Patient Identification

Note: Due to a NDA, only a high-level summary of the process can be shown. Details including findings and deliverables can be shared in person. 

Duration: Phase 1 (Discovery Research + Opportunity Area Identification) – 12 weeks, Phase 2 (Concept Evaluation) – 5 weeks

The Problem

A leading manufacturer of patient identification solutions realized a need to innovate their current product line in order to maintain their market share, especially as hospitals shift towards barcode systems and require machine-readable patient wristbands. To identify disruptive opportunities, the objective of this program was to examine the wristband journey (i.e., “A Day in the Life of the Wristband”) from three points of entry–main admit, labor and delivery, and emergency department–and uncover the variety of unmet needs, challenges, and workarounds. 

Initial Thoughts and Questions

• What is the product ecosystem beyond the wristband? Who are key competitors in this space, both in terms of market share as well as potential market disruption? What are the identification methods utilized in analogous spaces (e.g., “MagicBand”)?

• What are current and emerging technologies relevant to the wristband product system? How might these be applied to patient identification? (e.g., direct thermal vs. laser printing, toner, types of media, RFID, inductive vs. solar charging, near field communication, biometric identification, vital sign monitoring, tegaderm and other wearable-friendly materials, etc.)

• What are the clinical workflows through the three points of entry? When, during each workflow, is identification confirmed or verified? How? By whom?

• What are the hospital policies and protocols related to patient identification and safety? (e.g., “5 Rights”, Code Status, “Eight P’s”, etc.) What information technologies and digital platforms are utilized?

• What trends in healthcare and society will impact these clinical workflows and patient identification protocols? (e.g., Affordable Care Act, National Patient Safety Goals, Medicare Reimbursement, Patient-Consumers, etc.)

Approach

As the Design Strategy and Research Lead, I defined the research approach. The original approach, as we defined in the proposal, was to complete hospital observations of patient identification processes and contextual inquiries to identify clinical workflows and deviations from the standard protocol. However, due to the schedule and budget, we were unable to secure the required credentials and approvals in time. As a result, I suggested a different approach – interviews with key opinion leaders and extensive secondary research into clinical workflows, competitive products, analogous industries, healthcare policies and trends, and hospital information management systems. In order to articulate the nuances of the ecosystem, we completed in-depth interviews with nurses, who perform the majority of patient identification activities, and hospital risk management administrators, who determine and enforce patient identification policies. We also performed environmental audits of the primary areas (e.g., admission, patient room, etc.) to gain insight into the context of use.

Analysis Framework

The guiding framework for the analysis was to first, review the clinical workflow maps to identify key patient identification touchpoints. Then, we indicated where, within the process, errors occur. Each “failure mode” was further broken down into contributing factors or root causes to provide deeper insight as to why these errors occur and to indicate potential opportunities for improvement. The root causes were categorized into cognitive, social, functional, and environmental factors. As we hypothesized at the beginning of the program, many failure modes are the sum of various contributing factors; some failures are even due to little or no functional compromise. By illustrating the detailed breakdown of each error, our team and our client developed a wider lens to view their product and began discussions as to how the wristband could, for example, alleviate the cognitive stress of task interruption.

Ideation Workshop

After presenting the research findings and opportunity areas, I moderated a one-day ideation workshop with internal team members and client team members from industrial design, mechanical engineering, R&D, chemistry, marketing, and new product development. Based on various design prompts we provided, the group produced over a hundred ideas. The core team then down-selected and refined the concepts utilizing three primary criteria: technical feasibility, market viability, and user desirability/need. Each concept was supported by indications from research, implications for design, and user benefits. 

Concept Evaluation and Outcome

After proposing 16 concepts, the client began R&D efforts on the few they found most appealing. However, to ensure they were pursuing meaningful and relevant solutions, we proposed conducting a concept evaluation with nurses and hospital purchase influencers (i.e., risk management, materials management and purchasing, patient satisfaction). 

Respondents were shown the concept illustrations and asked a series of questions to determine the perceived value, usability, and compatibility with current workflows and infrastructure. Through the analysis, each concept was detailed with an overall response from users, desired features, key considerations, perceived value, and potential risks and barriers. The concepts were then visualized to demonstrate priority, based on the explicit feedback provided by respondents along with nonverbal cues such as intonation, gestures, and facial expression. 

From the first phase of this program, the clients were able to become subject-matter experts, well-versed in the nuances of patient identification. From the second phase, we provided the client with an innovation roadmap and criteria to prioritize product development. The concept evaluation revealed that the few solutions that the client was working towards were, in fact, the least relevant and valuable to users. Therefore, we were able to course-correct, illuminating more meaningful solutions for the client to pursue.