1. msk patient
navigator service
service design | mark jones | f09
aparna unnikrishnan
prashant desai
tal shay
van vuong

2. I have CANCER

3. Will I lose my hair?
Is this normal?
I have CANCER
What are the How much work
side effects? will I miss?

4. Is this pain from the Chemo or What can I eat?
something else?
How will this affect
my family?
How long with it take?
What are the chances
Will I lose my hair? of survival?
Is this normal?
I have CANCER
What are the How much work
side effects? will I miss?
When will I be able to How much is this
come back to work? going to cost?
What are the financial
assistance available?

5. Who has the knowledge to answer
these uncertainties at MSK?
medical info physical comfort emotional logistics
Nurses Nurses Counselor Social Worker
Doctors Doctors Previous patients Receptionist
Physicians Assistant Physicians Assistant Caregivers Volunteers
Dietitian Friends and Family Previous patients
Is this normal?
Volunteers
What are the chances What can I eat? How will this affect
of survival? my family? What are the financial
Is this pain from the assistance available?
What are the Chemo or something What happens to my
side effects? else? relationships? When will I be able to
come back to work?
Will I lose my hair? I’m depressed what
can I do? How long with it take?
How do I treat the side
effects? How much work
will I miss?

6. Who really answers
these uncertainties?
medical info physical comfort emotional logistics
Nurses
Is this normal? What can I eat? How will this affect What are the financial
my family? assistance available?
What are the chances Is this pain from the
of survival? Chemo or something What happens to my When will I be able to
else? relationships? come back to work?
What are the
side effects? Will I lose my hair? I’m depressed what How long with it take?
can I do?
How much work
will I miss?

7. The patient journey and the
need for reassurance
Emotional
Physical Comfort
Medical Information
Logistical
need for reassurance
start 1st round start 2nd round start 3rd round
of treatment of treatment of treatment

8. How can we better reassure
first time patients who have
emotional, physical, medical and
logistical uncertainties throughout
their journey?
need for reassurance
most need for reassurance is after first
treatment when things are unfamiliar
start 1st round start 2nd round start 3rd round
of treatment of treatment of treatment

9. Matching the right source to
deliver each types of reassurance
medical professional MSK veteran
medical, logistical
physical
previous patients
patient emotional
physical

10. msk patient
navigator service

11. msk patient
navigator service
Components of the Navigator Service:
Navigator team is a group of clinically trained
professionals hired to help patients navigate the health
system and answer logistical, medical, physical and
emotional uncertainties

12. msk patient
navigator service
Components of the Navigator Service:
Navigator team is a group of clinically trained
professions hired to help patients navigate the health
system and answer logistical, medical, physical and
emotional uncertainties
The mobile application allows patients to track
symptoms at anytime and anywhere

13. msk patient
navigator service
Components of the Navigator Service
Navigator team is a group of clinically trained
professions hired to help patients navigate the health
system and answer logistical, medical, physical and
emotional uncertainties
The mobile application allows patients to track
symptoms at any time and anywhere
The web portal allows patients to get personalized
service from the Navigator Team, learn from their
experiences, and connect with past patients to
resolve uncertainties

14. From interpersonal ...to self-reliance
guidance...
Interpersonal service Guidance to MSK Volunteer network Symptom tracker
avigator initiates
N Navigator helps Anytime access to Patients learn
communication by patient find their previous patients how to track their
contacting patient + way through MSK who can relate symptoms - thus
monitors them from services and the to what you’re learning how to
remote location. web. They guide going through. An reassure themselves.
the patient through international network
other uncertainties of survivors allow
that might be out patients to ask
of their range of questions at all times.
expertise and contact
other experts when
needed.

15. Scenario 1: The initial call and
introduction to web portal
Interpersonal service Guidance to MSK Volunteer network Symptom tracker
avigator initiates
N Navigator helps Anytime access to Patients learn
communication by patient find their previous patients how to track their
contacting patient + way through MSK who can relate symptoms - thus
monitors them from services and the to what you’re learning how to
remote location. web. They guide going through. An reassure themselves.
the patient through international network
other uncertainties of survivors allow
that might be out patients to ask
of their range of questions at all times.
expertise and contact
other experts when
needed.

16. The Navigator initiates
the communication
“How are you doing?”

17. Jane fears she is
missing too much
work because
of nausea

18. Hi Jane, preferences
You are logged on to your profile.
TREATMENT TRACKER
What is on your mind?
Sypmtom Tracker
secnereferp ,enaJ iH
.eliforp ruoy ot no deggol era uoY
REKCART TNEMTAERT
Pain Tracker
?dnim ruoy no si tahW
rekcarT motmpyS
rekcarT niaP
timbus
stceffE-ediS
eliforp tnemtaert ruoy ot gnidroccA
.stceffe-edis eseht tcepxe thgim uoy
Jane reviews
tnemtaert tuoba erom nrael ot kcilC
message from Navigator (1)
.stceffe-edis rof
submit
seros htuoM
ssol riaH
aesuaN
etiteppa fo ssoL
information Side-Effects
According to your treatment profile
Stories chosen specially
for Jane
sent by
you might expect these side-effects.
Click to learn more about treatment
for side-effects.
Navigator Mouth sores
Hair loss Andrea's Story
through the
Andrea in Austria
Nausea
Loss of appetite It began November 2004.
Andrea was in her junior year
at The Ethel Walker School, an
web portal
all-girls boarding school in
Simsbury, CT. She developed a
serious pain in her hip, which
she attributed to the intensive
dance program she had joined
at the beginning of the
semester. A trip to the
on-campus doctor resulted in a
prescription for a muscle

19. Scenario 2: Tracking, learning
and enabling
Interpersonal service Guidance to MSK Volunteer network Symptom tracker
avigator initiates
N Navigator helps Anytime access to Patients learn
communication by patient find their previous patients how to track their
contacting patient + way through MSK who can relate symptoms - thus
monitors them from services and the to what you’re learning how to
remote location. web. They guide going through. An reassure themselves.
the patient through international network
other uncertainties of survivors allow
that might be out patients to ask
of their range of questions at all times.
expertise and contact
other experts when
needed.

20. Hi Jane, preferences
You are logged on to your profile.
TREATMENT TRACKER
What is on your mind?
Jane has the
secnereferp ,enaJ iH
Sypmtom Tracker
option of having a
.eliforp ruoy ot no deggol era uoY
REKCART TNEMTAERT
Pain Tracker
?dnim ruoy no si tahW
rekcarT motmpyS
rekcarT niaP
Hi Jane,
timbus
stceffE-ediS
eliforp tnemtaert ruoy ot gnidroccA
.stceffe-edis eseht tcepxe thgim uoy
preferences
tnemtaert tuoba erom nrael ot kcilC
navigator help her
.stceffe-edis rof
submit
seros htuoM
ssol riaH
aesuaN
You are logged on to your profile.
etiteppa fo ssoL
TREATMENT TRACKER
What is on your mind? PREFERANCES
track her treatment Side-Effects
According to your treatment profile
Stories chosen specially
for Jane I would like to track
Sypmtom Tracker
and periodically call you might expect these side-effects.
Click to learn more about treatment
this by myself
Pain Tracker
for side-effects.
I would like a nurse to
submit help me track my
Mouth sores treatment
Hair loss Andrea's Story
Nausea I would like a family
Andrea in Austria
secnereferp ,enaJ iH
.eliforp ruoy ot no deggol era uoY
REKCART TNEMTAERT
?dnim ruoy no si tahW
member to help me
rekcarT motmpyS
rekcarT niaP
Loss of appetite
Side-Effects It began November 2004.
timbus
Stories chosen specially
Andrea was in her junior year
stceffE-ediS
eliforp tnemtaert ruoy ot gnidroccA
.stceffe-edis eseht tcepxe thgim uoy
tnemtaert tuoba erom nrael ot kcilC
According to your treatment profile track my treatment
for Jane
at The Ethel Walker School, an
all-girls boarding school in
.stceffe-edis rof
you might expect these side-effects.
seros htuoM
ssol riaH
Simsbury, CT. She developed a
aesuaN
etiteppa fo ssoL
serious pain in her hip, which
Click to learn more about treatment
CONTACT
she attributed to the intensive
for side-effects. dance program she had joined
at the beginning of the
Mouth sores
Would you like a nurse to
semester. A trip to the
on-campus doctor resulted in a
Hair loss
call you periodically for
prescription for a muscle
Andrea's Story
consultations
Andrea in Austria
Nausea
Loss of appetite It began November 2004.
Andrea was in her junior year
no
at The Ethel Walker School, an
all-girls boarding school in
Simsbury, CT. She developed a
yes
serious pain in her hip, which
she attributed to the intensive
dance program she had joined
yes (email only)
at the beginning of the
semester. A trip to the
on-campus doctor resulted in a
prescription for a muscle

21. She can also track
her pain at anytime
through a mobile
application

22. appears
As Jane tracks Hi Jane, preferences
her symptoms the You are logged on to your profile.
TREATMENT TRACKER
navigator reviews Sypmtom Tracker
the data and tags:
week month
provides timely mouth sores
nausea
advice though Message from nurse Jackie:
Nausea is one the most common side
the portal. effects of chemotherapy.There are couple
of things you can do to keep it under
control though; Eat small meals through-
out the day. Also do not eat fatty, greasy
foods right before or during treatment
and drink lots of fluids at room tempera-
Pain Tracker ture
hour day week month

23. might cause
Navigator View preferences
Nurse View You are viewing Jane’s data. preferences
While reviewing JanesYou are viewing Jane’s data.
PAIN TRACKER
Sypmtom Tracker
PAIN TRACKER
data, the navigator sees Pain Tracker
Sypmtom Tracker
patterns and calls Jane
hour day week month
Pain Tracker
to check up on her
11am 12pm 1pm 2pm hour 4pm day
3pm 5pm 6pmweek 8pm 9pm 10pm 11pm 12a
7pm month
feb 1 4 7
11am 12pm 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm 12a
feb 2
feb 1 4 7
feb 3
feb 2 8
feb 4 8
feb 3
feb 5 7
feb 4 feb 6 8
feb 5 feb 7 7 7
feb 6 feb 8 7
feb 7 feb79 7
feb 8 feb 10 7
feb 11
feb 9 7
feb 12
feb 10
feb 11
feb 12

24. Hi Jane, preferences
After a few rounds You are logged on to your profile.
TREATMENT TRACKER
of treatment, Jane Sypmtom Tracker
is able to track and
week month
tags:
interpret her own mouth sores
nausea
pain
data.
Pain Tracker
hour day week month
10
9
8 8
7 7 7 7
6 6
5 5
4
3
2
1
feb 5 feb 6 feb 7 feb 8 feb 9 feb 10

25. Scenario 3: Access to a wide network
of volunteer cancer survivors 24/7
Interpersonal service Guidance to MSK Volunteer network Symptom tracker
avigator initiates
N Navigator helps Anytime access to Patients learn
communication by patient find their previous patients how to track their
contacting patient + way through MSK who can relate symptoms - thus
monitors them from services and the to what you’re learning how to
remote location. web. They guide going through. An reassure themselves.
the patient through international network
other uncertainties of survivors allow
that might be out patients to ask
of their range of questions at all times.
expertise and contact
other experts when
needed.

26. It is late and Jane has
uncertainties...

27. A volunteer from across
the world answers
Jane’s questions instantly

28. Blueprint: navigator and symptom tracker
(scenarios 1+2)
Physical Evidence Phone Web portal Web portal Web portal Phone
Web portal Email Mobile application
Customer Actions
Patient receives check Patient receives latent Patient / family Patient tracks Patient receives check Patient reviews their
ups from navigator and response with package of member inputs their progress and ups from navigator and previous progress
tells Navigator about their information. patient progress suggestions from tells Navigator about their before next treatment to
worries the navigator worries anticipate what to expect
and plan accordingly
line of interaction
Contact person
On stage Navigator contacts Navigator introduces patient Navigator contacts
patient to ask how they to the symptom tracking patient if there is a need
are doing and answers service, and shows an for closer follow up
questions. Has example of logging today’s
personal dialogue symptoms in the system
line of visibility
Contact person
Backstage Navigator contacts Navigator sends patient Navigator tracks patient
relevant MSK services to answers or directs them progress and inputs advice
find answers for patient to appropriate sources. for patient
questions if they can’t Navigator may have personal
answer it themselves conversation to deliver and
translate info
line of internal interaction
Support
processes Database of patient Portal creates a
treatment dates, type of visualization of patient
treatment and contact progress throughout time
information connected
to Navigator calendar
Database of prepared
texts for suggestions for
common conditions
Starting point Symptom tracker service Navigating service

29. Blueprint: volunteer network
(scenario 3)
Physical Evidence Web portal Online chat
Phone
Customer Actions
Patient experiences Patient reviews profiles Patient chat online or
concern of volunteers who can be call the volunteer
contacted at that time
line of interaction
Contact person
On stage
line of visibility
Contact person
Backstage Volunteers update
their status if they
are currently in a chat
/ phone call with a
patient
line of internal interaction
Support
processes Volunteers sign Volunteer Access phone numbers
up for time slots profiles are directed to volunteer
when they are updated phone, to allow free calls
available and on the site and protect volunteer
can be reached personal contact info

30. Testing value proposition
and business case assumptions
Assumptions to test Resources required Experiment results Expected insights
to test assumptions measurements and next steps
Whether patient are Offer the personal symptom Frequency and The results of this
comfortable and interested tracking feature to a limited exhaustiveness of patient experiment will provide
in tracking their own test market within the symptom logs usability data for the
symptoms over time. Memorial Sloan Kettering symptom logger - this
patient portal. data can inform future
improvements to the
patient portal
If the volunteer network Create an “E-mail” test Satisfaction levels of If the volunteer network
will be willing to contribute scenario within the participating patients will be willing to contribute
their time and support existing Volunteer-Patient with regards to volunteer their time and support
through the patient portal network. response and support. through the patient
portal - if they are, then a
volunteer communication
tab can be designed for
the patient portal
If patients will feel Provide a test group Frequency of patient Results of the paper
comfortable inputting of patients with small emotion logs. Determine if prototype can be used
emotions through a mobile personal journals and have patients are willing to log towards designing an
device. them log their emotions in this information (and when appropriate mobile UI.
their notebooks. they remember to)

31. THANK YOU!

32. appendix
additional
materials
+
previous project
versions

33. CHA-CHA BLUE PRINT
Mobile phone
Physical Evidence Mobile text
Cha-Cha website
customer texts customer calls customer
Customer Actions cha-cha with to ask question waits for
question verbally response
line of interaction
Customer receives Customer receives Customer receives Receives thank you
Contact person welcome message confirmation that answer to question in from Cha-cha
Onstage message has been natural language from a
received person via SMS
line of visibility
Cha-cha receives Cha-Cha sends Cha-cha sends
Contact person question from automated welcome automated
customer message Guide sends answer Cha-Cha sends
Backstage confirmation
message to customer automated thank you
line of internal interaction
Message is sent Forwards formated Generalist or specialists
Support processes to expeditor question to generalist searches for answer
or translator or specialist or searches for stock
answer
service design F09 | desai | shay | unnikrishnan | vuong

34. NEWBORN AFTER HOURS ANSWER LINE BLUE PRINT
Physical Evidence Phone
Customer Actions Mom calls clinic Mom tells Mom leaves a
receptionist she
on machine +
contact details
line of interaction
Contact person Receptionist Receptionist asks Machine instructs
no
Onstage the mom to leave a the mom back
for the nature of message on machine details to leave in provide guidance on
your call message
line of visibility
Contact person Receptionist checks
Backstage if someone is pages person to message
call
line of internal interaction
Support processes Service bill is added
for patient’s next bill
What value does this analogy add to our service?
service design F09 | desai | shay | unnikrishnan | vuong

35. ID ORIENTATION AND REGISTRATION BLUE PRINT
ORIENTATION REGISTRATION
email messages, Print collateral Voice mail, Email Course Info sheet , Websites : ID, IIT Emails, ID registration
Physical Evidence
google group webpage Mailing Envelope checklist, schedules and other design related forms, MyIIT
websites, emails registration site.
Customer Actions New Students receive New Students receive New Students receives Students attend the
Students seeks for Student makes the
email / student access information package contact from the course introduction
additional information course decision
to Google Groups mentor
line of interaction
New students New student does non Ongoing dialogue
Mentor and
start interacting IIT research about the between faculty,
mentee interacts
Contact person within The new students are Students, Professors subjects advisors and admin.
and exchanges Students receive the
Onstage themselves and informed about the interactions takes
information PIN for registration
ID announces to also current ID course introduction place. Advisor signs off on the
either through Admin provides with the
the new student students through dates and time. chosen courses
phone, email, in New student looks at SeeID and IIT registration materials
group abt the message posting
person Student registers at IIT
Google Groups. and answers New students speaks to current students
line of visibility website
The current ID The Mentor reaches
Admin is receiving
Contact person students sets administration out to the new
information from
Backstage up the Google sends out the students, (their
new students on new
Groups information respective
chosen classes.
mentees )
line of internal interaction
Administration The current student body or the Welcome ID recruits mentors and IIT website is updated
organizes admin designs the package and pairs them with the mentee
The Admin schedules
Support processes the groups and puts the content together.
the course introduction
gets together Faculty puts the course ID and IIT admin
event
email IDs of the The new student addresses are Mentors and mentees are asked to descriptions on See ID collaborates and
new student collected send in information so that they can registers students into
body be paired up. the IIT system
Admin sets up the SeeID.
Faculty prepares the
content
service design F09 | desai | shay | unnikrishnan | vuong

36. Process -- treatment
have asked the right
questions in the right way
Symptoms
finding credible info
Physical Workarounds for them
Medical Comfort
Pain
doctors/nurses
Reassurance
What kinds of uncertainty do they
have that don’t stem from lack of
disease information?
Logistical
Stress
location
Emotional Anxiety
process -- admin Depression
family
friends
NED

37. other treatment
other doc
side effects
way finding
2nd Opinion symptom meaning
more info
longer than expected (before
Problems tests: make sure all
consultation) needed are done
interpret results
New Cancer Patients
finance
Social diet
Kids Support/
Lifestyle
Partner NED-
Clinic
No Evidnece
anxieties Friends of Disease
State of People at
what to expect
Mind Clinic Family
Home
receptionists
chemo
Chemo Brain
volunteers Nurses
Doc
need for reassurance
Emotional feelings
Medical

38. Value Statement:
Provide first time patients highly personalized,
immidiate, interpersonal reassurence and
feedback, for when they experience uncertanities
in between treatments.
Who is your target customer: What are the benefits of our offerings:
First-time cancer patients + immediacy of reassurance
+ personalized experience
What are their concerns: + accessable support
Emotional Reassurance, becoming comfortable with + proactive/ solution oriented
the treatment in the initial phase when you are more + push not pull
lost. What are the kinds of uncertainties do they have + Help predict future experience
that don’t stem from lack of disease information?
Online communities ie http://patientslikeme.org, http://
What are their unmet or underserved needs: www.caringbridge.org
Emotional reassurance and physical comfort
Compared to what is offered by our competition?
What are our offerings for these customers: +websites
+ Personalized experience +patient- to- patient service
+ Concierge/ buddy/ advocate +online forums
+ Direct link to profession +social support groups
+ immediate feedback + doctors/staff at clinic
+ individualized learning tools (tracking symptoms so
you know when to expect side effects)
+ guidebook

39. Value Statement Draft
Provide first time patients continuous, personalized, interpersonal reassurance and guidance, for
moments of treatment-related uncertainty, pain, and confusion through offering timely, patient-specific
awareness tools and professional support between treatments.
The MSK Navigator Portal enables MSK’s team of friendly nurses to work together with their patients
to monitor cancer symptoms, side-effects, and pain over time resulting in greater predictability for the
patient. They gradually transition from Navigator initiated follow-up and guidance to patient self-service.

40. Service Description Draft
When starting chemotherapy treatment, a patient can be overwhelmed with information about what to
expect – particularly in regards to pain and symptom management. While the internet holds a wealth
of information for cancer patients, it is often cumbersome and confusing to navigate non-personalized
websites in hopes of locating relevant, in-the-moment information.
The MSK Navigator Portal enables MSK’s team of friendly nurses to work together with their patients
to monitor cancer symptoms, side-effects, and pain over time resulting in greater predictability for the
patient. They gradually transition from Navigator initiated follow-up and guidance to patient self service.
Through the MSK Navigator portal, patients are encouraged to track the distressing side-effects of cancer
and treatment and are provided 3 different options to do so:
(1) Self-Tracking (Patient Self-Service): By selecting the self-tracking options, patience can develop self-
awareness over time, and are able to anticipate and preemptively prepare for the next occurrence of
cancer and treatment related side-effects. Patients are also able to communicate with a nurse directly
if any additional concerns arise and are able to do so through indicating their preferred communication
channel at the MSK Navigator website.
(2) Nurse Assisted Tracking (Nurse Link): The Navigator Portal provides a direct connection to MSK nurses.
In MSK Navigator, patients are provided the option of allowing nurses access to view their pain and
symptom logs. By sharing this information, patients enable nurses to track their personal logs over time,
and subsequently provide timely medical support and intervention. With MSK navigator, nurses are able
to provide first time chemotherapy patients with personalized pain and symptom specific reassurance
through continually anticipating patient-specific needs throughout chemotherapy treatment.
(3) Family member assisted tracking (Family Friends Link): Patients can also provide their loved ones
access to their logs. In doing so, family members can help monitor the patient’s progress and provide a
more complete picture

41. PATIENT SUPPORT BLUE PRINT
possible starting points
Mobile
Mobile
Physical Evidence Email
Phone
Phone
Email
Website
Patient gets
immediate response Patient recieves check
Customer Actions
Patient has ups from navigator and
uncertainties and tells Navigator about there
contacts their navigator worries Patient receives
via SMS, email, Patient receives latent response
website or phone confirmation with package of
message has been information.
received, approx
time for answer.
line of interaction
Navigator recieves Navigator contacts Navigator sends patient Navigator sends patient
Contact person message and answers or directs them
patient to ask how they timely messages or
Onstage imediately answers are doing and answers calls patient to inform to appropriate sources.
or sends message questions. Has them about treatments, Navigator may have
that they are working personal dialogue potential side effects personal conversation to
on it deliver and translate info
line of visibility
Navigator is given basic
Contact person Navigator does
information about treatment
Backstage investigation for questions
and is educated on basic
they can’t readily answer
information.
line of internal interaction
Support processes
MSK web portal MSK has a team of experts Team of experts dispatch
that helps answer and specialists composed answers to navigator. If
questions and of a nurse, counselor and Expert team on call to answer there is a lot of content, they
directs to relevant information science person. navigator questions. MSK may package information
stories and Navigators are given basic provides support for navigators. in an email or other printed
information. information from the experts To direct them to answers they material.
in the form of workshops cant find themselves
and training.
service design F09 | desai | shay | unnikrishnan | vuon

42. the end...