Mahtab: Welcome to episode two of The Crux Of It. We are going to be talking about the user experience of delivering healthcare online. I'm Mahtab Rezai. I'm the principal and the CEO of Crux Collaborative. We're a user experience consulting firm specializing in regulated industries, and obviously healthcare is one of the biggest regulated industries there is. I'm joined by my coworker, Katherine Block. Hi Katherine.

Katherine: Hello.

Mahtab: She's a consultant and a user experience designer. She's a project coordinator. She's an all around jack of all trades. She's also a fire dancer but that part of her skillset does not often come into play as much when it comes to user experience consulting, sadly. Maybe we can find a way to bring some fire into it.

Today we're going to spend 10 minutes talking about the unique design considerations of delivering healthcare online. This is really such an important topic because the growth in the online healthcare space and in med tech has been, and continues to be, exponential. The options of how to seek care and do so online in using these tools feels like it's growing week to week. Sometimes it feels like it's growing day to day. It's really important to understand - and take the unique aspects of designing for a user who's seeking care - into context when designing these experiences and these tools.

We're going to talk about some of those things today. The first thing we're going to talk about is the defining characteristics of an audience that's seeking care online. Katherine, why don't you start us off. Talk about some of the things that we consider or know about these folks.

Katherine: Sure. Obviously people are seeking healthcare online because they are sick or they might be doing it on behalf of a sick child, so dealing with the stress of not knowing what's wrong, not feeling well, they're just not feeling all that great. You want to remember that they're already in a state of not feeling good.

Mahtab: They're in distress. The way that we behave in any context when we're in distress is different than the way we behave when we're not. Any day-to-day action, the way that we're driving when we're in distress is different than when we're driving when we're calm.

Katherine: Absolutely.

Mahtab: What's another thing?

Katherine: Another thing is they're often in a hurry. It's not something that they necessarily planned on being sick and they've got other things that they want to do and get to or just get this taken care of. Maybe get a prescription and get going on that so that they can start to feel better. It's important to remember that it needs to be pretty quick.

Mahtab: Also I think for caregivers, when they're trying to care for someone else they're also feeling an extra sense of urgency because they're feeling the responsibility of, whether it's their child or someone else not feeling well, and wanting to resolve that as quickly as possible.

How about the third thing, which is a little bit about feeling vulnerable and worried, which plays into what happens when you're in distress and in a hurry. When that happens you can get thrown off by these other factors. You can get thrown off when you see a cost that could be associated with something you need, or when you see a data point about an outcome, or what something could be. Have you observed that when you have done research studies?

Katherine: Yeah, I think especially the bit about cost. If it's not clearly explained what the cost is, what it's for, what's included in that cost and setting expectations for other potential costs, when people are sick it's not something they want to have to pay that much more for.

Mahtab: They will immediately lock into a number and go down a worse case scenario standpoint, or if it appears to be too small there'll be an immediate suspicion and lack of trust. Especially when people are feeling vulnerable and worried, giving them small bits of information a little bit at a time, helps. We, in the course of conducting research on these types of experiences and having folks in the ulab to go through, have identified some key things that often appear, four things we would say not to do. The “What Not To Do” of the UX of delivering healthcare online.

Thing number one?

Katherine: Not telling them how long it's going to take. If people are already stressed out, and we go back to being in a hurry, being in distress, if they don't know how long something is going to take - they're not going to want to sit there for minutes, potentially hours, clicking through and answering questions. They want to know how long is it going to take? How many more steps do I have before I'm done and I can get what I need and get out? I think that that's a big not to do.

Mahtab: Absolutely. It's amazing the amount of relief just a little bit of context in being told, "Oh, there's just five things and then I'm going to get to an answer," as opposed to the amount of stress they feel even when they're just on thing two but they don't know how many more there are going to be until they get to an answer. Just telling them it's this many steps or this will take about 7 minutes or whatever, it is so pivotal to getting them to engage with and stay with the experience till they get to the outcome.

Katherine: Just allowing them to feel like they're making progress helps make them feel more comfortable with the process.

Mahtab: So key. Thing number two?

Katherine: Not providing enough options to answer questions. For example, if you're giving them a survey and asking them questions about what their health condition is, if you don't give them enough or the right options to answer, you're not going to get the right details from them or they're not going to be sure how to answer those questions. Sometimes if it's a yes/no question but they don't know how to answer it, you have to give them some room to say, "I don't know."

Mahtab: Give me an example of what one of those types of questions could be.

Katherine: When did these symptoms start, especially if you're dealing with a child. You may not necessarily know when their throat started to get scratchy. Having a few options for days, weeks, but then an I don't know option, because sometimes they're not going to have that answer.

Mahtab: They might feel like, "I guess I can't keep going."

Katherine: Or I have to lie, or I have to give the wrong information which could impact the diagnosis that they get.

Mahtab: That's so important. Making sure that there's a whole variety of options including the option to not know exactly, especially around health. I just think that's so tricky.

Katherine: Right. The other part of it is in the options that they have to answer, if they're asked to provide the degree of something, if it's mild, moderate or severe, give them the context for what those mean. Give them that context to be able to answer it confidently.

Mahtab: That's a really good point. Thing number three to not do?

Katherine: Leave them hanging. Making them wait for a long time to get a diagnosis, or not giving them an idea of how long it's going to take to get a diagnosis. Often in the digital age we have this instant gratification expectation, and yet in healthcare that's not a reasonable thing to expect. Sometimes it takes time for clinicians to get to their survey or their questions and answer that. Give them an expectation for, you'll receive a follow up in about an hour.

Mahtab: Just even the context of what's happening.

Katherine: Right.

Mahtab: I think that's the other thing is, a lot of times we feel like we're left hanging when we don't know why we're waiting. If someone merely says, "These results typically take about such and such time," then you're like, "Oh, okay, this is what's happening." I think a context or a reason for wait times is also super important.

Katherine: Right, like a clinician is reviewing these. It gives a little bit more of a human factor to what's being reviewed, not that the system is assessing their information and they'll get a response right away because of that.

Mahtab: Last but not least is: not meeting them where they are. Part of what happens here is people are looking for immediate relief. We talked earlier about the fact that they're in distress, they are worried, they're concerned. Sometimes these online delivery tools are also trying to be helpful. They're often trying to affect outcomes outside of just this one instance. What happens when they do things like provide a wellness information or behavioral change information in the wrong context is they are met with complete resistance and they lose trust. At that moment where that consumer is, or where the member is, is they want help about the immediate thing. They want immediate relief. They don't want to know how to prevent this in the future.

Once you've helped them there absolutely is a receptivity to some of that information, but making sure that you're doing things in the right order and you're meeting people where they are in their process is so key.

Katherine: It's also important to consider instances where you can't help them, where you can't provide a diagnosis where there's not enough information that they've been able to provide, or that it might be worse than they think it is. It's important to not just tell them, "You have to go see a doctor," but in the meantime here are some other things that you can do that often help relieve symptoms or might make you feel better in the meantime. Here's some over the counter medications. or something that you can get access to.

Mahtab: I think that's a good chunk of information to start with. If you have any questions about what we shared, other questions or topics you'd like us to answer or discuss, or any other feedback, our contact information is on our website. Thank you for listening. You can find us on Sound Cloud, on iTunes, and on cruxcollaborative.com/thecruxofit. Bye.

Katherine: Bye.