OnTrack
A Carnegie Mellon Capstone Project with UPMC Enterprises
With the goal of reducing hospital readmissions, five human-computer interaction students set out to support patient-provider collaboration in hospitals. We created OnTrack, a tool that engages patients in co-creating their care plans alongside hospital staff, helping them feel increased ownership of their health moving forward.
About the Project
The Problem of Readmissions
Readmissions cause both emotional and financial stress for patients and caregivers. Many of these readmissions can be prevented if patients better understood how to care for themselves following their hospital discharge.
Readmissions & Discharge Planning
UPMC Enterprises charged our team with coming up with a solution to help reduce readmissions by exploring the discharge planning process.
We were asked to create a tool that addressed factors outside the hospital that are critical to patient outcomes, like a patient’s support system, transportation, access to follow-up care and more. Our task was to support clearer communication and planning around these “soft factors” during care transitions, ultimately reducing a patient’s risk for readmission.
Patient‑Provider Collaboration
- Providers can better understand patients’ lives outside the hospital.
- Patients can more fully clarify, understand, and even shape and co-create their plans.
- Chronic disease patients’ adherence to care instructions will improve, due to a sense of ownership and empowerment, leading to better health outcomes and reduced readmission rates.
Our Vision
Discovery Methods
Understanding The Problem Space
We conducted research to gain an end-to-end view of discharge planning by looking at a patient’s journey from hospital stay, to discharge, to the home.
Researching The Domain
Literature Review
Healthcare Landscape
Our Competitors
Exploring The Patient’s Journey
In‑hospital Shadowing
We observed how each role in the discharge team interacted with the patients and with each other during in-depth shadowing sessions. We identified pain points and opportunities for increased collaboration during these interactions.
Expert Interviews
We consulted experts in healthcare, care administration, pedagogy, human-computer interaction, and service design throughout our process to gain insight into how we could increase patient engagement and improve patient-provider communication at hospitals.
Interviews
To gain in depth understanding of a patient’s experience during the discharge process and after, we interviewed over 15 patients who were recently discharged from the hospital. We also visited them in their homes to see where they kept their discharge packets and how they managed their complex medication regimen.
Diary Studies
We gave diaries to patients so they could record their thoughts and feelings for 10 days after discharge from the hospital. They also recorded if they were able to follow their care instructions each day, as well as personal obstacles and challenges that made following instructions difficult.
Rehab Facility Visits
Through interviews, we found that heart failure patients who visited cardiac rehab facilities had lower readmission rates than those who did not. We gained access to a rehab facility where we observed some of the best practices used in keeping the patient motivated.
Synthesis
Generating Insights from Our Research
Affinity Diagram
Our interviews and shadowing sessions generated over 1,400 notes which we grouped into meaningful clusters using an affinity diagram. We used this process to draw high-level insights that provided the basis for generating design ideas.
Patient Personas
Through our primary research, we discovered the common behaviors, thoughts, and feelings that influence non-compliance, synthesizing these findings to create patient personas. We also used findings from our literature review to decide on the medical conditions and age group for the personas we developed.
Journey Map
We came across a variety of stories about patients’ care transition journeys. We synthesized this information to create a hospital journey, focusing on opportunities for additional collaboration between patients and providers in creating the discharge plan.
Ideation
Establishing a Vision For The Product
Setting the direction
To understand what design ideas would be most feasible and have the highest impact, we created a short-list of 40 ideas of possible solutions based on 10 of our top findings. We then asked our client to map these ideas to an impact vs. feasibility matrix while explaining their rationale.
Testing Our Early Visions
To validate the need for certain features, we created storyboards and shared them with providers and patients to get their quick reactions, as well as trigger deeper conversations about their needs.
Design
Creating a Collaboration Tool
Role Playing
We used generative role-play to brainstorm what tablet interactions might be effective and engaging in the context of a hospital space.
Paper Prototyping
Next, we tested our best interface ideas with patients and providers using paper prototypes to discover which interactions they found most effective and engaging.
Interactive Wireframes
After selecting the most effective interaction base, we created semi-functional wireframes and tested how usable patients found each screen.
Wizard of Oz
We worked in the backend to manually simulate and test features that weren’t yet functional, but that we intended to include in our final design.
Functional Prototyping
Synthesizing our testing findings from previous design iterations, we created a functional prototype with high-fidelity visuals. We observed how patients used it, both at the hospital and at home, to test the usability and look and feel.
Next Steps
From testing, we concluded that OnTrack has the potential to change patient-provider relationships and drive patients to be in control of their plan. We have passed our solution to UPMC for further development and pilot testing.
Final Deliverables
- a 3-minute concept video
- a high-fidelity, interactive prototype
- a web-based, functional prototype
- a 40-page research report
- a 40-page design report
- 2 × 40-minute presentations
“This application is engaging because it shows interest in me as an individual. These are things about me the hospital should know, and they don’t ask those questions now.” —Mary, Heart Failure Patient
“This is fun! It’s like playing solitaire or bingo!” —Dora, Diabetes Patient
Team Quetzal
Anna Malone
Team Lead
Anna has a background in English, Philosophy and UX Design. Within the field of user-centered design, she aspires to empower people and improve their daily lives.
Diya Deb
UX Lead
Diya has a background in Industrial Design and UX Design. She views user-centered service design systems as a means of introducing positive social change.
Jay Liu
Tech Lead
Jay does UX design, prototyping, and web development. He endeavors to serve and empower people through the effective design of technology.
Mike Szegedy
Design Lead
Mike has over 10 years of industry experience in interaction design and UX research. He enjoys difficult problems and exploring new design spaces.
Tina Jose
Research Lead
With a background in Design and Psychology, Tina has worked in the digital space for over 10 years. She enjoys finding elegant solutions for complex problems, and sees herself as an advocate for the user.