HXD Reflections: Exploring Digital and Analog Patient Experiences

The following is an article written by Katie D. McMillan, MPH, Associate Director of the Mobile App Gateway at Duke Health. This post is the second in a series reflecting on the recent Healthcare Experience Design (HXD) conference in Cambridge, MA. Powered by the team at Mad*Pow in Boston, HXD is focused on the future of health with a lens toward human-centered design.

In early April I had the pleasure of attending the Health Experience Design Conference, hosted by MadPow. This was my first time at HXD. It was suggested to me by André Blackman, the founder of Onboard Health, during the Digital Health Impact and Transformation Summit in NC, and upon further investigation, HXD felt like the right type of conference for me. Intimate (at least in conference terms — just a few hundred people versus thousands), creative, multi-disciplinary, and in one of my favorite health tech cities — Boston.

I spend my work days thinking about the intersection of design and technology in healthcare, working with researchers, clinicians, and health system administrators to build or buy solutions to improve patient engagement, education, monitoring, tracking, access to resources and more. I feel like I am constantly beating the drum for significant investment in user experience and design when it comes to technology solutions. It occasionally falls on deaf ears who favor function over form. I liked the idea of being surrounded by what I hoped were ‘my people’ who think beyond features and contemplate and care about the health care experience and how technology can play a beneficial role.

Photo by Lance Anderson on Unsplash

I have my usual events I attend each year like Connected Health, but I love to throw something new into the mix to expose myself to new ideas and people. I noticed when I looked around the audience during the first keynote that this event attracted a younger, hipper crowd (few suits), with remarkably more women than I am used to seeing at healthcare conferences. I was pleased about these differentiators.

I am one of those conference nerds that tries to go to as many sessions as possible. Please tell me I’m not the only one who struggles when it is time for concurrent sessions! Luckily — the first one I chose featured Jennifer Smerdel of the Mayo Clinic Center for Innovation. Jennifer knocked it out of the park. What I found so compelling about her presentation was the amount of in-depth research she conducted to understand the experience of patients at Mayo Clinic. She shadowed over 70 patients on their care journey and documented friction points in both the physical spaces as well as PROs.

PROS, or Patient Reported Outcomes, are a hot topic in healthcare right now, and discussions on how they are collected, used, and incorporated into care plans vary widely. As Jennifer spoke to patients, they believed the information they filled out would be seen by the provider for use in their care decisions, despite the amount of times she explained that it was for population health and research purposes only. Administration at the Mayo Clinic thought it was acceptable to ask patients every 2 weeks to fill out forms, while patients were only willing to complete something once or twice a year! Jennifer also shared a story of a patient with a brain tumor who really struggled through 35 questions on a tablet that was hard to look at and took over an hour to finish. These stories can help us better design patient centered care and I look forward to following Jennifer’s work.

Another presentation that jumped out to me was by Madhavi Jagdish of Pear Therapeutics.

Pear Therapeutics holds the honor of creating the first FDA approved digital therapeutic. If you aren’t familiar with digital therapeutics it’s a special area of digital health tools that are considered to be treatment in conjunction with or replacement of traditional pharmaceutical treatment. These types of products are held to a high standard of research rigor for clinical validation. Pear’s current offerings include products for substance use disorder and opioid use disorder and they have quite a few products in the pipeline.

Madhavi spoke about how they are using React Native to build their apps so they can code in one language and deploy to both Apple and Android phones and how they are moving towards modular components and UI kits to accelerate the pace of development. The crowd had many questions — including myself! What was their business model? (Selling to payors.) How did they use agile development when they were subject to federal approvals? (Lots of paperwork.) How did they identify new areas of ‘drug’ development? (Market research.) Pear is one to watch and it was really interesting to me to hear that while they are a market leader in digital therapeutics, they are still a startup trying to figure out processes, logistics, and efficiency.

Photo by Thomas Kelley on Unsplash

Finally, I was really entertained by Cynthia Sharpe of Thinkwell Group. She has the COOLEST JOB — she designs theme parks and museum experiences! I was quickly sucked in to her Disney case study. I knew Disney’s processes were, well, magical, to say to least, put hearing how it works under the hood blew me away. The way they plan for the best and worst case scenario, how they dress their staff so guests can intuitively understand who’s in charge, and the way the make waiting in the hot Florida summer sun an actually pleasant experience takes an incredible amount of planning. Her co-presenter, a physician turned experience designer shared his own story of being at Disney with his family — hot and tired at the end of the day. His daughter wanted a slushee and he wanted to go home. The slushee lady made a comment or joke to the family and they moved into her aura. She knew that what the family needed wasn’t really a slushee but a place to rest and regroup. I learned that Disney has tons of these spots around their campus.

A light went off in my head — where are the regroup spaces in clinics or hospitals? Our waiting rooms are public. Typically, you check in, have vitals read, move into an exam room, and then pay your bill if you haven’t and walk out. But what if you receive bad news? Is there anywhere else to sit and collect yourself that doesn’t have a sterile exam table in it and flu shot posters? Not that I’ve seen. This is a huge opportunity to imagine contingency plans for patients where not everything is business as usual and treat them as humans who need to process emotions. I hope to see change in the physical design of clinics so we can really care for patients.

This is just a small sample of the sessions at HXD but I am already looking forward to next year. It’s heartening to be surrounded by people filled with energy and ideas, who also believe the world can be a better place through some attention to detail and design.