A Carnegie Mellon Capstone Project with UPMC Enterprises
Associated project: Student Portfolio
November 21, 2015
About this Project
While this is a student project, I include it in this portfolio because it allowed me to explore a problem space more thoroughly, diving deep into research, synthesis, and design. It has established a solid foundation, which I have built upon since in the 5+ years working in the industry.
This project was a collaboration with my capstone project team, Anna Malone, Diya Deb, Mike Szegedy, and Tina Jose. We also co-authored this article. The version you are reading on this site contains my adaptations to fit this portfolio. (The curious can see the article as originally posted)
The Problem with Readmissions
Readmissions cause both emotional and financial stress for patients and caregivers. Many of these readmissions can be prevented if patients better understood how to care for themselves following their hospital discharge.
Readmissions & Discharge Planning
UPMC Enterprises charged our team with coming up with a solution to help reduce readmissions by exploring the discharge planning process.
We were asked to create a tool that addressed factors outside the hospital that are critical to patient outcomes, like a patient’s support system, transportation, access to follow-up care and more. Our task was to support clearer communication and planning around these “soft factors” during care transitions, ultimately reducing a patient’s risk for readmission.
We chose to focus on a collaboration tool to improve communication between patients and providers during discharge planning, so that
- Providers can better understand patients’ lives outside the hospital.
- Patients can more fully clarify, understand, and even shape and co-create their plans.
- Chronic disease patients’ adherence to care instructions will improve, due to a sense of ownership and empowerment, leading to better health outcomes and reduced readmission rates.
Status Quo Today
- Discharge plans are based on medical conditions
- Patients are overwhelmed once they get home
- Patients are asked the same questions over and over again; and questionnaires are tedious
- Patients are given instructions and don’t know that they can ask for alternatives
- Patients have trouble following abstract instructions like “follow a low-sodium diet”
Our Vision for Tomorrow
- What is meaningful to each patient is incorporated into their plan
- Patients are encouraged to plan ahead while they’re at the hospital
- Providing information is fun and engaging for patients
- Patients co-create their discharge plan with providers so they have a greater sense of ownership
- Patients get actionable suggestions that meet them where they are at, helping them make baby steps
“Noting the patients’ current state and giving them small, baby-step changes that would impact them now will incentivize them to make bigger changes later.”Care Manager
Due to the confidential nature of this project, we cannot share any details about our research findings or final product. Read on to learn more about our process and methods.
Researching the Domain
We reviewed papers and articles to understand why readmissions are a problem and identify the medical conditions for which readmissions can be prevented.
Using the domain knowledge gained from our literature review, we created a visualization of the healthcare landscape and mapped out all the stakeholders involved.
We researched competitors in the discharge planning space to identify gaps and missed opportunities in the market.
We conducted research to gain an end-to-end view of discharge planning by looking at a patient’s journey from hospital stay, to discharge, to the home.
Exploring the Patient’s Journey
In Hospital Shadowing
Rehab Facility Visits
Generating Insights from Our Research
Establishing a Vision for the Product
Setting the Direction
To understand what design ideas would be most feasible and have the highest impact, we created a short-list of 40 ideas of possible solutions based on 10 of our top findings. We then asked our client to map these ideas to an impact vs. feasibility matrix while explaining their rationale.
Testing Our Early Visions
To validate the need for certain features, we created storyboards and shared them with providers and patients to get their quick reactions, as well as trigger deeper conversations about their needs.
Creating a Collaboration Tool
Wizard of Oz
Our client asked us to create a 3-minute concept video to quickly communicate our design concept to other stakeholders. I played a major role in the making of the video, from camera work throughout post-production.
Through the film, I wanted to convey the big vision and concept and the personality and interactivity of the solution. (Detailed screenshots redacted.)
- a high-fidelity, interactive prototype
- a web-based, functional prototype
- a 40-page research report
- a 40-page design report
- 2 × 40-minute presentations
Evaluation Criteria & Next Steps
Within our scope and timeframe, we weren’t able to pilot our solution at the hospital. Before implementing our solution, we strongly recommend that UPMC conduct a pilot within the app’s intended environment of use. The pilot should include a sample of patients using OnTrack and a control group. The effectiveness of OnTrack should be evaluated along the following metrics:
Does OnTrack reduce miscommunication, helping patients, caregivers, and hospital staff coordinate better?
Will OnTrack account for all of the staff’s logistical challenges, or should some revisions be made?
Do hospital staff continue to use the inpatient component of OnTrack through the entire length of the pilot? Do patients continue to use the outpatient component of OnTrack for the entire 30-days after discharge?
Are patients using the inpatient and outpatient components of OnTrack more likely to adhere to their care instructions than the control group?
Are patients using OnTrack less likely to be readmitted within 30 days than the control group?