Master thesis

Designing for patient empowerment
within the Danish healthcare sector

Presenting our master thesis in a TED inspired form at the Thesis Talks event in September 2019 at the IT University of Copenhagen.
Team member
Julie Bugat Freudendahl
Regitze Breddal Puck
Presenting our master thesis in a TED inspired form at the Thesis Talks event in September 2019 at the IT University of Copenhagen.
My master thesis aimed at redesigning a patient portal, MyChart, in order to create a digital portal that facilitates patient empowerment for outpatients during waiting time at the outpatient clinic. The thesis was done in collaboration with the nephrological outpatient clinic at the Copenhagen University Hospital. Thus, involved the participation of healthcare professionals, patients with chronic kidney disease, and other relevant stakeholders.
A glimpse into the process
The thesis was conducted as a service design project, involving various qualitative methods in combination with service design tools. The project followed the framework of the double diamond model, involving four stages of (1) discover, seeking to understand the challenge; (2) define, analyzing and framing the challenge; (3) develop, identifying design opportunities; and (4) deliver, testing and implementing design solutions. At the below figure, you can see an overview of the methods and tools used throughout the project.
Overview of the project process guided by the double diamond model.
We used a lot of different methods to gain an understanding of the healthcare professionals work practices, and how it feels to be a patient living with chronic kidney disease. To investigate the latter, cultural probe kits were created and handed out to patients for a week. Through different activities in the cultural probe kit, a patient was able to self-document his or her feelings, events, and interactions with regard to his or her disease. We found this a beneficial method as the patients did not feel observed while participating in the study. The activities were handed out in a canvas bag with a name tag, info tag, and contact tag. In the bag, an information letter explained the different probes and how these should be used as activities. One activity was a book in which the patient could report their moods each day for a week. Similarly, a disposable camera was to assist the patient in capturing these moods in specific situations. Another activity was postcards with unfinished sentences that the patient had to answer each day. These supported as a starting point for the patient to reflect upon his or her disease. The cultural probe kits helped us as designers to emphasize with the patients and gain an understanding of how it is to live with kidney disease.
To gain an understanding of how it is to live with a kidney disease, we handed out cultural probe kits to patients at the nephrological outpatient clinic.
The field of design research has shifted from a user-centered design approach focusing on designing for the user, to an approach of co-designing with the user. Thereby, the user has gone from being a passive objective of a study to an active participant in researching and designing their own future. During the project, we held two co-design workshop, respectively involving patients and healthcare professionals. 11 persons attended the co-design workshop with the patients, and seven persons attended the co-design workshop with the healthcare professionals. The two workshops had different purposes: Whereas the co-design workshop with the patients focused on uncovering future possibilities for the service experience at the nephrological outpatient clinic, the co-design workshop with the healthcare professionals focused on the current application of MyChart and idea generation for optimizing the patient portal.
Involving both healthcare professionals and patients with chronic kidney disease to co-design future possibilities of MyChart and the service experience of the outpatient clinic.
To summarize our empirical data, four personas of patients with chronic kidney disease were created, respectively Anna, Jacob, Daniel, and Peter. The personas are all very different in terms of level of health literacy and level of engagement in their course of disease, however share the same experience at the nephrological outpatient clinic. To visualize this, a patient journey map of the activities before, during and after an encounter at the outpatient clinic was created. Often, a journey map limits its focus to only one character, however we found it beneficial to combine the four personas different journeys in one patient journey map in order to easily compare similarities and differences. From the map, it is evident that the personas' activities before and after an encounter at the outpatient clinic differ, while the activities during an encounter are similar. In addition, the visualization also shows that a service failure occurs due to a delay in the patients scheduled time causing waiting time.
A patient journey map following the journeys of four personas, Anna, Jacob, Daniel and Peter. The map focuses on the experience before, during and after a hospital encounter at the nephrological outpatient clinic.
The project resulted in a proposed redesign of MyChart based on the ideas of the patients and healthcare professionals from the co-design workshops, as well as the empirical data gathered through qualitative methods. The proposed redesign functions as a proactive service recovery strategy and is related to the appointments feature that already exists in MyChart, and includes three features of (1) a self-service check-in, (2) a progress overview, and (3) a reflective questionnaire. The proposed redesign is intended to give patients more control over their time of waiting while being remote from the outpatient clinic, as well as be able to tune in to specific topics they wish to talk about with their doctor. Thus, the proposed redesign is intended to empower patients in their care at the nephrological outpatient clinic, while integrating the current work practices of the healthcare professionals. To visualize how the proposed redesign is used in relation to the current practices at the nephrological outpatient clinic, a future state map has been created taking point of departure in a service blueprint. Thus, the future state map consists of activities done by patients, frontstage and backstage activities of healthcare professionals as well as support processes of the hospital.
A future state service blueprint of the proposed redesign of MyChart, showing visible and invisible actions that consitute the service of the clinic.
We defended our thesis the 21st of June 2019, and got an A for the thesis (12 in the Danish grading scale). We have already presented the results of the thesis for the nephrological outpatient clinic, however expect to present the results for the regional team responsible for MyChart.
We had our thesis defence the 21st of June 2019, and got an A for the thesis.
Download the master thesis