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Northwell Health: Strategic Recomendations

Northwell is the largest integrated healthcare system in New York State committed towards caring for millions of individuals and their families. 

Parsons SDM partnered with Northwell to look into how they could personalize and digitally transform patient and caregiver experiences.

 

TEAM
A class of 16 students worked together for the Integrative Studio in Spring 2022

COURSE INSTRUCTORS
Leah Cabrera Fischer
Ankita Roy


DURATION

4 Months

Process

We followed the double diamond model to propose a strategic recomendation to the client partner. 

IMMERSION

SYNTHESIS

IDEATION

PROTOTYPE AND TEST

Dove into secondary research to build context around healthcare and break down goals into actionable research strategy

Interviewed various stakeholders to find insights, pain points and motivations of the users to formulate opportunity statements

Conducted ideation workshops with stakeholders to break biases and set grounds for innovation in patient journeys

Developed low to high fidility prototypes and tested with patients and caregivers leveraging usertesting.com

Healthcare is

Complex and Ambiguous

33%

of U.S. adults went without recommended care, did not see a doctor when sick, or failed to fill a prescription because of costs



average wait time for a new patient-physician appointment

24 days

How might Northwell decrease entry barriers and increase accessibility in the healthcare system?

Opportunity

Opportunity

How might Northwell offer care for non medical factors that prevent patients from staying on top of their health?

Healthcare is

Missing Context

80%

of the factors that influence our health operate outside hospital walls




average cost of no-shows per patient for health systems 

$200

Lost in Translation

3.1 m

immigrants are living in New York, of which 50% have a limited English proficiency




of New Yorkers identified as having difficulties associated with limited English proficiency

23%

Healthcare is

Opportunity

How might Northwell improve the healthcare quality and access amongst patients with Limited English Proficiency?

Phases of a Medical Journey

Healthcare starts at home where a patients personal motivation helps him to book his first medical appointment and extends to when they are back home . Hence, we broke down health journeys into 3 stages to map and locate the impact of the 4 opportunity areas we identified. 

ACCESS TO CARE

DELIVERY OF CARE

EXTENDED CARE

A patient's healthcare journey starts with the initial step of awareness and action towards starting a healthcare journey

Initial experiences with the system begin when a patient is actually receiving the healthcare service they need

The path to recovery after a patient has been diagnosed and has left  the hospital when friends and family take responsibility

Sensemaking within Chaos

Primary research with 34 patients, 12 caregivers and 4 doctors helped us to identify pain points and motivations to leverage while designing for.

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So I had a strong migraine and went to the hospital, I  made an appointment with a  primary doctor, who later  directed me to a neurologist and by the time I got my results back my headache was already gone and so were my dollars. Next time I am simply going to CVS.

 

Priya

Patient

Ambiguity Breeds Avoidance

People have a preconceived notion that the healthcare system is complex and inaccessible, which creates fear in their minds leading to avoidance.

Key Research Findings
 

  • People perceive that the healthcare system is complex

  • Lack of precise and clear information

  • Lack of trust in the system

  • Ambiguous estimates and costs

  • Hard to figure out what doctors you need

  • Self-medication is a widely accepted practice

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I was about to deliver Emilio. I didn’t take the translator service because I was worried about the cost and I didn’t want another stranger in the room. As my contractions worsened, I struggled to understand what they were saying. I wished there was someone who could support me in Spanish, but it was too late.

 

Sofia

Patient 

Familiarity Breeds Comfort

The needs of patients with poor english are often multi-faceted, ranging from functional translation supports to emotional support, advocacy, and cultural bridging. 

Key Research Findings
 

  • Lack of empathy & belongingness

  • Lack of awareness of eligible services & costs 

  • Lack of guidance to identify symptoms of health issues

  • Services are not offered at the right time

  • There exist communication gaps & language barriers

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We think about people trusting us and we’re trusted messengers, but we don’t think about how they view trust. This is chronic behavior in health systems and community-based organizations. Everybody’s busy, but we forget to prioritize the people that matter.

 

Lisa 

Health Care Provider 

Trust is Foundational

Reaching socially excluded patients requires health systems to build trust in communities that have been historically marginalized/ ignored and offer resources in a respectful, dignified way.

Key Research Findings
 

  • Lack of trust in the system

  • Lack of awareness of eligible services 

  • Lack of guidance

  • Lack of belongingness

  • Feeling of being unheard & self-conscious

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While I was suffering in pain, my doctor and specialist kept sending me back to each other. I felt like I was running in circles with no answers and real help! When I found a new doctor, I had to get more tests and scans because my old doctors never faxed them to the new one.

Rachel

Patient

Co-Ordination is Paramount

Communication, between a patient’s care team of doctors, surgeons, nurses, and caregivers is fragmented and siloed, often leaving the patient or caregiver chasing for answers.

Key Research Findings
 

  • Communication with doctors is isolated 

  • Lack of visibility into recovery timeline 

  • Limited ownership and control of sharing medical reports

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It takes a village to care for an unwell loved one and our family and friends support us by helping. But in certain situations, it breaks my heart to see my wife in pain. Us not knowing how to provide care or what to do to help doesn't help.

 

Jason 

Caregiver

Care Goes Beyond the Hospital

Patients with chronic care situations require extended care outside of the hospital premises, however, symptom management and emergency care are barely catered to outside hospitals.

Key Research Findings
 

  • Ambiguous information on care

  • Lack of emergency support & assistance

  • Lack of visibility into treatment duration

  • Lack of proper coordination between caregivers and care team at a hospital

Formulating Design Principles

We identified and materialized 'North Stars' for Northwell to follow in the future and gradually scale up in their overall product eco-system. These principles are non-negotiable values out of research and need to resonate with all design solutions going forward.

Holistic
Care

Empathetic Communication

Cultivate Belonging

Cohesive Experience

Care for patients by providing not only functional but also emotional support, in a warm and familiar way that makes them feel at home

Request and deliver information in an empathetic, mindful and dignified manner, making patients feel heard while creating a judgment-free safe space that enables comfort and honesty

Provide inclusive and accessible experiences that cultivate a sense of belonging while keeping in mind patients cultural, social, economic and emotional aspects

Reduce friction by avoiding unnecessary, repetitive actions and proactively share information internally so that every touchpoint with Northwell feels like a seamless continuation of the last one

Enabling Access with

Specialist Connector

Similar to when a kid comes to his mom and asks for help to identify his pain, this tool takes patients through a series of steps, helping them find the right specialist according to their needs and pains.

  1. When a person feels pain, they can simply express their discomfort using simple questions 

  2. They can directly point out the area(s) of discomfort and select the intensity of pain

  3. The backend would capture the location, intensity, frequency and duration of pain to recommend a specialist the person should see for the problem

  4. They can then directly go and schedule and appointment with a doctor 

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Most patients do research before visiting a doctor. However, some patients require additional support. The health advisor coaches patients according to their needs across the entire journey.

 

“Like an advisor for college students” 

  1. Initiated after appointment booking, people have access to a health advisor, a personified chatbot 

  2. The health advisor would provide information about eligible services and reduce complexity by giving information beforehand

  3. For specific details that are beyond the capabilities of AI, the health advisor(AI) adds a cultural advocate(human) in the chat

  4. These advocates are looped into the conversation based on requirements at each instant

Assisting and Guiding with

Health Advisors

Making Care Inclusive with

Accessibility Screener

Asking patients respectfully about external factors can help them reflect and help Northwell identify those suffering from social difficulties that can be getting in the way of accessing healthcare or recovering properly.

  1. Patients might be asked to fill out the accessibility screener after sign-up

  2. The results of this screener impact the services they require

  3. Over time, this data can help Northwell predict patterns of services required specific to demographics or location and inform the development of service infrastructure

  4. After answering the questions, statistics of the community with same conditions is displayed in order to reduce anxiety and the feeling of being alone

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Key Learnings

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I realized the importance of meticulous documentation and clarity of the design process when working and collaborating with a large team 

Discovered the power within co-creation with stakeholders. When used at the onset of ideation, co-creation workshops have the potential to break the status quo and push boundaries for innovation/ disruption