Portfolio: Delving into Understanding

I contend that the UX discipline is centered around the soft skills of Understanding, Definition, and Communication. This is the first of four portfolio pieces, where I delve into how I’ve illuminated and guided digital health projects with powerful skills in Understanding. (My other portfolio pieces are linked sequentially, and explore Definition, Communication, and also Design Leadership.)

My professional focus has been on digital health, healthcare and medical devices for coming up on twenty years now. Absolutely foundational to my work practices are research activities that illuminate user needs so that we may design the right solutions for the right target users. (I’m not one to shy away from the word “user” — I’ll use the more specific “customer” or “patient” or “physician” where appropriate but “user” is a helpful short-hand.)

Generative Research

The first research activities that are critical to the success of new products are generative in nature — they actually produce original insights into the behaviors and goals of people, which allows us to identify opportunities for innovation and market success.

Typically, ethnographic-style research in the field is the most productive and efficient method for generative research. I have led many field research efforts in this way, combining interviews and observation of users in their work context.

When re-designing a medical device known as the Pacing System Analyzer at St. Jude Medical, such work included observing cardiac rhythm management device implant procedures in the operating room. I’ll never forget the smell of cauterizing flesh! But, this was a small price to pay for the depth of insight achieved about the challenges of clinical field engineers conducting their tests with the Pacing System Analyzer system at a distance, alongside surgeons and associated medical professionals who stand in the sterile field around the patient. This understanding allowed us to define more usable industrial design elements of the ultimate solution (a longer cabling system) and high-lighted the imperative of rapid, automated tests to ensure proper functioning of the pacemaker or defibrillator.

Simple schematic of actors in the Operating Room context of use when the Pacing System Analyzer is used

When re-designing the entire hardware/software system that became known as the Merlin Patient Care System (PCS) Programmer at St. Jude Medical (now Abbott), I led several months of field research at clinics all over the country.

Example of a “follow-up” room filled with Programmers at a clinic

The Programmer system is used to monitor and update the functioning of Class III implantable cardiac rhythm management devices (namely, pacemakers & defibrillators). We were able to identify that the true primary persona who uses the system is a Pacer Nurse — the Nurse, as usual, is the lifeblood of the whole healthcare industry. Previously, St. Jude Medical had designed their Programmer software considering the needs of the Electrophysiologist, who is a physician with extremely advanced technical understanding of the heart as an electrical system and who speaks a unique language as a result. A system designed for the Electrophysiologist is very hard for a Nurse to use, but a software system designed for a Nurse (which can produce printed reports designed for the Electrophysiologist) becomes a friendly and usable system.

Merlin PCS persona set — featuring Marlo Fisher, the Pacer Nurse

Our team created personas that represented the various actors of the Programmer system. We used them to prioritize various users’ needs and socialize this understanding of our true design target. The Pacer Nurse persona, Marlo Fisher, became a touchstone for the organization throughout the subsequent years of design and development. When the Merlin PCS launched, its marketing tagline was: “Designed by clinicians, for clinicians”. The product was lauded by the industry and Pacer Nurses in particular, and after its launch the company moved rapidly from a distant third in the market to a close second behind Medtronic.

Merlin PCS: “Designed by clinicians for clinicians”

When re-designing the Revenue Cycle Solution for the Huron Consulting Group (formerly known as Stockamp), my Devise Consulting team conducted interviews and observations with all of the various roles involved in this complex aspect of hospitals’ operational workflow. We conveyed the insight that properly-designed revenue cycle software could become the “glue” of the back-office activities associated with hospital activities, and this view took hold with executives and informed our subsequent design activities. No aspect of the revenue cycle workflow operated in total isolation from another. The key patient improvement we enacted through this insight was reducing the number of pre-procedure calls from the hospital to the patient to a single touchpoint that handled both pre-registration and billing items.

A snapshot from videos of Revenue Cycle Solution users, as captured during field research

Evaluative Research

The other kind of research that’s critical to UX understanding is evaluative research that studies how existing products and services, or design concepts, are functioning today with users. I’m well versed in such research. Most often, this comprises usability testing (some call this “user testing” but this is a misnomer because it’s not the user who is tested but rather the software’s usability for people).

Another common method is focus groups, which have their place in understanding the value and positioning of a product or service in the marketplace (as opposed to its usability in terms of how well detailed interactions function). Another form of evaluative research is having analytics from instrumented digital systems, which allows product owners and designers to study the use of systems at scale. Examples of this tool for websites include Google Analytics or Hotjar, while native apps usually require custom code development.

At Qantas Insurance, our Product team conducted all kinds of evaluative research on a regular basis. We managed two platforms: the (mobile-responsive) website that sold the insurance policies themselves, and the native app, now known as Qantas Wellbeing, that provided value for insurance policy-holders and prospects. We would run focus groups to understand the value of new features with target audiences. We would conduct rounds of usability testing with concepts to ensure that we had the language and interactions correct for our different customer segments. We also stood up analytics solutions in our digital platforms and studied data on a regular basis — to the point where I created the role of and hired for a Product Analyst on my team.

I have many more examples and stories of how UX research activities created new and deeper understanding of the range of personas in the problem space, the user goals & unmet needs to be served, and the business opportunities around them all. However, UX research is almost never an end-in-and-of-itself. And in my practice, I move directly onwards to defining solutions that serve and delight target users while delivering great outcomes.