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Care Link: Telehealth Enterprise Application Software

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The Design Process

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Identifying a viable Opportunity Space

 
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From our market research, we know that long-term care services is an area of opportunity. Which was why we decided to focus on providing our service to facilities, bypassing the individual directly, thereby reaching a potentially greater audience.

 
 

Competitive Feature Analysis Diagram: This allows us to better understand what features and attributes are currently lacking in the industry.

Positioning Matrix: Current solutions heavily focus on the logistics and scheduling of staff in facilities. Care Link aims to tackle telemedicine enterprise software solutions from a human-centered approach; focusing on our users.

 
 

How would Care Link sustain as a business?

After we understood our competition in the industry, we drew up a lean canvas to better position Care Link as a business entity that could ultimately make profit a a startup company. Some of the factors we considered include operating costs, fixed, variable costs, and infrastructure costs. 

We understood that as an enterprise software solution, Care Link would need to consider another user: the "chooser", directors in these long-term care facilities. Consequently, with the new user in mind, we had to find a revenue stream that would benefit both our business and the facility that we would be working with. 

Conclusively, Care Link would adopt a Price Per Seat solution, which would allow for us to retain flexibility of our pricing rates in reflecting the number of people using the software.   

 
 

Lean Canvas: Care Link as a business entity and what that entails.

 
 

Finding the Right User: Why Facility Caregivers? 

Before going into the field, we decided to flesh out our assumed roles with an affinity diagram. This is so that we can come up with better research guides for our interviewees. Our affinity diagram consolidated our interpretations of the secondary research we conducted on our assumed roles thus far. 

 
 

Affinity Diagram: Consolidating interpretations of secondary research of our assumed roles; Formal Caregiver Resident Aide, Assisted Living Facility Director, Residents with Alzheimer's

The overall theme we've identified for our assumed roles is that lack of training and feeling inferior leads to high-stress situations.

 
 

Bringing our Assumptions to the Field

Once we had a better understanding of caregivers from our secondary research, we went out to interview and observe caregivers working in the field. We use our assumptions to guide us in creating research questions and success metrics.

 
 
 
 

Our Key Insight

After our foray into the field, we came out with our key insight which led us to focus on facility caregivers. More specifically, on caregivers who are working in assisted living facilities. Caregivers working in assisted living facilities have twice the workload of those working in memory care facilities, who are often more trained as well. 

 
 

Assisted Living Facilities

  • Caregiver: Care-recipient
    1:12

  • Structured more for general needs and activities of elderly residents.

  • Has less regulations and typically cheaper in fees.

  • Caregivers are not required to have basic nursing training.

Memory Care Facilities

  • Caregiver: Care-recipient
    1:6

  • Accepts less residents

  • Provides more specific clinical services to upper stage Alzheimer's recipients

  • Caregivers are required to have basic nursing training.

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What is Integral to their Occupation?

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There is a revolving door for caregivers, as it is a high burnout rate occupation.
— LORI (MANAGEMENT)
Getting to know the person’s habits, and understanding their visual cues for example, crossing their arms, is crucial.
— LAKESHA (CAREGIVER)
The most important patient is the patient you’re with at the time, don’t think about others when you’re dealing with them. Everybody else can wait.
— ODESSA (CAREGIVER)
Record changes they’ve witnessed and make sure everyone involved (physicians, family members etc) are on board with the plan of care.
— WENDY (MANAGEMENT)

From the data that we had gathered, we came up with patterns that we found to be relevant to the subject matter. The behavioral continuum helped us in consolidating qualitative data and giving us the means to quantify them. 

After spotting distinct behavioral clusters of our interviewees, we had the characteristics we needed to outline two personas that have now been validated by both primary and secondary research.

 
 

Meet Beth, our primary persona.

 
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Background:

Beth is a 45 year old caregiver at an assisted living facility. She has studied up till high school, and has no further nurse training. She currently earns CA minimum wage.

Motivations:

  • High-stress nature of her occupation.

  • Fear of unintentionally hurting residents she's grown to care for.

  • Becoming on par with Certified Nursing Assistants.

Pain Points:

  • Lack of formal education on nursing.

  • Cumbersome reporting process.

  • Handling difficult residents.

Goals:

  • Stress-free management of residents under her care.

  • Meet the specific needs of both residents and their families.

  • Cover more residents without compromising quality of care.

 

Activities:

  • Alternating between residents and their needs, prioritizing and quickly assessing which needs her attention first.

  • Carrying out Activities of Daily Living

  • Following resident routines

  • Communicating with other caregivers about residents' information in-between shifts.

  • Engaging with residents to keep them active.

 
 

Iterative Design: Testing and refining while user testing

With our primary user being identified, we fleshed out the ideal flow we envision for her as a caregiver working in an assisted living facility. Ideally, we would want Care Link to decrease the stress-induced by the nature of her work.

 
 
 

Ideal Flow for Beth

 
 
 

Field Research Tools

Before going out into testing with our users, we created cue cards as a form of tool in accordance to Steve Krug's rules on, making sure we do not lead them into an answer. Instead, we prompted them with questions, and scenarios. 

 
 
 

Iterative Design Process

 
 
 

Round One

Key Paths Targeted: 

1. Login

2. Access Resident Profiles

3. Viewing Timeline of all Tasks

4. Setting up Live Video Call with Nurse

5. Receiving Management Notifications

6. Taking an Audio Note

7. Viewing Post-Shift Lesson Plans

 

 

 

Insights:

Key Wireframes:

iPad Mini Wireframes

Landing Page: Resident Schedule

 

Note Taking + Resident Profile

 

Help Livestream with Certified Nursing Assistant

 

Design Concerns:

Tablet too large, not practical for active caregivers. High chance of breaking.

Time stamps to indicate when note was taken.

Audio notes low discoverability.

Contextual Concerns:

Adding dietary restrictions and health status

Make schedule more specific to resident

Lesson plan should be limited to 5 minutes for it to work.

Round Two

 
 
 

Key Wireframes:

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Task Schedule Timeline

 

Resident Notes

 

Help Livestream with Certified Nursing Assistant

 

Insights:

 

Design Concerns:

Hardware, tablet still too large.

Task listing too overwhelming.

Contextual Concerns:

Live streaming not practical.

Unreasonable expectations for lesson plan

 
Caregivers would value task completion above anything else. They don’t really want to know so far ahead.
No nurse would be on their station for the whole day. That is just not how it works. They use their walkie talkie.
Most caregivers are older women and would have difficulty with the complexity of your interface.
Realistically, no caregiver has the interest or time to watch a bunch of videos. Managers don’t want another thing to keep track and provide content for.
Specific lesson plans would single out caregivers for their faults. Training should be done as a group.
 

Round Three

-- Neil (Director of Facilities/IT)

Key Paths Targeted: REVISED

1. Login

2. Access Current Resident Profiles

3. View timeline of current tasks

4. Request Help from Caregiver

 5. Take an audio note

Key Wireframes:

iPhone Wireframes

Creating Task Note Via Audio Recording

 

All Tasks View

 

Official Resident Documentation

 

Insights:

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Design Concerns:

Implement ability to swap tasks

 

Contextual Concerns:

Resident profile 

Make schedule more specific to resident

Expand on HIPAA Regulation

 
This subject is super HIPAA sensitive… We can’t purchase this unless it is HIPAA compliant
The profile page is too “clinical. They should know about the resident before working with them. Not what their blood type is. Help them understand what methods they can use to calm them down.
Caregivers should be able to see what other tasks are currently going on, and then switch with them... It is a hectic environment and changes need to be made.
 

-- Susan (Residential Aide)

From the contextual concerns raised, we addressed how Care Link would be able to achieve HIPAA Compliancy by outsourcing our cloud server to ClearData. 

Final Round

Key Paths Targeted:

1. Login

2. HIPAA Terms and Conditions

3. Access current resident profile

4. View timeline of current task

5. Request help from caregiver

6. Swap Task

7. Take an audio note

 

Information Architecture

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Final Scenario

 
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Beth is a new caregiver and meets with Laura to create her facility account. She then securely logs into Care Link with her provided ID and password.


System Requirements:
The ability to create an account through management. 
The ability to login securely and access caregiver profile.

 

After logging in, Beth is reminded to accept the facility terms and conditions under HIPAA. She understands the importance of resident information security and agrees.

System Requirements:
The ability to receive and accept regulation information.

 

Beth is provided with her first task of the day and start walking to room 43 to assist Bob with his morning bathing routine.

System Requirements:
The ability for Beth to view her current task and what resident she needs to help.

 

While walking Beth accesses Bob's resident Profile to learn more about him and his needs. She discovers that he has Stage 4 Alzheimer's and used to serve in the military.

System Requirements:
The ability to access resident profiles and find their general information.

 

Beth arrives at Bob's room, introduces herself, and thanks him for his military service. Bob responds very positively to this and asks him if he is ready to take a bath. Before proceeding, Beth reads the task notes and finds that Bob's shower routine has been getting more difficult over the past 5 months.

System Requirements:
The ability to view previous task related notes.

 

Beth then reads the task advice and is reminded on some strategies to help Bob get through his bathing routine with less frustration.

System Requirements:
The ability to view task advice.

 

Beth is helping Bob into the bath and notices a large bruise on his leg. She didn't read about it in the notes, and wants to get a second opinion from a more experienced Caregiver. She sends a help request to other caregivers in the facility.

System Requirements:
The ability to request help from another caregiver in the facility.

 

10 seconds later, Beth is notified that a residential aide is on the way to assist. The residential aide arrives and says that the bruise looks fines, but should be monitored.

System Requirements:
The ability to receive status notifications from other caregivers.

 

Beth starts an audio note to record that a bruise was found on Bob's leg. The note is added to the task notes and is available to caregivers on other shifts.

System Requirements:
The ability to take and save an audio note.

 

Beth proceeds and finishes Bob's bath routine and completes the task on her phone. The next task of the day is then provided.

System Requirements:
The ability to check a current task as completed.

Visual Development

 

Reflection:

I’m very grateful to have worked on this project as it has led me to the kind of designer I am today. I realized the importance and the skill it requires to gather insights from the field and how meaningful design can be in changing the lives of our users, when it’s done right.