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Developed by: Becca Shuman, Karly Nelson and Jordan Gamble


Contents 2 4 6 8 10 16 18 20 22 26 28 30

Research

Problem Interviews Pain Points Experience Map Ideation Perceptual Maps Insights Future Experience Map

SafeLink

Name Storming Storyboard SafeLink App Development

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Imperfect heal

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lth is stressful.

It is more stressful when patients lack emotional and logistical support from loved ones when getting to and from the hospital. Many people do not have a support network to help them with transportation, or if they do have one it cannot provide enough of what they need.

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Interviews

Maura

Andrea

Supervisor of Social Work at Barnes Jewish Hospital

Social Worker at Barnes Jewish Hospital

Deals with getting patients to and from the hospital

Pick the elderly as a focus area; they have more constraints on their transportation and more factors that go into determining which methods of transportation they can take.

“We’re liable.” More problems with getting people home than to the hospital Calls multiple cab companies and fills out multiple forms

“The case-worker is the educator.” There are lots of barriers and hoops that people have to go through to even arrange transportation. People are exhausted even before they make the trip the day of their appointment.

Some patients will take advantage of the system Automatic service that calls patients to remind them of their appointment. The problem is, it hangs up after so many rings. Some patients say they missed their appointment because they didn’t get a call.

We met with multiple social workers and patients and discussed the pain points in their daily work life in regards to transportation. We also talked about issues patients have in navigating their way to and from their appointments.

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Janelle

Ruthie

Social Worker at Barnes Jewish Hospital

Patient, Christian Hospital Age: 70

Patient originally scheduled for the interview never showed up due to Call-a-Ride issues

Cataract issues, diabetes, oxygen tank Lives alone

Patients miss appointments because of “attitude problems” “It’s such an impossible task most of the time that it seems futile to try too hard.”

Granddaughter goes to work all day and school at night, but Ruthie depends on her for rides sometimes Applying for power chair

If a patient is readmitted within 30 days, BJC has to pay a fine The hospital is considering having their own transportation system

Doesn’t like asking people to do things for her Has issues maneuvering/walking in the snow or rain

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Pain Points

After sitting down with patients and social workers and getting some feedback, we pointed out the areas of pain and difficulty for the two users. Areas included data documentation of patients, recurring patients taking advantage of the cab voucher system, and patients’ difficulty securing adequate, consistent transportation.

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Patient Navigating transportation and their appointment by themselves can be overwhelming They don’t always want to ask their friends and family for help because they want to be independent

Social Worker Feels like a travel agent, spends too much time coordinating travel plans There are so many factors to consider when navigating a patient’s transportation plan that it can be a complex task Don’t have time to spend with more social patients Reactive rather than proactive. They respond to the needs of their patients when they come up.

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Experience Map An experience map shows what the user is doing, thinking, and feeling during each step of the transportation process.

Patient Social Worker

Doing

Planning

Actual Travel

Appointment

Booking Appointment Figuring out transportation

Am I going to get there on time? Am I going to be able to find the building? I hate parking. Where am I? Is the doctor going to be on-time? Is the doctor going to listen to me? Am I going to get along with the doctor?

Finding room and building, waiting for appointment, getting prescriptions, describing their health issues, comprehending doctor’s instructions

Working with other patients

If the patient misses an appointment, follow up and figure out why, try to better plan for next time

“Am I going to get there on time? Am I going to be able to find the building? I hate parking. Is the doctor going to be on time? Is the doctor going to listen to me?”

“Is this appointment going to be done in time for my Call-a-Ride? Is it getting too late or dark to use public transit? What am I going to have for dinner?

(Call-a-Ride, walking, asking family/friend for ride, driving, understanding how public transportation works, calling a cab). Remembering to

bring meds or any other documentation to the appointment. Asking patient how they are getting to the appointment. If they don’t have a plan, help them create one and follow up to make sure they understand and are prepared for their transportation plan

Thinking “How I will execute my

transportation plan? I need to set my alarm the day of the appointment. Who is going to be around to drive me? If I miss the bus, what’s plan B?”

“Will the patient get here on “I wonder if the patient is time? Will they need other going to make the appointservices once they arrive? ment on time, or even at Will we have to pay for their all.” transportation? How are they getting home?”

Feeling

Anxious, nervous, can be overwhelmed or stressed Frustrated that so much of their job is planning transportation, sympathetic to the patient’s situation

Frustrated, tired of waiting, feeling lost Frustrated that so much of their job is planning transportation

Nervous, doctor might not understand my situation


Getting Meds

Transport Home

Planning Next Appt

Home

Mobile Pharmacy, Beverly Hills Pharmacy deliver, pick it up from Pharmacy, have someone else pick it up from pharmacy

Talking to social worker, figuring out what my insurance covers, waiting for ride home, walking, taking a cab, figuring out public transportation, asking for a voucher, waiting for someone to figure out transportation for you

Make it at hospital, make sure I have transportation for next appointment

Physically getting out of the method of transportation and getting into house

Possibly coordinate a transportation plan where they can get their meds on the way home. Or have a loved one pick them up

Ask patient about plan for getting home, ask about family members/friends, call Logisticare/FirstTransit to schedule cabs, give cab vouchers, check patient’s insurance, possible counseling if they are stressed or distraught

Working with other patients

Might get a call if they can’t get into their house.

“How am I going to remember to take my meds? Can I pay for them? Is getting my meds going to delay my transportation home? How will I get to the pharmacy?”

“It’s getting late, I haven’t eaten. Where is my ride? When will the next Calla-Ride be here? Will the social worker give me a cab voucher?”

“Maybe my caregiver can give me a ride? Maybe it’s a different time of day so they have different transportation options?”

“Will the patient be able to get their meds? Pay for their meds? Remember to take their meds? Will they have to be readmitted because they don’t take their meds?”

“Is the patient just trying to get a free ride home? Does the patient really need our help? Is the patient covered by insurance? “

“If I gave this person a voucher “Did the patient get home this time, will they keep okay? Will the patient be asking? Will they even show able to get into their house up next time if they had a or will they turn around and bad experience with this come back to the hospital?” appointment?”

Glad they got the meds or frustrated they weren’t able to, upset about having to take so many meds, worried about remembering meds properly, how are they going to pay for the meds

Exhausted, hungry, dreading next appointment, lonely Frustrated by having to call many cab companies, feel bad about patient waiting for hours, cynical

Overwhelmed, feeling a little more confident because now I know how to use public transportation or terrified of having to using public transportation again

“Can I get into my house? Is someone else home to keep me company? Do I have food to eat?”

Exhausted, afraid if I get back late at night in unsafe neighborhood Concerned


Ideation

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We then went into the ideation phase of our project where we brainstormed solutions that would address the pain points we uncovered in our research. During our ideation, one specific story from one of the social workers stood out in our minds.

Social workers coordinated transportation for a patient only for them to end up back at the hospital because they could not get into their house.

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Ideation

We chose our top six ideas.

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During the ideation phase, we used different lenses to shape our brainstorming. We chose the lenses of gaming and social media to help us think of more interesting ideas. Based on the social media lens, we latched onto the idea of using texting or audio communication to solve this pain point, because it is a low-tech solution that would be applicable to people who can’t afford smart phones.

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Ideation

In order to assess the applicability of using this method of technology, we looked at the cell phone usage (both smartphone and traditional) among the elderly to determine if any sort of texting or phone communication would be feasible for this demographic. We found that 76% of people 65+ have a cell phone, with 18% owning a smartphone. We also found that 86% of people who have an income of less than $30,000/year have a cell phone, with 43% owning a cell phone. Number of texts sent/recieved per day, by age group Based on adults who use text messaging on their cell phones

120

109.5

100 80 60 50

41.8

40

25.9 20

20

10

14 6

0 18-24

25-34

35-44

Mean texts per day

45-54

9.8 2 55-64

4.7 2 65+

Median texts per day

Source: The Pew Research Center’s Internet & American Life Project, April 26 – May 22, 2011, Spring Tracking Survey. N=2,277 adult internet users ages 18+, including 755 cell phone interviews. Interviews were conducted in English and Spanish. 14


Cell Phone and Smartphone Ownership % of American adults within each group who own and cell phone and the % who own a smartphone Cell Phone

Smartphone

91%

56%

Men (n=1,029)

93%

59%

Women (n=1,223)

88%

53%

White, Non-Hispanic (n=1,571)

90%

53%

Black, Non-Hispanic (n=252)

93%

64%

Hispanic (n=249)

88%

60%

18–29 (n=404)

97%

80%

30–49 (n=577)

95%

67%

50–64 (n=641)

89%

45%

65+ (n=570)

76%

18%

No high school diploma (n=168)

83%

36%

High school grad (n=630)

88%

46%

Some college (n=588)

92%

60%

College+ (n=834)

95%

70%

Less than $30,000/yr (n=580)

86%

43%

$30,000–$49,999 (n=374)

90%

52%

$50,000–$74,999 (n=298)

96%

61%

$75,000+ (n=582)

98%

78%

Urban (n=763)

92%

59%

Suburban (n=1,037)

91%

59%

Rural (n=450)

85%

40%

All adults (n=2,252)

Race/ethnicity

Age

Education attainment

Household income

Urbanity

Source: Pew Internet Spring Tracking Survey, April 17 – May 19, 2013, N=2,252 adults ages 18+. Interviews were conducted in English and Spanish and on landline and cell phones. Margin of error is +/- 2.3 percentage points for results based on all adults.

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Perceptual Maps

We created perceptual maps to compare different characteristics of our ideas. We tested cost, complexity of implementation, and degree of impact to see where our ideas landed on the scale. We focused on inexpensive, simple to implement, and huge impact ideas. Texting as a solution stood out on both charts.

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17


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Top three insights: 1

A social worker’s day-to-day work life is more reactive than proactive in helping patients navigate transportation.

2

Patients sometimes get home, can’t get into their house, and have to come back to the hospital.

3

Some patients have to navigate their illness and their transportation without help from friends or family. Therefore, the social worker can be a main source of support for patients. However, they are often too busy to fully provide for this personal support.

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Future Experience Map We mapped out what the patient and social worker are doing, thinking, and feeling during each step of the ideal situation with our service.

Get Home From Hospital Doing

Thinking

Feeling

Patient Social Worker

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Text Social Worker

Receive Auto-Response

Arrives home

Texts number that corresponds to social worker’s app; just texts HOME

Receives automatic response, with time and date of next appointment and other important information

Puts the information of the patient’s next appointment into the app

Receives text from patient

Sends automated response to patient through app. Receives notification on phone for peace of mind.

“I need to text my social worker.”

“I’m home and this is easy.”

“Now I remember when my next appointment is and can plan transportation accordingly.”

“Will the patient be able to get into their house?”

“I’m glad the patient got home safely and into their house. Now they won’t have to come straight back to the hospital.”

“This is easy, I now have data on the patient and know that they’re home safe.”

Relieved to be home

Cared and looked out for

Reassured, reminded

Worried, stressed

Happy, reassured

Satisfied


“It’s our duty to make sure the patient gets home and make sure the home is functional.” ­— Maura Darcy

Supervisor of Social Work at Barnes Jewish Hospital

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Name Storming

communit

Service Adjectives Helpful Stress-reducing Connecting Safe Inexpensive Easy Supportive Caring Simple Beneficial Informative

Simple Useful Quick Home Support Network Text Phone Direct Call Door

Key Simple Low-tech For old people Patients Hospital Understandable Intuitive Door-to-door Friendly Community

User Adjectives

safe helpful 22

Stressed Busy Financially strained Overwhelmed Unsafe Worried Cautious Old Disabled Sick Alone Stubborn Self-sufficient Dependent Juggling lots of things Elderly Confused Unsupported Ill Lively

Friendly Lonely Dependent Poor Unhealthy Low-tech Knowledge Can’t afford transportation Limited resources Frustrated Tired Scared Annoyed Independent (wants to be) Proud Has a lot going on Car-less Lives in a rough neighborhood


ty support easy connected Interaction Adjectives Safe Cared for Happy Connected Community Reminded Simple Comfortable Smart Helpful Relaxed Reassured De-stressed Relieved Updated Kick-ass Cared for At ease Supported

Informed Helped Empowered Independent Responsible Hip Cool Looked after Not alone Secure Comforted Hasn’t hurt their pride/ dignity Social worker­­—comforted Not frustrated Reminded One part of the day made simpler and easier

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SafeLink is a mobile phone service that connects patients and social workers through text and audio communication. The service helps social workers ensure their patients get home safely while giving the patient better access and control over their healthcare.


Storyboard

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SafeLink At the beginning of the program, the patient has a meeting with their social worker. They discuss additional contacts, how long it normally takes for them to get home, and what they would like to happen if they can’t get into their house (call someone, order a cab, etc.).

1

2 The patient then remembers to call or text the social worker to let him/her know that they are home safely.

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The patient leaves the hospital and travels home.


3

The social worker receives a notification that the patient is home and safe. Selected friends and family also get a notification that the patient is home.

4 The patient receives information about their next appointment.

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App Development

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We wanted a simple, easy-to-use app for the social worker to get all the information they need. The homepage allows him/her to quickly see which of their patients are traveling, which are home safe, and which need help. They can click on each patient individually and see their contact and personal info.

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App Development

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