Originally published on Medium.


Lately, at Designit in Colombia, we’ve been in conversations with different health clinics in our country. For them, it’s meant taking a fresh look at innovation and patient experience. Although user experience (UX) and customer experience (CX) are well-discussed in many countries, they are being newly discussed here. I blame this lag on the watering-down of the language surrounding design thinking. Fortunately, these dynamic conversations left us wanting to have more of them.


There are a lot of strategic and technical problems with the healthcare system. It’s hard to take the first steps into the unknown and be creative when coming up with solutions. The challenges are many, and patients and providers face these challenges every day. Continuing to do things in the same old way invariably leads to a variety of problems (including a financial crisis). Since taking the leap of trust is tricky, there are a couple of smaller actions that can help improve things incrementally without being too disruptive. Putting ourselves in the shoes of those living in the current, broken system offers designers new insights. If we do this, we can approach our healthcare system with a much-needed sense of empathy.


We’ve all been patients and/or caregivers on an occasional basis. In my case, I recently spent a couple of days at the hospital keeping my mom company. And while dealing with all the complexities of the hospital (the insurance company, and all the different players involved), I decided to conduct my own research instead of moaning about a frustrating situation. Here are five ideas born out of my own experiences. My hope is that they might help clinics become more human-shaped. Perhaps they might even consider service designers as an everyday, necessary component of every Colombian hospitals’ workforce.


#1: Emergency Rooms Need an Emergency Redesign

There are different reasons to go to an emergency room. None of them should mean waiting in a first-come, first-serve queue to get to triage and see a nurse. There are a lot of flow charts and decision trees that suggest how to approach a wide variety of conditions and situations. A nosebleed, a broken finger, an infection — they all require different types of care. But on my last trip to the ER, what I saw was that (at this specific clinic) an emergency is only an emergency if the patient arrives in an ambulance. If not, then it’s all first-come, first-served – unless maybe you were bleeding profusely or unconscious.


Whenever I give a talk about design in healthcare, I tell a story about a personal visit to the ER. In that moment, I needed a specific medication, but my doctor was out of town. When I called my insurance company, they advised me to go to the ER to get the prescription. (There are many wrong things about that, but we can address those in a different article). When I got to the ER, it was overcrowded and in crisis. Every doctor and on-call nurse was present, and still there were too many patients to care for. So, the ER director came out of those big doors that separate patients from the staff. He explained the situation, and then designed a different triage method in which patients like me, who felt fine and needed something simple (like a prescription), were seen by a Nurse Practitioner, taken care of, and dismissed rapidly without burdening other more critical patients. Surprisingly, there were a lot of patients like me, whose need was an “easy fix.” The cavalry of complex medical care was redirected to more critical patients who needed specialized care.


Understanding why ERs get so overcrowded is crucial. People don’t necessarily understand the difference between urgency and emergency. This might be at the root of some of the negative experiences and unmet expectations patients have when they need these services. Understanding the reasons people are there in the first place is the first step to fixing these issues.


#2: Make Signaling and Waiting Times More Transparent

It’s very common to be sitting in the waiting area of a hospital emergency room, and to hear your name being called: “Patient Ana Nolan, to Radiology.” Apparently, Ana is supposed to know where Radiology is. In the specific case of my last visit, “Ana” had to go through a set of doors where someone who had called her name would be waiting. Ana has no idea of this, and it’s up to her to ask around or find a security guard to help point her in the right direction. There have to be simpler, more efficient ways to guide patients to where they’re supposed to get the care they need. Proper signaling (both from humans and from signage) would help our Ana find her way. The person who called her name could also go through the doors and accompany her to wherever she needs to go, but this seems to be the exception rather than the rule.


On the other hand, signaling is just one small part of a huge opportunity regarding the conveyance of information. Transparency around waiting times is another opportunity. As a daily commuter, I’m a fan of using Google Maps to figure out which bus to take, or Waze if I’m driving. With Waze, sometimes I like to know the best route, but I also like to know the time that it will take me to drive from point A to point B (I also like to win a minute or two, but that’s not relevant right now).


At hospitals and clinics, you may not need to know how long it will take to go from the ER to Radiology, but waiting times are always a source of anxiety. Why not be straightforward with how long the routine at Radiology will take? And how about explaining to a patient what will happen during her visit: “Ana, first you’ll be called to Radiology for an echocardiogram, which takes around 20–30 minutes. Afterwards, we’ll come get you and take you to the lab so they can take some blood samples. Collecting blood samples will be fast, but receiving results from the lab may take up to 2 hours. Once we finish this, I’ll come get you to take you back to the waiting area, where you can meet your family again.


#3: Fix the Bureaucratic Inefficiencies of Badly Designed Tech

Most of the waiting time in hospitals is a consequence of inefficiency. I was utterly surprised to see that it was faster for me to run from Admissions to the Nurse Station carrying a folder with my mom’s hospitalization forms than it was for personnel to handle this for me from their end. Somehow, during all this, the responsibility of getting things done — and quickly — ended up in the hands of the patient and caregiver. Of course, we were the ones in a hurry to get my mom a proper room to spend the night at the hospital, but that should not have only been our priority.


Usually, these types of situations are a result of organizations falling victim to bad technology (and politics), rather than technology being used as a strategic tool that enables frictionless and seamless processes. I see this everywhere in South America. For example, with phone companies: “I’m sorry ma’am, I know you are holding the receipt proving you paid the monthly fee, but the system hasn’t updated the information, so I can’t help you. You need to come back to the office in 10 days.” Go back to the office? Ten days? It’s like we’re all the victims of a system we’re unable to fix.


#4 Help Patients and Loved Ones Stay Connected

In today’s world, everyone’s devices are running low on battery. We’re all looking to stay connected, especially in moments of health emergencies. If you want to lower anxiety and keep people distracted and spread evenly across a waiting room, why not distribute chairs near charging stations? Don’t be the type of place that locks outlets so people can’t charge their phones. They’re probably in need of reaching out to loved ones (remember, they are at a hospital). Given that patients are often accompanied by friends and families, it’s best to keep them occupied and their batteries fully charged.


#5 Remember the Common Objective: Caring for Patients

Everywhere in the world, doctors work within hospitals and clinics, and doctors are affiliated or associated with these institutions. Regardless of their background, their contractual terms or the type of affiliation, every provider’s role is to care for patients. Nowadays, the idea of collaborative and multidisciplinary healthcare teams is not a disruptive concept. While it’s difficult to achieve, it’s extremely important. People should expect to be cared for by teams that don’t see conditions, but rather see patients who are in fact people. Within hospital walls, all providers should work as a team. When a patient is referred to the ER by an affiliated doctor, the patient deserves to be taken care of as efficiently as he or she would be if internal provider had made the referral.


Having a patient endure an eight-hour wait because an affiliated doctor is the only one who can sign their hospitalization forms (and in person) sounds unreal. But it happens everywhere, every day. Part of understanding what the patient experience is (and how to redesign it), means understanding the whole system around patients. This system includes doctors, and we need to understand doctors, their practices, their schedules and the way they move around from place to place to provide care. If we understand doctors are constantly moving from consult to consult, attending to patients, visiting hospital rooms, in surgery, etc., then we understand that imposing an extra visit to a hospital between surgeries and consults can overburden an already inefficient system. This doesn’t even touch on the issue of physician burnout.


These are just a few opportunities based on my observations while visiting a hospital during a family emergency. Imagine what service designers, researchers and UX designers could do on a daily basis! If you work at a hospital, clinic, or private practice and this article resonated with you, let’s touch base. Meanwhile, here at Designit we’ll keep our fingers crossed, hoping that Colombian hospitals will understand the value of creativity when solving complex structural and systemic problems. There’s a huge place for service designers in healthcare.

María Ana Barrera

María Ana Barrera

Service Designer, Designit

María Ana Barrera is a service designer and researcher with more than eight years of experience across innovation, strategic design and product development. She is passionate the role of design in healthcare and is knowledgeable about various research methodologies, system thinking and human-centered design. Her pro-bono work includes an innovation consultancy for the Pediatric Care unit in the Hospital Universitario Fundación Santa fé in Bogota, Colombia.

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