Delhi Development Authority
Information Architecture Redesign
Disseminating the Elements of Pre-Attentive Processing:
Understanding Visual Perception through Psychophysics and the Neural Processing Mechanisms
Disseminating the Elements of Pre-Attentive Processing:
Understanding Visual Perception through Psychophysics and the Neural Processing Mechanisms
Spring Health
Ethnography study
Spring Health is a tele mental health start-up that offers precision care channelised by its team of Care Navigators. The goal of the study was to understand the role of Care Navigators, their workflow, and challenges using the varied technology systems.
Our research involved conducting a series of interviews to reveal their pain paints and concluded with presenting insights and recommendations to improve this situation.
My Role
User Researcher,
Team of 4
Methods
Interviews, Affinity diagramming, Thematic analysis
Tools
Zoom, Otter,
Mural, Dovetail
Context
Spring Health is a tele mental healthcare start-up that aims at providing precision care. A critical part of the services the company offers is Care Navigation, provided by experienced clinicians who offer guidance to patients and connect them to a suitable provider in their network. These care navigators come from extremely challenging previous settings, to spearhead the development of protocols and processes, while conducting care navigation with a growing number of members. As a start-up the company used off-the-shelf solutions to enable interconnection between internal, external communication and electronic health record (EHR) systems, allowing Care Navigators to work and collaborate effectively remotely. As the company grew the initial startup processes and technology solutions were no longer sustainable.
In this context, Spring Health sponsored a UX research project and asked us to explore the problem of “increasing clinical time” for Care Navigators.
Project goals
The study had three goals:
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Gain an understanding of the workflow of Care Navigators, their needs and challenges.
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Insights and frameworks based on our research findings to guide innovative decisions for the future of the Care Navigator experience.
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Identify opportunities for improving the Care Navigator experience.
My Role
My role during this project was as a UX researcher on a team of 4. I was involved in each stage of the process, that included:
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Literature Research
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Stakeholder and Care Navigator Interviews
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Data analysis
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Presenting findings to client
Methodology
We conducted a qualitative field study into the Care Navigator Experience at Spring Health, the process included:
1. Research
2. Analysis
3. Synthesis
Primary: Interviews
Secondary:
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Stakeholders
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Care Navigators
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Care Co-ordinators
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Literature review
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Care Navigators job descriptions
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SH and its competitors
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Affinity diagramming
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Interview coding
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Journey mapping
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Job profile vs actual job
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Findings
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Need analysis
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Recommendations
Research
Primary research
Semi-structured interviews
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Conducted via Zoom
5 stakeholders
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Director of Operations,
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Clinical Navigation Manager,
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Director of Care Operations,
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Head of Health Plan Operations,
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Data Science Lead
Method
With
Why
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Understand company’s mission and goals
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Stakeholder's view of Care Navigation and understanding of the critical needs to be addressed
7 ethnographic remote interviews
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Individual interviews conducted via Zoom
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1 moderator + 1-3 note takers
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60-minute sessions broken up as follows:
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Semi-structured interviews (20 minutes)
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Photo elicitation using Mural board (20 minutes)
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Screen share walkthrough of SH technology tools and workflows (20 minutes)
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5 Care Navigators and
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2 Care Coordinators
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Understand their profile, a day-on-the -job
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To help identify needs and problems
Secondary research
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Scholarly articles on adjacent topics
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Care Navigator job descriptions
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SH and competitor websites
Care Navigator ethnographic interviews (60 minutes)
Conducted remotely via Zoom
Each interview session (60 mins) was divided into 3 parts:
1. Open-ended questions (20 mins)
Discussed the Care Navigators background and the daily activities to help identify needs and problems in the discovery phase.
Graphics source: undraw/illustrations
2. Photo elicitation (20 mins)
Participants sorted, and associated emotions with a collection of images selected to reflect different aspects of their job.
This technique was used to identify mental models and needs in a problem space.
3. Screen share walkthrough (20 mins)
Participants shared their screens and performed work tasks, which allowed us to see them interacting with interface issues directly.
Care Navigator Interview
Stakeholder Interview
Analysis
After each interview, we started organising the data.
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Insights from interviews and photo-elicitation exercise were analysed by clustering in Mural
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Interviews were coded line-by-line tagging needs, problems and the context of use for the multiple software tools used by Care Navigators and themes developed using Grounded theory coding using Dovetail
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We captured unique incidents or situations that were illustrative of Care Navigators experience in their work and role. We tried to better understand their personalities.
A day on the job
CN analysis
Mural board:
Collaborative task analysis and synthesis
Dovetail app - Interview coding
Findings
From our earliest interviews, we began to uncover disconnects in how the CN experience is perceived...
...and disparate technologies make an already complex job more fragmented.
Key pain points: Root causes
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Fragmented technology
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UI/UX design
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Organisational structure
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Siloed providers
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Member behavior
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Nature of the job
Initial job description: Guide members to the right care and better outcomes.
Full picture:
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Initial and follow-up calls
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Flurry of associated tasks
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Prepping before and after calls, or simultaneously while on a call with patient
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Triaging unscheduled chats, calls, and emails (up to 1,000/day for 13 CNs and CCs)
Critical gaps in the CN tool ecosystem
Need analysis
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Photo elicitation: Visual card sort
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Identified categories and emotions
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Workflow analysis
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Identified 117 Care Navigator tasks
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Mapped daily journey
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Task prioritisation
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Member call task analysis
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Initial member calls: Cognitive task analysis
From Card sort to needs: Maximise the quality of clinical time
33% tagged comments related to Zendesk, 25% related to SH admin and how it integrates with Zendesk
Recommendations
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Technology fragmentation and UX/UI Design
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Investigate features in Zendesk that might be able to alleviate ticket issues for Care Navigators.
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If Zendesk features don’t work, investigate Salesforce Health Cloud or Kareo Engage.
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Investigate integrating Acuity’s API into Spring Health Admin. Allow Care Navigators to handle scheduling in Admin.
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Organizational structure
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Address the need for transparency between siloed departments.
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Develop an SLA system for incoming tickets based on the triaging system the Care team uses - giving priority to urgency instead of recency
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Limitations and Challenges
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Small number of CN participants (initially only had access to 3 of 11 CNs), pushed for 5 CNs total
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Technology tools contained protected health/other confidential information. So we had to workaround it, we stopped video recording prior to the workflow walkthrough
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CNs are employees, might not feel comfortable sharing all of their insights. Therefore we anonymised all participant data
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No login access to the SH technology platform
Results and Next Steps
If the team were to continue this project past the final deliverable, some next steps would include:
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Conducting user interviews in CN's physical work setting (not only remote)
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Gather more information on toolkit used by competitors, to provide additional insights.