"We want to support the patient from long-distance to increase dynamic contact points in their 8 weeks of THA surgery rehabilitation, so patients can feel secure." - Stephan (orthopedic surgeon)
User Story
When a patient get over the shock of having to undergo a Total Hip Replacement surgery, the challenge of living a lifetime with Osteoarthritis begins. The patient has to make sure that they understand and will execute the instructions & exercises correctly, because 80% of recovery chances lands on 8 weeks of rehabilitation right after THA surgery. If not done right, the consequences are that either you can't walk without pain in future, can't play sports forever, or you may need an upcoming 2nd surgery due to dislocation or infection.
However, 40-80% medical information provided by healthcare practitioners is forgotten immediately, almost half of the information that is remembered is incorrect. Patient's are in urgent need of support to handle the constant change of information from practitioners through out 8 weeks of their rehabilitation journey.
Renier de Graaf Hospital - Orthopedic
(MSc Thesis Project, TUDelft)
June 2015 - June 2016
UX Researcher & UX Designer
Illustrator, InVision, Interview Scripts, Context-mapping Booklet prior Interview
Business Briefing
Next to a successful surgery, hospital aim to provide support to improve osteoarthritis patient experience for the complete treatment journey. There is a gap of understanding, where patient live their life with osteoarthritis outside of hospital’s knowledge range. The result of this design presents a strategy to help patients & THA team to manage the exchange of healthcare information, and to collect emotional & physical data to tailor the treatment plan.
1 UX Researcher/Designer (Me)
1 Orthopedic Surgeon- Client (Hospital)
1 Prosthesis Company Representative
1 UX Design Expert- Project Consultant
1 Ergonomic Expert - Project Consultant
Design Process
Design Strategy:
1. Eliciting patient’s expectations in relation to the structure, process, and outcome of their care.
2. Propose a change of patient’s perception or cues of action, by designing routes of communication with information strategies.
Design Strategy:
1. Manage and communicate realistic expectations to the patient.
2. Provide corresponding (written & visual) information support.
3. Address patient’s need of the up-to-date digital trends of patient-medical information relationship.
Participants: In total number of 4 young THA patients (average age of 58) were recruited and participated in the user research. Half male and half female, all in Dutch nationality, across different recovery stages from 3 weeks to 2 years after the surgery.
Young THA patient were targeted and recruited because demographic research shows that the upcoming osteoarthritis treatment will be facing baby-boomer generations in upcoming 5-10 years; thereof, tracing the background and habits of the target group will help to provide guidelines to service solutions responding to their specific needs.
Purpose of sensitizing-booklet: to probe patient to reflect through important incidents of their THA treatment pathways with sufficient time and in patient's own privet space, aim to retrieve impressions that might have been forgotten or unsaid. Patient receives the sensitizing booklet through post mail to their home from 4-7 days before the interview session was held, and should be complete before the interview.
The interview took place in patient's homes. (To observe how participants move up/down stairs, and to meet their care taker & family in person.)
Part 1. Go over important highlights in the sensitizing booklet - dive in deeper about positive & negative experiences in their journey.
Part 2. Capture patient's personal background and major concerns through part 1, extend the conversation towards a focus on treatment information communication, aim to understand the gap of needs from the current healthcare services and their ideal scenarios.
Part 3. At the end of interview, patients were asked to conclude their treatment experience in a 1 minute video recording to demonstrate their believes.
The interview aim to understand the reasons behind a standard service for THA regulation, to sketch a neutral point of view about healthcare services offered from Renier de Graaf hospital, and to avoid biased interpretation of patient's need (Goldstein, Elliott, and Guccione, 2000).
Part 1. The consultation content (during consultation meeting between surgeon and the patient prior the surgery). How decisions of patient's conditions being informed and discussed, compare examples of different individual cases.
Part 2. Confirmation of the standard THA treatment pathway, making sure literature review & observation session result were in-tune with surgeon's knowledge and perspective.
Part 3. What is hospital/surgeon's vision about their THA service offerings in 5-10 years from now?
The result demonstrate how treatment information pathway carried out between patient and different healthcare professionals (GP, orthopedic surgeon, orthopedic nurses, physiotherapist, and pharmacies), under home or care environment. The involvement of patient's loved ones as physical or mental support outside of Renier de Graaf Hospital's knowledge is becoming clear. Through this result, we see emphasis of where the treatment information miscommunication occurs, as well as a list of patient's pain-points and wishes to design for.
THA Patient
1. Design an effortless way to help the patient to remember & perform rehabilitation exercises accurately, prevent over-active or over-passive behaviors.
2. To help the patient to know what to expect in the next step of each recovery journey, to be able to receive instant feedbacks when uncertainty occurs.
3. Receive active feedbacks and supports in time from healthcare professionals.
4. Enable patients to maintain an overview of the recovery progress, from the aspect of physical activities, pain medication management, and appointments from different healthcare organizations.
Orthopedic Surgeon
1. Effective monitoring of patient's recovery progress, including physical activities, possible infections, possible dislocation of the prosthesis, and wearability (personal habits) of prosthesis use.
2. Effective communication regarding THA related information, to and from both parties between the patient and the orthopedic surgeons.
3. Help the patients to set realistic and beneficial expectations towards the recovery procedure, answering to patients' questions as a mean to achieve this result.
4. A vision of realistic implementation of the final design in the near future, where it will become a boost to surgeon's flow of work instead of disturbance, beneficial to all stakeholders in the Hospital.
Prosthesis Company
1. Think ahead of the market, expanding the product portfolio on top of the current prosthesis manufacturing services, explore the potential market in the digitalized era.
2. Provide patient-oriented services, reach to the end-users (the patient) as the next step of business strategy, to build brand awareness.
Be “Manager” of his/her recovery pathway, feeling the power of control over his/her instant conditions.
Images below demonstrate the development process of details from screen to screen in terms of physical & digital interactions between THA patient and actors from healthcare environment. 4 categories of activities was enlisted as result of user study and defined UX requirements:
(1) My treatment plan (2) My activity snapshots (3) My medication history (4) My OA calendar
1. Login with a patient number.
2. Rehabilitation exercise reminder and animation demonstration.
3. View your activity diary to monitor the progress overview.
4. Add snapshot of moments with photos or videos to remember.
5. Ask direct questions to the THA team at any time & place.
6. Receive instant support & feedbacks from surgeon at times of alert.
7. Request medicines according to personalized level of pain.
(A) Apply for new medicine prescription & home delivery
(B) Arrange appointments with the Hospital
(C) Asking personal questions to the appointed person in his/her THA team
Answer & respond to patient's requests and needs in time with clear message history
Option 1:
Hospital turn the recording off forever according to patient's request. The disabled micro-chip track & trace function is not revertible to prevent from possible hacking.
Option 2:
(A) Upgrade to the post recovery version to continue the use of service App.
(B) Some functions would be changed, enabled, or disabled after the system upgrade. (For instance, patient would be in long-term contact with physiotherapist hence certain functions would be enabled; at the same time no more digital feedback from the surgeon after the 8th week.)
4 interaction designers participated in one-on-one product-service evaluation of my design. Each participant were giving the background and scenarios of THA treatment journey. Participants click-through the design on InVision and speak-out-loud on the point of improvements.
