Making an impact with design in healthcare

I n August 2017, I was working on a project to redesign the tools online sellers use to manage and ship their orders. For sellers, getting sales was exciting, but keeping track of order statuses and shipping products all over the world was hard, especially as their shops grew. Regardless of the type of seller, ranging from side-hustle to full-time job, managing and shipping orders was taking away precious time doing what they love — creating beautiful, one-of-a-kind, handmade products. Our hypothesis was that if we built better shop management tools, we would enable our sellers to spend more time doing what they love, ultimately improving their .

One month later, in September 2017, I was sitting in Nashville, Tennessee, at a roundtable with two medical oncologists, one nurse and two billing administrators, discussing frustrations they had with a particular feature of their electronic health record. I had left my previous job with the realization that as a designer, I had many opportunities, some more impactful than others. Instead of helping people buy and sell things or spend more time scrolling on their phones, I wanted to contribute my skills to something that would actually lives.

My search took me to Flatiron Health, a healthcare technology company building a learning healthcare system in oncology. After learning more about Flatiron’s mission, I was excited to join, but I knew nothing about cancer, let alone healthcare.

I’ll admit, I was nervous. At the surface level, I was worried about declining opportunities at well-known companies and selfishly wasn’t sure I could handle thinking about cancer every day. At a deeper level, it was uncomfortable joining an industry I knew nothing about and I knew it would take real work to bring a diverse set of roles together to solve a hard problem. It was tempting to continue down the same path, working at company known for design and collaborating with people who think just like me, but instead I put my fears aside and decided to dive in to an industry that was suffering from the lack of design thinking — an industry starved of design.

Instead of helping people buy and sell things or spend more time scrolling on their phones, I wanted to contribute my skills to something that would actually improve lives.

My first project at Flatiron was to improve the way medical providers calculate chemotherapy doses. Although chemotherapy can be life saving, it’s also extremely toxic so, as a patient’s health changes over time, doses need to be manually updated to ensure patients are given the correct amount.

Medical providers calculating chemotherapy doses rely on their electronic health record (EHR). The EHR is an essential tool used in nearly every physician’s office across the country to digitally store and access patient records, and perform tasks like scheduling and administering medication. EHRs are not typically known for thoughtful design and are generally plagued with usability problems. The complex user experiences consume precious time doctors spend with their patients and fatigue users who interact with them for 8–10 hours a day. One of Flatiron’s priorities is to redesign core workflows to enable providers to spend more time with their patients, improve patient safety, and restore medical providers’ confidence in the digital tools that they use everyday.

When I started the project back in September, I worked directly with Ali Fugaro, one of Flatiron’s physicians assistants. We both had very different perspectives and expertise. Prior to Flatiron, Ali had worked in a clinic directly with patients, and had experience using various EHRs to calculate and prescribe chemotherapy. Ali is deeply knowledgeable about cancer care and had experienced the challenges of EHRs first-hand. On the other hand, I could barely pronounce the names of most things on the page I would be working on, but am skilled in creative problem solving, facilitation, and interaction design.

Not only will I never be the user, a medical provider, but there can be dangerous consequences when making assumptions and guesses.

In previous roles, consumer facing offerings, it was easier to speak the same language during the design process. Users were normally savvy consumers and my team was familiar with the design process. It was often easy to pretend that I was the user, make assumptions, and forget to challenge my own biases.

In the healthcare industry, it’s not as easy. Not only will I never be the user, a medical provider, but there can be dangerous consequences when making assumptions and guesses. And because the people I am collaborating with are less familiar with the design process, it’s important to find new ways to align and communicate.

Ali and I met weekly to discuss the project, ask each other questions, and align on priorities. As the project progressed, Ali and our customers, including doctors and pharmacists, played a crucial role in gathering diverse feedback. The clinical staff joined brainstorming sessions, design critiques and sprint planning. Practices joined research sessions to help us assess usability and identify unique chemotherapy dosing procedures. The strong bond between design and clinical was essential to understanding the problem’s depth and determining solutions to make it better.

It’s been a year since I have joined Flatiron, a decision now, looking back, was so obviously the right choice. I’m not concerned with whether people know the company I work at, instead I’m excited to tell them about our mission and the fulfillment that comes from working on solutions to real problems.

Unlike some industries where design is abundant, the healthcare industry still needs design. Our products are still catching up, greatly benefiting from simply reworking pages to follow standard design principles. Our partners are new to the design process, but willing to learn and excited to be involved. In the healthcare industry, design’s impact goes far beyond incremental improvements to things like conversion and engagement and is much more than visual consistency. We have the potential to establish new ways to collaborate, facilitate creative problem solving across a diverse set of roles, and reimagine healthcare. We have the opportunity to actually improve lives.

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