians must use whatever system their organization chooses to adopt. How they vocalize and react to the system matters and trickles down the organization. Physicians are crucial to whether the hospital sees value in its purchased solution and whether the organization renews its contract.

Realizing all of the above expanded our thinking. Could we create a better way to help clinical decision-makers visualize and experience workflows before they’ve been hard-coded into an EMR system system? Or, during system configuration, could we create a better way to engage the wider clinical staff and get their buy-in or feedback?

Surely, there must be.

We still love the idea of automating workflow creation, but by focusing on the underlying problem, we opened up these other exciting design ideas.

To close out for this week, I’ll leave you with one of my favorite diagrams.

Many times, design is presented as an elegant, iterative process represented by loops, diamonds, and so on.

I’m personally a fan of this one:

Research is this messy, abstract — sometimes awkward — phase. I am not suggesting that we should give up on managing the process, but I do think this more authentically reflects how it feels to do research in an early stage project. A single insight might dramatically shift the direction you take — or even make you go backwards and question everything you did before.

We’re learning to embrace this feeling, all while working towards that single, straight line.

Thanks for tuning in again. The HIT Squad is ramping up for HIMSS, the largest healthcare IT conference in the US, next week. You can look forward to a post about that in the near future.

Selin and Jeong Min putting up our new wall decal. Indeed, we’ve been hustlin’.

And, if you’re going or know someone who’s going, have them holler at the HIT Squad — we’d love to connect.