Using Human-Centered Design to Expand Telehealth Into the Hospital and Continuum


Reema Shah MPH; Estee Neuwirth, PhD; Lan Nguyen; Carissa Lim; George Go, MD; Tamara Hillstrom; Dan Huynh, MD; Margaret Pierce; Colette Lundahl; David Miura; Lisa Arellanes

Abstracts from the Kaiser Permanente 2019 National Quality Conference

From Northwest and Southern California

Background: As technology advances, telehealth provides a unique opportunity to meet the needs of members, care teams, and caregivers outside the traditional health care delivery setting. Compared with ambulatory arenas, telehealth in inpatient care and for posthospitalization care is limited, and the number of transitions, staff interactions, and acuity of patients causes additional complexities when designing a telehealth solution. Using human-centered design provides the opportunity to design a solution that can meet member, staff, and clinician needs while addressing the complexity of the setting.
Methods: Administrative and physician leadership in the hospital and continuum in Southern California and the Northwest were first interviewed to understand where there were opportunities for improvement in the hospital and continuum and how telehealth may be used to solve those gaps. After the interviews were synthesized, leadership, members, and caregivers then met to prioritize opportunities for further understanding and eventual design. Both Regions selected engaging family and caregivers of Medicare members through telehealth. Further ethnographic interviews, observations, and codesign sessions were held with Medicare members, caregivers, clinicians, and staff to develop solution concepts to better engage families and caregivers.
Results: Several distinct insights emerged: 1) caregivers felt overwhelmed by their new role and found it difficult to find the right resources; 2) there are often multiple caregivers with different caregiving roles; 3) caregivers and patients do not feel equipped to manage patient medications; 4) caregivers, especially remote caregivers who were not by the patient’s side in the hospital, often felt unprepared for discharge; and 5) caregivers and patients want a way to be able to connect to their care team for unexpected events postdischarge. These insights led to the design of an ecosystem of telehealth solutions that involves video, texting, and telephone capabilities to better connect members, caregivers, and the care team.
Discussion: Using human-centered design allowed for concepts to surface that may not have been considered if frontline staff, members, and caregivers were not involved in the design process. The next steps of this work are piloting in the Southern California and Northwest Regions. Because the solution is technology-focused, feasibility and cost must be considered throughout the design process and can be limitations to executing a design for which the technology is not available. Leaders play an important role in defining how a given solution can be made feasible in the short-term.

Abstracts from the Kaiser Permanente 2019 National Quality Conference


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