UX Research - Who Cares?

Lisa Trumstedt at UXDX Community: Stockholm. Video: https://youtu.be/iMAIy-DhVE4

Readable transcript: edited from the recording's captions for readability (fillers and false starts removed, punctuation and section headings added). Wording is the speaker's own. Timestamps are positions in the video. Names marked [?] could not be verified against the audio.

Primary care is facing major challenges

[00:00:00] Host: So without further ado, I give you Lisa. Thank you.

[00:00:14] Lisa: Thank you. Nice to be here and see that so many of you are coming back from the sunshine in England. I'm Lisa. I work at Doctrin right now. A short introduction of myself: I think this is kind of a work related issue. You know, I'm used to putting everything up in a user journey. This is kind of my user journey, or my lifeline. It's a nice tool where you can just put up what you think is the most important or not important. There you have it.

[00:00:56] Lisa: So right now I work as a UX researcher at Doctrin. We had a short introduction of what we are and what we do. I'll give you some background about primary care, which is facing major challenges, and that's our area where we are working with our platform. As you see, new expectations, new technology and new needs, that are not unique for the healthcare sector. Those are the factors that are driving every new kind of revolution, or when we see a movement among the industry. But we also have this aging population, and this causes some big problems for primary care.

[00:01:46] Lisa: What we can see is low patient involvement. How do you think? Patients do not feel involved in their own patient journey when they are visiting healthcare centers, when they are meeting doctors and specialists. And that's really too bad. We have some quality problems. We have fantastic, absolutely fantastic doctors and nurses working out there, but these kinds of illnesses, mental illnesses, are quite hard to detect because you need more time with those patients, and time is something that our doctors and nurses really have a lack of.

[00:02:27] Lisa: So up to 75% of mental illnesses are not detected today. And we can also see that for the doctors themselves, the work absence is stress-related up to 19%, and that's not really, really good at all. And healthcare costs increase 1% or even more faster than BNP every year. Of course, we can't have it like this, and in the healthcare sector we have to help the doctors and nurses.

[00:03:10] Lisa: We can't just bring in more doctors and nurses. We need a new organization and a new way to work, and we really think they need some new tools to work with as well. And that's why we started Doctrin.

What Doctrin Flow does

[00:03:23] Lisa: We have a clear purpose. We want to radically improve healthcare, with our mission here: help healthcare providers to intelligently digitize the patient journey. I think that's awesome and really cool. With our platform and products, we can give the patient more involvement in their own patient journey, and we can certainly help the doctors and nurses work more effectively. So let me show you. Hopefully.

[00:04:11] Video: We can help healthcare providers. We want more engaged patients, a better working environment, and better use of resources. That's why we created Flow: a platform to prioritize, treat, and follow up with patients. Safe, secure, and online. Let the patient create their own patient history using our intelligent questionnaire tool. Talk directly to the patient to provide self-care recommendations. Book physical consultations, or treat the patient online. Doctrin Flow allows you to prioritize, treat, and follow up with patients. Safe, secure, and online. It's the future of healthcare.

[00:05:11] Lisa: That's a short introduction to our product Flow, which is actually used by Capio, which is one of Sweden's largest digital healthcare providers. Next time you feel ill, you just have to try it. You go into Capio's site and you can get it right there.

[00:05:37] Lisa: And I want you to remember two things from this film, what's really, really core for us when we're doing our product development. Because this was mentioned, that patients — I think the voice was saying the patient's medical history, or the medical history. It's true. It's when you saw the patient fill in the questionnaire, and it will all be summed up in a report for the caregiver who goes into the caregiver view, and we'll have this report before you start the visits. And second, this asynchronous communication is something that we really believe in and that we know is really affecting how we're doing care today, and it's a really effective way to do it.

UX research is boring and nobody reads it

[00:06:32] Lisa: So let's bring the topic into what we do at Doctrin: research and monitoring. It was the last topic when I was invited to speak here today. And yeah, UX research is boring and nobody reads it. I don't know how you felt about it before. I certainly have. I have been in organizations and worked with customers that say, oh no, no, no, no. We certainly do. We're so sure of what we're going to do, you don't need to do that. That research is, and nobody wants to read about it.

[00:07:12] Lisa: Well, I guess if we don't do the research, we don't get the user needs. In this phase we ask our whys, and those very important questions: are we really solving a real problem? For who are we doing it? And will the users use the feature or product we're developing? If we don't do that, we don't have any good ideas to start sketching on, or to do early user testing on. And if we don't do that, no good and nice design prototyping can be done either. It all starts there.

[00:08:05] Lisa: And of course, we are doing user tests early. We're doing them in the next step as well, and we're going forward to develop. And of course, it's also very, very important to do the monitoring in a nice and smooth way. Today I'm going to talk about the research and user tests, and the monitoring.

[00:08:36] Lisa: User tests and research, we do that to stay focused and be aligned with our users, which is doctors, nurses and patients. We are doing our user tests early. Just as mentioned before, we have to fail fast. We can't afford to do — I actually read on your guys' UXDX site that 33% of features are actually not supporting, or are affecting, the real product negatively. And that, we can't afford that as a company, as Doctrin. We have to work fast and fail fast, because our money really runs out and we can't do it that way. And of course, we have to be data driven and learn from our data as well. That, with the user tests, is one of the strongest ways to work, we think.

The user journey as a tool

[00:09:48] Lisa: And if we look at the user journey, that's what I think is a good tool to have. It helps us to stay focused and mitigate pain points for both doctors and patients. We use it to break down silos, or break down walls, I think you mentioned before. And this is to create one shared organization-wide understanding for our customer journeys. This assigns ownership for key touch points for a team or each specific person, and it really unifies our teams among the biggest problems to solve. And it can really also help us to prioritize. I think as a UX researcher, this is a really powerful tool to illustrate the work you'll be doing in the field, when you're doing interviews or when you're doing your user tests or when you're doing all that kind of research work. So this is something we are using daily at Doctrin.

[00:11:05] Lisa: Let me just take this example of how the traditional patient journey looks. I think you are all quite familiar with that. It starts now, in 2018, and I think most of the people I speak to, and when we see the statistics, they still call their local healthcare center. Or in the best case they can fill in a form. And then they have to wait. The pain point here. And then the nurse will call back and will ask a couple of questions, and hopefully you will get an appointment. I think the average waiting time for a doctor today in Swedish primary care is five to six days.

[00:12:01] Lisa: You have to go by the healthcare center, and then you have to wait again before you have this examination with your doctor. During the examination you meet an excellent doctor, of course, but this pain point is related to the medical history report, as I mentioned before, which in our products is done by the patient before the visit. Now, as we do it the traditional way, the doctors are answering all the questions when doing the examination with the patient, and it will affect the doctor. It can be a little bit, you know, how to work in the computer as well, and looking at the patient in the eye, and then he and she has to do the diagnosis as well.

[00:12:50] Lisa: And I've seen statistics on that, that our doctors are spending 4 million hours asking questions each year, when it can all be done before, by the patients themselves. After the visit you might go and take some tests, and to have the result from the test you will receive a letter, or maybe a phone call. And that will take — that's really, really stupid, isn't it?

[00:13:26] Lisa: So if we do it the way we're doing right now, with Doctrin Flow, you can 24-7 start your user or patient journey, and log in with BankID into the chat. There you start to do the medical history report by answering the questions, and you will know at a fixed time when you get an answer from a doctor that starts chatting with you. And afterwards, if you have to go and take some tests, or if you have to maybe have a revisit or something, you will get this information in the same channel, of course, in the chat.

[00:14:15] Lisa: And this, we know, works quite well. 83% of patients feel involved in their patient journey they have done through the Doctrin platform, and 84% more visits per doctor a day, because they are working asynchronously. They can have a few patients at the same time and they are working quite effectively.

Testing early: the pain scale example

[00:14:46] Lisa: So when we know why we are doing something and have an idea that we want to test, we bring in the users really, really early in the process. It's really, like someone mentioned, you're doing design on a napkin. Or we test it in our systems for doctors and patients that we have built, kind of test labs of our own. So if we want to create brilliant products, we need to make sure our users can and want to use them, hopefully efficiently and with ease, of course.

[00:15:30] Lisa: There was a question before of how many user tests you should do, and of course this really depends on what you're doing and the scope of the project. But really, really, one test is so much better than zero. So let's see an example here. When we tested, luckily early in the process, we tried to put one more question in our questionnaire.

[00:16:08] Lisa: This is the patient's view when you go into Doctrin Flow, and you have some questions. We have chosen now, I think, sinus in English. Bihålar[?]. Sinus, sorry, sinus. And we have this question: how would you define the pain in your sinuses? And we asked the patients to put down a number between 10 and zero, where 10 is the worst imaginable you can think of and where zero is no pain at all, and no problem. It's probably not the smoothest way to beg the patient for doing this, but it worked well, and no problem to do it. We couldn't see any mistakes.

[00:17:06] Lisa: And then we put in another question. Here you can actually not see that we changed the question, but this is a question about, how would you define your state of health, how would you behave today, on a scale where 10 is the best possible and zero is the worst imaginable? And this made a little chaos with our users. Even if you had maybe one question between those two, they were mixed up, because it's the same scale, but we mixed it up.

[00:17:47] Lisa: So we might help them with doing it something like this, with help from smileys or symbols. And we might do it like this, with one standing scale and the other one flat. That might be the best way to do it. We're not sure yet, we are doing some more user tests. And this is here: now we haven't spent one hour of development yet. Now we can go further on with some good ideas to put some real design on, and do some nice prototypes.

Monitoring, goals and dashboards

[00:18:26] Lisa: And now, as we skip the design and development phase, we go over to monitoring. We're working at high speed at Doctrin. We have four autonomous teams, as we were talking about before. And speed without data means you aren't learning anything, and that's quite correct. We really have to know when we have reached our goals, and how we — when we succeed when we're building something.

[00:19:05] Lisa: We are giving the power to the team to set their own goals and OKRs, and they should all be connected to our vision. And this, maybe it looks boring, but it's quite good when you have to get it done. So this is an example: in order to help healthcare providers to intelligently digitize the patient journey, Team Y, we mitigate pain points in the patient journey so that patients in an efficient way can get in touch with healthcare and get an appointment, by giving them the smoothest and easiest questionnaire to fill in their own medical history report.

[00:19:57] Lisa: And we know when we have succeeded, when our product works, when we see a questionnaire completion of 95, 98, 92%, and when patients rate their visit satisfaction by mostly the same, and when we can see that we really got real recommendations from other visits within our platform.

[00:20:23] Lisa: Absolutely, when you're working with goals and KPIs, and when you want to join the whole company or the team, and to make them look at the figures and make them funny — not funny, but interested in what we have reached — we set up our dashboards.

[00:21:05] Lisa: Here we have really something to work with at the screen, but of course we are working with our dashboards, and here's just one example. I'm not supposed to show this one, so let's move on.

[00:21:17] Lisa: This is what it's really been about: stay focused, keep on listening to the user needs and to what you're really developing among your products. Fail fast and be data driven and learn from your data, and keep the whole company and team engaged by monitoring your success. I think these are three ways that we think are really smart to work. But what we're aiming for, that's where we also put in our heart. That's what we are aiming for and what we're working for every day at Doctrin. We want to improve healthcare for one billion people, and that's what makes us go to work and makes it meaningful to work with developing our platforms. And that's probably the best thing about my work. So, thank you.

[00:22:25] Host: Thank you.