Developing strategies to pilot a Kiosk based Hospital Check-In experience.
Identifying gaps in current systems and developing systems recommendations to implement a new experience through user research.
Overview
This case study details a design research project conducted to enhance the patient check-in experience and to lower staff burden at Geisinger Health, a leading healthcare provider. The existing system, plagued by inefficiencies was causing frustration for both patients and staff. Long wait times created bottlenecks and detracted from the overall quality of care.
The Ask
The leadership wanted to identify gaps in the current check-in system and develop a strategy for enhancing patient experience as well as operational efficiency while implementing a digital kiosk solution.
Outcome
A comprehensive one-pager document (click to view) was created for senior leadership along with a set of service blueprints (click to view), outlining the key findings, recommendations, and design strategies for a digital kiosk system.
Client
Geisinger Health
Sector
Healthcare
My Contributions
User Research and Visual Design
CONTEXT
Staff Shortages and Inefficient Processes Creates Check-in Bottlenecks and Strains Resources
Geisinger hospitals faced significant challenges in their patient check-in and check-out processes. Staff shortages has exacerbated the problem along with the lack of standardized procedures and reliance on manual tasks creating bottlenecks.
To address these concerns, Geisinger sought to implement a digital self-check-in/out pilot program across five hospital units. Their leadership objectives focused on streamlining operations, and optimizing staff utilization through a digital-first approach that reduced reliance on Patient Access Representatives (PARs).
..Freeing up our front-line nurses from check-in tasks allows them to focus on what they do best..
- Research Participant
Process timeline
August
September
October
November
December
Understanding experience
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Clinic visits
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Contextual inquiry
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Stakeholder interviews
Research Synthesis
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Current state overview
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Service Mapping & Blueprinting
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How might We
Final Design
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One pager prototype
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Testion and Iteration
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Final Presentation
They started from the hard part, understanding the technology and creating a vision for a believable product that is not currently on the market. It was exciting to see the product development process and the outcome.
- Dr. Donato Ceres PhD. Founder and CEO of Aquamox Inc
Client Testimonial
Challenge
How can we assist to leadership's vision of a digital-first kiosk experience through research and actionable insights, ultimately improving customer satisfaction and operational efficiency.
RESEARCH STRATEGY
Optimizing for Market Success: A Multi-Phase Approach to Identifying Target Customers and User Needs.
Our process was to understand the needs of two crucial user groups: patients and staff. For Patients, They crave a clear, streamlined check-in/out experience to minimize stress during their healthcare journey. Ideally, they want options that are user-friendly and reduce wait times. For Staff, They desire efficient workflows to manage patient flow effectively and reduce their workload.
Our research goals included:
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What challenges exist within the technology framework?
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What are the intricacies associated with Patient Account Representatives (PARs)?
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How is the current check-in service model structured?
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What refinements can be proposed for the check-in service model?
4 interviews with patients and families
about their experience and perspective about current checkin process, including services that they get.
7-10 interview with staff and providers
about their experiences in understanding current workflows, technology adoption painpoints.
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PAR/Front End (workstream lead Holt)
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Rev Management
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Clinical/Admin
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Health IT
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Patient Contact center
2-4 interviews with leadership
about their perspective and strategies about staffing challenges.
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Building empathy through interviews and observation studies with potential consumers
1.
Understanding the current technology state.
This initial phase involved a thorough examination of Geisinger's existing technology landscape. We meticulously scanned all available technologies, including established systems like Epic and MyG. This comprehensive assessment aimed to create a technology map. This map served as a critical foundation for our project, providing a clear picture of:
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Existing Capabilities: Identifying the functionalities and limitations of the current technology infrastructure to ensure compatibility with the proposed kiosk solution.
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Integration Points: Pinpointing potential integration points between the kiosk system and existing platforms like Epic and MyG for seamless data flow and information exchange.
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Potential Challenges: Proactively identifying any technological hurdles that might hinder kiosk implementation, allowing for early mitigation strategies.
2.
Understanding the Responsibilities and pain points of PARs.
Building on our technology assessment, we took a user-centered approach to understand the human element. We conducted a contextual inquiry at a Geisinger facility, observing PARs in their work environment and witnessing the check-in process firsthand. Additionally, we held in-depth conversations with four PARs, gaining valuable insights into their responsibilities, challenges, and areas for improvement.
Snapshot of duties and research synthesis of PARs
3.
Developing Service blueprints to understand current checkin model.
After primary research, We created affinity maps and clusters to code and analyse the interview notes to identify themes and opportunities for improvement. Key themes included streamlining data verification processes, reducing the necessary number of PARs, and strengthening quality control measures to address turnover issues.
Highest Staff dependency due to data verification.
Snapshot of service blueprint for the current checkin process
KEY FINDINGS - INSIGHTS
A System in Need: Unveiling Challenges
After primary research, We created affinity maps and clusters to code and analyse the interview notes to identify themes and opportunities for improvement. Key themes included streamlining data verification processes, reducing the necessary number of PARs, and strengthening quality control measures to address turnover issues.
Confusions in check-in
The multitude of check-in options without a corresponding check-out process indicates a potential source of confusion for patients.
Fragmented Payment System
The technology for collecting payments was not comprehensive, neglecting certain payment types.
PAR Accountability challenges
The decentralized operational model of PARs resulted in competing priorities and a noticeable lack of accountability.
Technology Disconnect
The current technology infrastructure didn't seamlessly integrate with patient and staff workflows.
Training and Communication Gap
The reliance on staff uncomfortable with payment requests highlights a potential training and communication gap.
Balancing Technology and Customer Focus
Implementing technology solutions required careful consideration to ensure a balance between efficiency and a positive patient experience.
While the research uncovered a multitude of findings, we identified 3 core insights represent the strategic cornerstones for transforming the check-in process.
They address critical areas for improvement across technology, staff management, data collection and encompass the key aspects of a successful check-in system: People, Processes, and Technology. By focusing on these three core insights, we were able to bridge the gap between research findings and actionable solutions.
Centralized
Governance
Introducing centralized governance for PAR management will not only streamlines procedures but also improves communication between different departments.
Strategic
Harmony
Balancing conflicting department priorities requires customized strategies to achieve efficiency and precision in user experiences.
Data Quality
Enhancement
Enhancing data quality extends beyond technological upgrades; it necessitates enhancements in training and communication processes as well
OUTCOME
Insights to Action: Recommendations for systemic changes to implement kiosk-based check-in.
The proposed recommendations for improving the check-in process at Geisinger Health are categorized into three key areas: People, Process, and Technology (PPT). The PPT framework categorizes recommendations for a holistic approach. People ensures trained staff and user-centric design. Process focuses on efficient data collection workflows. Technology optimizes data use and aligns with existing infrastructure. All three areas work together for a well-rounded solution. ( Details about the recommendations are not shown due to NDA)
Centralizing PAR management
Capturing Patient Voice
Data Collection Strategy
Align on Minimum Data Set
Align EPIC with Stakeholder Expectations
The main challenge was crafting brief and clear information because, from a leadership perspective, there was a preference for easily comprehensible visual content at a glance. It was crucial for the language, visuals, and overall scanability to be simple and straightforward, avoiding any design jargon.
One pager document for the senior leadership including an overview, stakeholder relations and design reccomendations.
Proposal: Service Blueprint for a kiosk based check-in experience.
We created a service blueprint that includes a welcome kiosk, demonstrating how its implementation, along with the research-backed recommendations, can reduce PAR (Patient Access to Records) dependency. This underwent a pilot program at five Geisinger locations in Pennsylvania for testing and evaluation. (While the initial pilot program at five Geisinger locations in Pennsylvania did not incorporate all the recommendations during my tenure due to organizational priorities, future testing and iterations is said to include them.)
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Reduces PAR Dependency for data collection and verification
Proposed Service Blueprint for Kiosk-Based Check-in Process
Reflection
My internship at Geisinger Health has been a rewarding challenge. Stepping into an entirely new domain, I needed to quickly grasp the intricacies of a healthcare system, especially within the context of Geisinger's integrated health structure.
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Steep Learning Curve: Successfully tackled a new and complex domain (healthcare system) by immersing in learning its intricacies, particularly within Geisinger's unique integrated health structure.
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Design Advocacy: Demonstrated the value of design thinking in an organization not traditionally design-centric. Explained concepts and benefits to unfamiliar stakeholders.
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Project Management Proficiency: This project provided valuable experience in project management, allowing me to effectively plan and deliver within the healthcare environment.
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Leadership Communication & Clarity: Learned to facilitate a clear understanding of associated systems and service changes necessary for implementing a new, user-centered experience.