Health Design Challenge: One gal’s perspective

Last month, winners were announced for the Health Design Challenge, a contest put on by the ONC (Office of the National Coordinator for Health Information Technology) and VA (US Department of Veteran’s Affairs) that asked entrants to rethink the patient medical record. From the challenge’s site:

“ONC & VA invite you to rethink how the medical record is presented. We believe designers can use their talents to make health information patient-centered and improve the patient experience…. Innovators will be invited to submit their best designs for a medical record that can be printed and viewed digitally.”

This contest was an exciting opportunity for designers from around the country to contribute their time and creativity to help make health records more patient-oriented. The winner’s gallery (the best way to browse the entries, in my opinion) is an impressive collection of well-executed, eye-pleasing health record concepts; and some components of these designs will eventually become part of the VA’s actual health record system.

Personally, as a patient, UX designer and data visualization enthusiast, this contest was one of the most exciting things to happen this year. I didn’t submit an entry, but I pored over the submissions and would like to comment on some of the trends I saw.

User-centered design

I saw some great use of methods often employed by those working in the field of User Experience, like extensive user research, some great ‘experience strategies,’ personas, etc. Here is one quick highlight:

  • Personas
    The winning entry, Nightingale, introduces two personas: Ellen, the patient, and Gene, her caretaker. On each page of the design document, the designers feature Ellen and Gene and talk about how the design helps them accomplish their goals. This is a great example of a strategy for keeping patients at the forefront of the design team’s mind; develop detailed personas, get to know them like a friend or family member, and find creative ways to bring them along throughout the design process (almost as a member of the team). I loved the impact that this had; I also loved the cute watercolor effect.I recommend downloading the final PDF if you’d like to see more detail on how this team weaves the personas’ stories through the document.
    Screen Shot 2013-02-20 at 6.54.10 PM

Data visualization
One means of making complex information easier to understand is to visualize it. Our medical records contain complex information like lab results and histories, general medical histories, problem lists that have evolved over time, demographic and lifestyle information that has evolved over time, allergies and sensitivities that may come and go, etc. Some entries were more successful than others with regard to visualizing information, but the spirit making complex data more scannable and understandable through visualization is on-point. In fact I think I could write a whole post about the data visualization I saw in the challenge entries.

Just a few of the more successful examples included the following:

  • Lab results (context: where my result falls within the spectrum)
    The Blue Button / Method team had a nice example of this:
    Screen Shot 2013-02-20 at 9.02.03 PMTeam Grouping by Time had an interesting layout; though I am curious how it would fare in a black and white printed format (that’s true for many of these though).
    Screen Shot 2013-02-20 at 9.20.00 PM

    I was inspired by team Stay Well‘s lab summaries (which took 3rd place in the Lab Summaries); I liked their emphasis on the result number and location, and the way they minimized the visual weight of the lab result range.
    Screen Shot 2013-02-20 at 9.52.35 PM
  • Overall picture of my health
    I was excited to see two acquaintances get recognition for their entries; my Internet friend Dan McGorry‘s team Health Summary (from HealthEd) won for best lab summaries, but I think what’s interesting is the radial map of your health that they present (here shown with labels pointing to the icons).
    Screen Shot 2013-02-20 at 9.28.31 PMThis was a work inspired by the folks over at Involution Studios (Including my conference friend Juhan Sonin), whose hGraph has a similarly radial shape and attempts to communicate ‘overall health;’ their submission garnered an honorable mention:
    Screen Shot 2013-02-20 at 9.36.55 PM
  • My “problem list”
    Studio Tack’s 2nd place overall entry included an interesting body-based visualization that highlighted the organs and body parts that were affected.
    Screen Shot 2013-02-20 at 7.10.54 PM

Time as an organizing principle
I believe that one of the most difficult visual problems in this exercise is representing information that has changed over time; this becomes especially challenging when we are talking about trying to represent that information in the static, printed format. A few entries used a timeline view as an alternate way of exploring the medical history. A timeline is intuitive, and highlighting key moments in time may be a great way to help patients locate and share information with others. If it could be better adapted to the printed format (in other words, making decisions about what information to include in the printed format to avoid an enormous data dump), this concept could really help patients get a handle on their personal history and communicate about it with others. And full disclosure, I have a special interest in the timeline format.

An example from the Blue Button / Method team:

Screen Shot 2013-02-20 at 9.02.28 PM

Next, from the Grouping by Time team, who presents a somewhat confusing horizontal summary at the top (circle icons for the number of items in the list are identical to the age indicators over to the right), but then has a very clean history layout below.  I like how they are pulling out and highlighting key moments in the history.

Screen Shot 2013-02-20 at 9.19.44 PM

I liked the example below from Khyati Trehan, but I suspect it would be very difficult to automatically generate something like this and still maintain a legible output:

Screen Shot 2013-02-21 at 7.10.27 AM

One more from team Medical Chronicles; not sure how usable this would be, but it’s yet another time-based entry.
Screen Shot 2013-02-20 at 9.35.46 PM

Many of the entries included designs for paper print-outs that patients could keep on their person/in their wallet. I love this idea. Just last week, Seth Godin advocated on his blog post ‘The simple form that could save your life’ for everyone to keep a paper version of their medical history in their pocket. The paper examples from this challenge are really nice, though some of them do have limitations:

  • Some assume that patients will have a nice color, double-sided printer
  • Some of the more subtle visuals will become difficult to distinguish in a black and white printed format; for patients with some visual impairment, greyscale designs may be even more difficult to discern. Some of the entries included black and white variations to show off their design’s printed effectiveness.

From the Blue Button / Method team:

Screen Shot 2013-02-20 at 9.03.36 PM

The next example from team Accordion Mailer was intended to be a mailer – so patients wouldn’t actually have to be the ones to print this out (good thing, because it appears to be on gorgeous card stock):

Screen Shot 2013-02-21 at 7.14.14 AM

(Thanks Jeff Kellum for the link to the above example.)

One more great example from team SOYO (also from HealthEd) that is printable and simple, would still be effective in black and white, and which includes instructions for assembly:

Screen Shot 2013-02-21 at 7.18.25 AM Screen Shot 2013-02-21 at 7.18.15 AM

Anyway, speaking of portability, there were some great mobile designs and I even saw one responsive web prototype (Healthee, built by some kind of young, multitalented wunderkind doctor); but overall there were many entries that did not account for mobile at all. This is a huge opportunity area; providing access via mobile lets people access their info anywhere, anytime.

What’s next
This challenge was a great first step. Patients can obtain their information in a clean, easy-to-understand format; they can get more context and information around things like lab results and medications; they have a new tool for sharing information about their medical history. But this challenge was quite focused on the static information download or ‘view’ mode. How could we push this further?

  • Give patients the power to add information to their own record
  • Let them identify and flag errors
  • Get into the nitty-gritty interaction details; for example giving patients a legible high-level overview and letting them dive into their own details and history
  • Let them explore contextual information related to their conditions, lab results, medications, etc (e.g. ‘learn more about this blood test’)
  • Ensure there is full access and functionality via mobile devices

I’d love to hear your thoughts. I barely scratched the surface of the awesomeness contained within the entries; I encourage you to delve into them with a hot cup of coffee and a fresh powdered donut.


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