The document outlines a 5-step design thinking process for developing healthy healthcare apps: learn, define, ideate, build, and iterate. It provides examples of each step applied to a project aimed at improving blood pressure tracking and treatment decisions through a patient-physician app. Key activities described include empathizing with users, generating and refining ideas through prototyping, and validating concepts with users through an iterative process. The goal is to match technology to user needs through collaboration and user-centered design.

1. Design Thinking:
5 Steps to Healthy Healthcare Apps
Lorraine Chapman
Sr. Director of Healthcare | Macadamian
March 3, 2016
Jeff Belden MD
Professor | University of Missouri

2. Lorraine Chapman
Has no real or apparent conflicts of interest to report.
Jeff Belden MD
Has no real or apparent conflicts of interest to report.
Conflict of Interest

3. What is Design Thinking?
Five Principles of Design Thinking (with examples)
Learn
Define
Ideate
Build
Iterate
Agenda

4. Learning Objectives
Describe 5 easy steps to incorporate UX best practices into your product
development processes
Discuss rationale for including UX processes in any Healthcare product design
State common design research methods and activities that go into the creation
of ‘usable’ products

5. Satisfaction
Treatment / ClinicalSavings
Improve support for collaborative decsion
making to achieve BP
treatment goals.
Electronic
Secure Data
Incorporate patient-generated home BP
measurement into the display of BP data
and treatment decisions.
Patient Engagement and
Population Management
Improve ease of use of BP trend
display via the patient portal.
Introduction: How Benefits Were Realized for
the Value of Health IT

6. Who are we?
Lorraine Chapman
Lorraine is Sr. Director of Healthcare at Macadamian. She has
been practicing in user experience design for more than 18
years. She plays a pivotal role harmonizing end user needs,
client expectations, and current technology.
Her ability to grasp the subtle dynamics of a requirement
enables her to provide solid business direction to medical
information tool providers, electronic medical record vendors
and digital health companies. Lorraine’s expertize delivering
people-centered solutions makes her a sought after speaker
and presenter. Lorraine embodies Macadamian’s commitment
to solving big-picture problems for all the stakeholders in our
clients’ projects.
Highly engaged in the healthcare industry, Lorraine has
authored and contributed to countless articles, whitepapers
and events on the topics of user experience in healthcare, and
in 2014 she was appointed chair of the HIMSS HIT User
Experience Committee.

7. Who are we?
Dr. Jeff Belden
Jeff Belden MD is a family physician and Professor at
the University of Missouri – Columbia. He works on EHR
innovation projects at the Tiger Institute, a technology
collaborative between the University of Missouri and Cerner
Corporation. He is the Founding and Former Chair of the
HIMSS EMR Usability Task Force and a current member of the
HIMSS HIT User Experience Community. Belden was lead
author of Inspired EHRs: Designing for Clinicians, a guide for
EHR usability, online at inspiredEHRs.org.
He has a special interest in improving the EHR user
experience, and in the visual display of information.
He delights in working with a small team, a sketchbook,
and a whiteboard. His past experiences in photography,
filmmaking, layout and design, typography, and consulting
in healthcare software design inform his approach to user-
centered design thinking.

8. What is “Design Thinking”?

9. “Edison made it [innovation] a profession that blended art,
craft, science, business savvy, and an astute understanding of
customers and markets.”
– Tim Brown (CEO IDEO)
Tim Brown
https://hbr.org/2008/06/design-thinking

10. “Design thinking is a lineal descendant of that tradition. Put simply,
it is a discipline that uses the designer’s sensibility and methods to match
people’s needs with what is technologically feasible and what a viable
business strategy can convert into customer value and market opportunity.”
— Tim Brown (CEO IDEO)
Tim Brown
https://hbr.org/2008/06/design-thinking

11. 1. Define the problem 2. Create & consider
many options
3. Refine selected
directions
4. Pick the winner,
execute
Fast Company
http://www.fastcompany.com/919258/design-thinking-what

12. Where
magic
happens
Business
Experience Technology
Intersection for Innovation

13. Five Principles of Design Thinking
Learn
DefineIterate
Build Ideate

14. Learn
Empathize with the user, customer, client.
Listen, observe and engage with them.
Understand their desires, needs,
challenges and problems.

15. Ask the right questions to get the
right answers
• Questionnaires
• Focus groups
• Interviews
• Observation
• Contextual inquiry
• More research
• Timeline
• Events or activities
• Phases
• Related information
• Touchpoints
• Relative highs & lows
• Pain points and opportunities

16. Project: Better IT Tools To Display
Home & Office BP
Support collaborative (patient-provider)
treatment decisions
Foster patient engagement
in treatment actions
Understand BP in context of
medication and lifestyle changes.
Achieve better BP control

17. Observations
In video-recorded visits, family physicians shared:
Blood Pressure
11/05/
2015
8/14/
2015
2/28/
2015
3/10/
2014
136/87 146/93 151/96 162/98
Graphs Numbers
10of time
%
90of time
%

18. Very Detailed
Artifacts
Patients recorded home BPs range from…

19. Very Unstructured
Artifacts
…to…

20. Artifacts
Current BP graph examples

21. Artifacts – Coming soon
Rivers of data: Cuff downloads, HIE dumps, more

22. Personas

23. Define
Key stakeholder alignment and collaboration.
Define your value proposition.

24. Define
Visualize your value proposition with storyboards

25. Define
Visualize your value proposition with high level workflows

26. BP Project Aim
What do patient & physician need regarding
clinic & home BPs?
Design display for both for better informed,
shared decisions.
Can we summarize trend data?

27. Ideate
Generate many, many ideas!

28. Visualize your ideas with usage scenarios, concepts and evolving design
Ideate

29. Visualize your ideas with workflows and sketches
Ideate

30. Make lots of sketches, so you can discard most of them.
Ideate

31. Ideate
Refine ideas that pose problems.

32. Refine concepts and compare options.
Ideate

34. Build
Prototype to verify with your users and
stakeholders
Validate requirements and design direction
Do this iteratively throughout the entire process.
Objective Researcher
& Real User

35. Build

36. Build.
ISSUE: Some of the participants
wanted the ‘Details’ panel to update
depending on the context (e.g. no
‘Onset’ if they are in ‘Physical Exam’).
QUOTE: I'm not sure if that belongs
in the ‘Physical Exam’ but rather in
the ‘History’. The fact that he has been
having neck pain for one month is in
the ‘History’. This could be context
relevant details… a lot of these things
are more appropriate to the history than
the physical.
NOTE: All of the participants
indicated that most of the findings
they would like to include in the final
note should already be available in
the template as un-entered findings
(i.e. so that they do not have to add
other findings).
QUOTE: I think this seems to be a
simple way to enter these phrases,
so I think the key is having the
necessary phrases in the list.
That’s going to be a success factor.
KUDOS: To add the detail ‘severe’ to
the finding, most of the participants
hinted at free texting. However,
some indicated they would do this
by tapping on ‘Add text’.
Prototype to verify with your users,
customers, clients and stakeholders

37. Lessons Learned from Patients

38. Lessons Learned from Patients

41. Lessons Learned from Physicians

42. Lessons Learned from Physicians

45. Five Principled of Design Thinking

46. Talk to your users (both internal and external) to find out how you can help them
Co-create to find solutions to users’ problems & opportunities to improve experiences
Validate potential solutions with your users
Refine the solution and build a prototype
Test the prototype with users
Key Takeaways

47. The key to great design solutions is iterating on the design and collecting
user feedback throughout the whole cycle and not just at the end.
Key Takeaways

48. Satisfaction
Treatment / ClinicalSavings
Improve support for collaborative decsion
making to achieve BP
treatment goals.
Electronic
Secure Data
Incorporate patient-generated home BP
measurement into the display of BP data
and treatment decisions.
Patient Engagement and
Population Management
Improve ease of use of BP trend
display via the patient portal.
Summary: How Benefits Were Realized for the
Value of Health IT

49. Questions
Jeff Belden MD | beldenj@missouri.edu | Twitter: jeffbelden |
LinkedIn: jeffbelden | inspiredEHRs.org
Lorraine Chapman, Sr. Director of Healthcare| lorraine@macadamian.com| Twitter:@lorchapman |
LinkedIn: http://ca.linkedin.com/in/lorrainechapmanottawa

51. Thank you.