ux scotland conference 2013 - selfservice healthcare

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Friday 21 st July, time tbc Roger Donald (NHS Direct) & Kevin White (Nile) Self-service health care This document and it’s content is Copyright ©2012 NHS Direct, Nile HQ and UCD UK Limited.

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Presentation from Kevin White, Nile and Roger Donald, NHS for UX Scotland Conference 2013

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Friday 21st July, time tbc

Roger Donald (NHS Direct) & Kevin White (Nile)

Self-service health care

This document and it’s content is Copyright ©2012 NHS Direct, Nile HQ and UCD UK Limited.

TIM KELSEYNATIONAL DIRECTOR FOR PATIENTS AND INFORMATION IN THE NHS

“We have to deliver an NHS that responds to

the needs of the people that use it”

eHealth Insider, http://tinyurl.com/blsjxbj

The Challenge for the NHS

The economics

* DH Reference Costs 2009/10 ** PSSRU Unit Costs for Social Care 2009/10

*** Connecting for Health/University of Sheffield, Second Interim Report, Oct 11**** Estimated 2011/12 figure for digital symptomatic assessments - income / users

£219

£95

£32

*

**

*

£8-12

£0.44

***

****

NHS Direct symptom checkers

Decreasing demand on core NHS services

Online symptomatic health assessments

Self care advice online

Web chatwith NHS

Direct

Call-back from NHS

DirectPharmacy

Referred to GP, A&E, Dentist or

999

Why multi-channel for health?

Why should we do this?

What services do users want?

How do they engage with them?

Does channel effect activity?

Do we do it simply because it is there?

Multi-channel health care

Channel Access Fulfilment

Face to Face• Urgent Transport• Car + Parking• Bus + Walk• Rail + Walk• Walk

• A&E• GP• GP OOH• WIC• MIU

Telephone• 999• 111• 0845 4647• TAL

• Ambulance• A&E• GP• WIC/MIU• Self-care Advice• Information• Appointments

Digital• Choices (nhs.uk)• nhsdirect.nhs.uk• net doctors• GP web site

• Ambulance• A&E• GP• WIC/MIU• Self-care Advice• Information• Appointments

“Channels are not alternatives, they are complements. It is only by appropriately combining channels that organisations can improve customer experience and make step-change improvements in efficiency at the same time”

Professor Hugh WilsonCranfield School of Management

Taking control of your health

Taking control of your health

Taking control of your health

Taking control of your health

Taking control of your health

Taking control of your health

Taking control of your health

Taking control of your health

NILE’S BIT

Interviews and persona development

Grant IngramChronic SuffererAge: 62Semi-retired mechanic. Works at local Halfords“I need reassurance and the possibility to talk to someone”

Julie WarringtonParent with toddlerAge: 32Mum and part-time voice-over actress“I don’t want to waste GPs’ time with little things”

Alayah RobertsMostly healthyAge: 23Recruitment consultant“Easier than going to the doctor”

IA Development and testing

Always read the label

Safe, evidenced-based, clinical content is paramount

But…– Users may not read text– Users may misread important information– Users may misunderstand important information

Clinical clinical content

Interactive decision points

Patient decision aids

Patient decision aids

Patient decision aids

High stress conditions

Potentially high risk interventions

Helpful, reassuring information

Visualisations and supporting diagrams

Real life stories

Calming messages

What do people want?

What do people want?

Respondents indicated the following as very valuable features• Text explaining how to deal with symptoms (43%, N=853)

• Tips from individual doctors or nurses on self-care (45%, N=874)

• Information on medicines which would be effective (51%, N=871)

What do people want?

And if all their questions weren’t answered they would value• Telephone callback (48%, N=871)

• Webchat (28%, N=838)

• Email contact (25%, N=842)

• Live webcam or audit chat (17%, N=829)

What do people want?

And if they were still unwell, they would be inclined to• A face-to-face consultation (64%, N=858)

• Phone consultation (42%, N=854)

• Accident and emergency (34%, N=847)

• Online consultation (28%, N=830)

CHALLENGES AND QUESTIONS

Quick response

Is a 4 hour call back wait acceptable?

Do instant webchats drive an expectation?

What would you do?

“It told me to go to A&E for a cold … I mean why would I go to accident

and emergency for a common cold”– From iPhone App review

Expected disposition

Urgency of end point given

Low Medium High

Urgency of user’s

favoured end point

Low 53% 44% 10%

Medium 65% 80% 33%

High 74% 78% 70%

Percentage chance that a user will comply with advice

New ways of interacting

Testing with people in distress

Testing with people in the right context

More serious conditions

Alternative methodologies

• Ethnography• Theatre studies• Mobile ethnography• Co-creation

THE FUTURE

Interconnected future

Symptom checking

Self care

Appt. booking

Condition information

Prescription mgmt.

Decision support

Long term condition

mgmt.

Wellness

Social care supportCare

provider information

Directory of services Discharge

support

NHS Digital service roadmap

Future services – beyond 2015

MyNHS from 2015Existing Services

From 2013

YOUR QUESTIONS

Takeaways

Methodologies need to develop to allow us to connect with distressed or otherwise contextually relevant participants

Strong reassurance seeking behoviour

Multichannel does not necessarily mean the same thing on every channel

The future aims to put the user at the centre of their healthcare