Point of Care Testing in the Emergency Department
Ethnography and UI development for a new device
The Project
Our client, a major diagnostics company, had developed a prototype for a new Point of Care (POC) blood testing system, which would be first intended for use in cardiac testing in the Emergency Department (ED). This benchtop device tested troponin, which helps ED staff determine if a patient has experienced a heart attack. The POC space was new to our client, and they requested our help with two major tasks. First, we were to conduct ethnographic research in Emergency Departments, to learn the current workflows, stakeholders, and user needs around cardiac testing in the ED. This information would be used to inform the product design and launch as well as our second task: Develop an intuitive and user-friendly UI for the system, based on real-world workflows and needs.
The Research Approach
Ethnographic observation: Initial workflow research was based in ethnographic observation. I coordinated 2-day visits to each of 5 EDs around the country, where we observed care workflows for cardiac patients. During observations, we had informal interactions and conversations with nurses, lab techs, and paramedics. We also conducted in-depth interviews with key stakeholders on site, including the POC coordinator and supervising ED doctor, to learn about ED structural and purchasing systems, and high-level needs.
Evaluative and Co-creation Exercises: During our time on-site, we set up snacks/ meals in a room in the ED to thank the staff, and also to provide a space to discuss our project. During these interactions, we engaged in evaluative conversations, using early sketches of the prototype design, to prompt feedback. We also discussed UI elements, and engaged in co-creation activities, sketching and discussing, with participants their ideal interactions and how they would prefer to receive information.
UI development and directional testing: These inputs informed follow-on UI development activities, in which I and the research team worked closely with our interaction designers to develop 4 different UI concept prototypes, each highlighting different approaches to information presentation. These were tested in directional research sessions with different cardiac testing stakeholders in the US and EU, which informed the preferred UI approach and a number of design refinements.
As Research Lead, I led the ethnographic research/ analysis, and worked closely with the design and interaction teams to inform and contribute to the UI development and directional research.
Analysis & Synthesis
I led analysis and synthesis of our findings around key ED user needs, highlighting priorities around information desired, and the context, format and timing of that information. I worked closely with the design team to inform development of in-depth workflow maps for each ED visited, which demonstrated the diverse needs and current implementation approaches for cardiac POC testing. Our analysis identified and clearly demonstrated the impact of some issues with the prototype under development. The physical design and capabilities of the system, as well as the intended implementation requirements, were in many cases not aligned with the user needs we’d uncovered.
I also worked with our interaction design team to share our contextual learnings, communicating specific stories as well as overall themes, to convey the principles and user needs we needed to fulfill via the UI. We ideated around a number of different approaches to fulfilling these needs, exploring (for instance) different degrees of user control, automation/ speed, level of information detail presented, and other key elements of value. These elements were shaped into four distinct UI concepts, so user reactions to each approach could be understood distinctly, and we could assess the prioritization and acceptable trade-offs among these elements.
Post-directional testing, I contributed to analysis around preferences and how these could be integrated and refined into our final UI prototype.
Presentation and Impact
After the workflow research and analysis, we presented the findings to the executive leadership of the company, before moving into the second portion (UI development) of the project. As a result of our findings and detailed documentation, the executive team came to the decision, several months later, to halt development of the current prototype, which was deemed to be poorly aligned with current workflows, with too many issues for successful adoption. Design efforts were redirected, and the team relied heavily on the design principles we provided to inform follow-on R&D. The executives were deeply appreciative of the knowledge provided during this project, and went on to engage our research services for multiple other efforts- and all earlier in the development process, to help obtain the necessary user inputs prior to developing high-fidelity prototypes.