Better Patient Engagement Through User Experience

What is it like to engage users and customers in the healthcare field?  Each experience is different not only for the caregiver, but also for the patient. Can you recall a recent event that impacted your healthcare experience positively? What aspect of that experience contributed to you feeling engaged?  Let's think about patient engagement through the lens of User Experience (UX).

UX design vs. visual design

User Experience encompasses all aspects of the end-user's interaction with a company, its services, and its products.  This includes meeting the needs of the consumer, designing products that work as promised - perhaps better than promised - by anticipating customer needs, and creating a seamless experience across channels and experiences from marketing to service delivery.  

A common misconception with those outside the field of UX is that UX design is synonymous with UI design.  User experience design is about creating a holistic experience across devices, contexts, and usage modes. Visual design, among other things seen in the diagram below, are smaller parts of the whole that is UX Design.

Source: http://www.webdesignerdepot.com/

Source: http://www.webdesignerdepot.com/

Patient engagement vs. compliance

Similarly, patient engagement is not synonymous with compliance, but should be considered to be part of a holistic approach to healthcare.  Compliance can be described as the degree to which an individual obeys a directive from a healthcare provider.

Patient engagement is about increasing patient activation to help them take action to live healthily, prevent, manage, and treat disease states. Those that work in the healthcare field should be initiators of patient engagement, and UX designers should create tools to facilitate that engagement.

Customer engagement vs. customer service

In the context of the healthcare industry, the patient can be considered a customer. In the same way that patient engagement is not equal to compliance, customer engagement is not the same as customer service. Customer engagement and experience pertain to creating valuable, holistic, emotional, memorable, and individual experiences. On the other hand, customer service entails extracting value through, transactional, action-based, one-dimensional, and company focused interactions with the customer.

There are clear similarities between an individual as a 'patient' and as a 'consumer' with regard to the human-centric approach healthcare should adopt. For further reading on this subject check out Yes, 'Patient Engagement and Consumer Engagement are the Same Thing' by David Lee Scher.

Healthcare also happens outside the hospital

More than ninety percent of people partake in personal healthcare engagement in their own home and communities. Most aspects of care take place outside the hospital or clinic, meaning most healthcare experiences occur outside the hospital or clinic. It is apparent that we, as UX designers, must strive to facilitate patient and consumer engagement both in the clinic and in the home.

People want to comprehend and research their condition to feel empowered and equipped with the relevant knowledge about their condition. Unsurprisingly, the Internet is the primary source of this information. Once healthcare policy embraces this concept, the system will be better equipped to deal with proactive and information seeking patients. By educating and encouraging research into appropriate sources, the patient experience can be enhanced both at home and in healthcare institutions. User experience design can be used as a powerful tool for facilitating patient engagement and customer experience both within and outside healthcare institutions.

Thought leadership in patient experience

Let's take a look at a few examples of best practices in patient engagement and some considerations for the user experience designer.

Image Source: The Wall Street Journal (wsj.com)

Image Source: The Wall Street Journal (wsj.com)

“While we can’t please all people all the time, any goal short of 100% is unacceptable"
— Dr. David Feinberg, CEO of UCLA Medical System

David Feinberg is a prime example of best in class patient engagement. He listens to people; he spends two hours a day doing his rounds where he hands out business cards for his patients to contact him. At the same time his leadership team are exploring what is going right and wrong and work in a dynamic environment to learn how to deal with it in the moment.  As a result of this direct engagement, the number of patients at the Ronald Regan UCLA Medical Center willing to recommend the hospital to others skyrocketed, lifting their rating from the 57th percentile in July 2006 to the 95th percentile in March 2010.

Another incredible case is the Cleveland Clinic, which has jumped from the 55th percentile to the 92nd percentile in overall patient satisfaction among roughly 4,600 hospitals.

Image Source: Cleveland Clinic (clevelandclinic.org)

Image Source: Cleveland Clinic (clevelandclinic.org)

“The focus on customer/patient should be the most important thing in healthcare—and it can be a real differentiator in hospitals. But for many hospitals, patient experience is about making and keeping patients happy, which misses the point completely because patient experience is also about the philosophy of the delivery of care.
— Dr. James Merlino, Cleveland Clinic's Chief Experience Officer

In terms of designing a user experience for patient engagement, the following points  are guidelines to follow:

Make sure you know what success looks like.

  • Establish clear goals
  • Design metrics for success
  • Bring stakeholders into the process
  • Establish business case
  • Best designed technology that fades into the background (because users don't care about the technology, they care about the work they are trying to do)

Understand your customer experience.

  • Review customer satisfaction surveys
  • Conduct user interviews and focus groups
  • Consider in-situ ethnographic research
  • Map the customer journey and pain points
  • Incorporate the customer's into the design process

Always engineer for success.

  • Make experiences convenient and personal
  • Make experiences seamless across channels
  • Test prototype designs with consumers and redesign until you get it right (or as much as budget/resources allow)
  • Rethink policies and processes (ask why things are done the way they are, and what benefits could be gained from changing)
  • Redesign workflows and roles for the optimal experience

Implement, Monitor and Revamp

  • Train and educate staff
  • Measure engagement and customer satisfaction (or develop your own metrics driven by business KPIs)
  • Gather feedback from users regularly
  • Relentlessly review and continuously improve the experience
  • Build processes centred around getting the voice of the customer

These are practical approaches to engage healthcare consumers effectively.  None of them can be implemented overnight, effective change requires planning.

Engaging and segmenting users, such as the elderly, underserved, and millennials is key to understanding how better care can be delivered.  For example, text messaging services for the underserved user segment helps improve patient engagement and adherence to lifestyle changes.  Can you think of other creative ways we can reach different user segments as designers of future healthcare?

Continuous focus on user experience and patient engagement is key to good design in healthcare, however, facilitating engagement among staff and patients requires organisational change, iterative design, and a targeted measurement plan. Though there are challenges ahead, user experience will be a critical component of the long-term success of healthcare in both the clinic and community settings.


nicholas tenhue profile

Nicholas Tenhue is a user experience expert who currently serves as User Experience Manger at Orion Health. An alumnus of Microsoft Ventures, Nicholas also manages theuxblog.com, and hosts The UX Blog Podcast.