HealthCare – 2018
September – November 2018 (12 weeks) – U.S.A.
My Employer: Deloitte Digital (Seattle, U.S.A.)
To maintain confidentiality, the client’s name has been anonymized, and deliverables scrubbed of client logo and name. The current and proposed intranet names have also been scrubbed.
The Brief
One of America’s health plan and service providers, operating across 8 regions of the U.S., was experiencing a disconnect between corporate and non-corporate employees (“non-point-of-care” and “point-of-care” employees). The Healthcare Company (“HC” or “client”) approached Deloitte to investigate technology solutions for communications. Starting out as a project tasked to select a new platform for their intranet, the project quickly went broader as the chief panel (CIO, CHRO, and CCO) asked if an intranet refresh was the answer to bind HC. As my role of the researcher, this grew from finding out what people wanted to hear about on their intranet, to uncovering the whole communications ecosphere, where breakdowns were occurring, and mediums and forms that could help to solve these. There was also a concern on the digital maturity levels of the employees, and if a digital intranet was even the answer for communications.
The Deloitte team consisted of a Managing Director, Technology stream (Snr Manager & Manager), Capability stream (Manager) and Experience stream (myself).
My Role and Process
As the sole Experience Designer on the project, I was able to start on the project a couple of days prior to official kick-off, planning my activities and timelines to meet the expectations set out in the Statement of Work (SoW). The scope included a workshop with employees, up to 20 ethnography sessions, and up to 10 stakeholder interviews. My final deliverable would be a research report at the end of the 12 weeks, outlining what employees wanted to consume on their intranet. This would be visualized into intranet mock-ups, with the help of a visual designer, who would be brought on for the final couple of weeks.
With the chief panel expressing concerns that an intranet refresh may not be the simple answer to uniting employees, the project took a swift turn. This included our key stakeholder wanting representation across multiple regions, exploring the digital maturity levels across the enterprise, and understanding the communication ecosystem as a whole. This changed the scope dramatically (although unfortunately, not the timeline), with the final completed scope for my stream being:
- 2 employee workshops, totaling 39 employees + 10 stakeholders
- 2 stakeholder workshops
- 160 ethnographies
- A survey sent to all 220,000 employees, with 700+ respondents
- 22 stakeholder interviews
There were a lot of activities during the project I could cover. Below, I outline some of these activities, where there was a challenge to solve.
Challenges during the project
Aside from the obvious timeline issues, there were also some challenges along the way to overcome.
1. Adhering to the original deliverable expectations of a refreshed intranet, whilst also expanding to include the wider communication ecosphere. Outlined in the SoW was the requirement to have visualized screens for the new intranet. With the expansion in scope to be wider than an intranet, I needed to cater the research activities to reach the outcome of being able to redesign the intranet, as well as also listening to the concern of the wider communications ecosphere. I did this by separating out the research activities. The employee workshops would focus more on the intranet, with the ethnographies including the wider scope.
With the workshops focusing more on the intranet, I designed activities which helped to uncover problem issues, and promote future thinking. I did this by splitting the workshop in two – the first part of the day was about focusing on the past – the problems – and the second half on the future, and problem solving. The first activity (after introductions) was to understand the different personas who would be using the intranet. I had been given persona artefacts which had been completed by HC a couple of years prior. As they didn’t focus on digital aspects, this is where I placed the emphasis on for the activity. Post this, we did a journey mapping activity in the persona groups, first agreeing on two common use cases when using the intranet which had problems (the employee directory, and searching for policies came up), and then outlining the flow and the problems. The shift in focus then came in the Tweet Like Me activity, which was split into two parts. The first part was on outlining the current issues of the intranet, and writing these in a short “tweet”. The second half of the activity was visionary, asking the participants to write a short statement on their ideal intranet, and what they would boast about if it worked the way they wanted.
This shift to the future-thinking then enabled me to push on ideas for the future intranet, armed with the information of current problems, and the visions for the future. The next activity was on feature brainstorming, creating a “wishlist” of ideas. This fed into the next activity of Design Charrettes, where over multiple rounds, I asked the participants to sketch their ideal intranet home page (the first, feature image of this portfolio piece shows one group sketching their home pages). The presentations after each round (the first two rounds were completed individually, the third round was a group sketch) would highlight to me the different features people found important enough to elevate to their home page. Returning to the current state journeys completed earlier in the day, the groups returned to the walls, and were asked to “solve” the problems and create a new flow, without thinking of limitations or constraints. This blue-sky thinking was also augmented by the groups having mixed up into multi-persona groups, coming with a fresh angle to solve problems.
The final activity of the day was to prioritize the wishlist of features, by giving everyone different Monopoly denominations to place onto a feature. Using the wishlist boards earlier from the day, each participant was asked to spend their money wisely on what they would like to see implemented the most. The outcomes from these workshops included:
- An understanding of the digital habits and technology environment for each persona
- An understanding of the current problems of the intranet, in a couple of the most common (and frustrating) use cases
- A list of the most frustrating pain points, and a list of visionary features (wishlist)
- Sketches of prioritized features for the home page from every person in the room, and a group sketch from each table
- A prioritized wishlist of features
1+2: A persona example; 3+4: brainstorming common use cases and a journey map example; 5: Tweet Like Me example; 6+7: Design Charrettes in play and an example; 8-10: wishlist prioritization in two different locations and an example of one of the lists
The ethnography sessions were held in two different formats. One was the traditional format, of interviewing an employee in their place of work for an hour (or over the phone, if the location wasn’t possible). This format worked on the East Coast, driving between interviews in a number of states. On the West Coast, we were presented with the opportunity to host ethnography sessions over two days, in three medical facilities, where employees would drop in to visit us on the hour, each hour, across eight hours. This saw us interviewing anywhere from 2 to 11 people in an hour session, in each location. Our key stakeholder on the client side felt they couldn’t turn down this opportunity, especially as she wanted to ensure we captured point-of-care staff in our findings, and understood their digital maturity levels and communication methods.
I adapted the hour script to ensure we still got the outcomes we required, but also accommodated for more than one person at a time. I did this by running two individual activities simultaneously, and then running a focus group. The individual activities included some participants completing the enterprise-wide survey, which we had loaded onto 4 tablets, with the other participants answering four questions with sticky notes, on large pieces of paper we had hung on the wall. They were asked about their current communication mediums, the pain points, delight points, and what HC communications they are interested in hearing about. The participants would then swap activities, before all coming together to discuss in more depth the answers to the questions, allowing me to probe further. It also gave a chance for the participants to swap tips on delight points and solutions, which brought to light the break down in communications, and lack of standard processes and tools across the departments and roles. Taking a note of the roles at the start of each session, we were able to attribute each piece of feedback to a particular role.
1-4: The questions on the wall to answer with sticky notes (each persona had a different color); 5: we would pull down each set of post-its after each group, to discourage groupthink for the next group; 6: during the focus group, we would categorize comments by persona (colors along the top), with each tab in the Excel representing a different question. We ran this approach at all the medical sites. 7: the day after the ethnographies wrapped, we grouped and came up some initial high-level themes
The Affinity Analysis. Gathering research insights from 199 employees was no small feat, and created the largest affinity analysis I’ve ever worked on. I created three separate Excel workbooks – one for pain points, another for delight, and a third for wishlist items. Within each workbook was a multitude of sheets, consisting of insights from:
- The East Coast workshop
- The East Coast ethnography sessions
- The West Coast workshop
- 1 tab each for the four hospital visits for the on-site ethnography sessions across the West Coast
- The consolidated list, from all sources
- The final list, with duplicates removed, and themes assigned to every insight
The analysis captured 643 unique insights, which were categorized across 15 themes. Eight of the themes could be addressed via an intranet, with the remaining seven being wider communication ecosphere themes. I wrote three lists of recommendations – the first being the most important; and the second two being split by the two themes.
The recommendations at the start of the research report. 1: Most important recommendations; 2: intranet-specific recommendations; 3: broader communications ecosystem recommendations; 4-5: the 15 themes; 6: an example of a persona highlight – understanding their biggest pain & delight points, and wishlist items; 7: the intranet capability heat map, outlining capability maturity as defined by the HC core team, with green highlight and stars representing the overlay of employee wants; 8: an example of two of the themes, outlining the main pain points, delight points, and wishlist items, and the future capabilities for the intranet which could bring the theme to life.
2. The Survey. The survey was distributed via the current intranet and accessible for all 220,000 employees to fill out. This would help to address the concern of not getting enough diversity across locations, and across roles in HC. The first issue was around making the survey short enough to undertake within 3-5 minutes, whilst also collecting enough information to be valuable. HC only wanted to survey it’s employees once, and wanted me to really get the questions right. HC also wanted to pre-determine all of the possible answers – allowing users to select from a list of features, what they would want to see implemented. To encourage some qualitative answers to gain insight, I created two free-form questions, as well as adding in an option on questions for free text on outlier responses.
By uploading the survey on the intranet, I felt that it included an element of research bias. With one of the concerns being around if the employee population was low in digital maturity, we couldn’t only rely on results from employees who could easily find the survey online. So I suggested bringing the survey with me to the hospital/clinic ethnography visits, and had all of the interviewees complete the survey.
Due to time pressures (and that the survey had been bonus to the SoW scope all along) I just highlighted the top findings in the beginning of the research report, and included the raw findings (without analysis) in the Appendix. Luckily, this level of detail of the top findings was what the client was looking for.
I included the top insights of the survey in the beginning section of the report
The raw data was included in the Appendix, for the client to use as they wanted. For each survey question, I created a chart per location, for each role, as well as any free-form responses.
3. Presenting results with barely time to analyse. Two days after we had completed the whirlwind research tour including the two workshops and 160 ethnographies, we had to present the high-level findings and themes to the core stakeholder group (30 people) in a four-hour workshop. I knew I had to prioritise information that highlighted what we were uncovering, and fed into the rest of the workshop, which involved the core team creating solutions for each of the themes. The first thing I did was to create the pain point affinity analysis, loading in all of the data points, consolidating the data, de-duping, and then coming up with the themes. I uncovered 17 themes (which later, I would distill into 15), pulled some impactful and recurring pain points (where the duplication in points became helpful!), and listed some quotes and stories to bring the pain to life and give meaning in context. Myself and the Capability Lead then created posters of each theme, which we had printed overnight and then hung up the next day in the workshop room.
Starting off the workshop, we gave the core team time to walk the room and absorb all of the points, before splitting them up into teams along with three of the themes to “solve”. Each team had to outline a solution, what it would take to get HC there, and the impact. Coming back together after the break-outs, each group read out their themes and their solutions, and discussed them as a room. We then ranked every solution in an impact and effort matrix analysis, to help with prioritization of what to try to solve first.
1-3: Three examples of the 17 theme posters we displayed around the workshop room; 4: the impact/risk matrix
4. Visualizing the intranet recommendations. Towards the end of the project, a visual designer joined me for a couple of weeks to bring to life the intranet recommendations, wishlist items, and pain point solutions. As I was concurrently working on the research report, and receiving the survey results, I had to work quickly to not only onboard the designer and bring him up to speed on the research activities, but also start on very low fidelity designs. Before he came onboard, I created a list of the five screens I thought would be the most impactful, based on two personas using different mediums (I chose a non-point-of-care persona who would mostly be at their desk or in meetings, and a point-of-care persona who would share mobile technologies in a hospital setting).
1: Introducing the client core team to what conceptual designs were; 2-4: the screens chosen to visualize; 5: how to give feedback on designs
I would whiteboard sketch the features for each screen, based on the affinity analysis, and ask him to move straight into high fidelity mock-ups. In presenting the designs, I would find new stakeholders kept joining later review sessions, not having the context of a prior review, and thus providing unhelpful feedback. This, coupled with the fact that the designs would be socialised without me once I had left the project, prompted me to outline the use case for each screen.
1: An example of one of my brainstorm sketches – the intranet home page. The visual designer then took this for the basis of his mock-ups; 2-7: the use case and associated screen for the point-of-care worker (mobile screens); 8-13: the use case and associated screen for the non-point-of-care worker (desktop screens)
Learnings
From the Healthcare Company project, I learnt the following points:
- Expedited onboarding. How to quickly bring new team members on the project, and enable them to deliver outcomes quickly. This meant creating many templates, and guides for the research sessions, such as facilitator guides and note-taking guides for the workshops and ethnography sessions (I was able to share the facilitator and note taking roles with specifically-onboarded team members, as well as with the client). These outlined the outcomes required from each activity, prompts for the facilitators to get the employees answering the questions in a way which would align with outcomes, and picture examples of what I was looking for (e.g. photos of previous workshop activities, and previous research reports). This helped everyone in understanding the outcomes I was looking for, so no time with participants was wasted, and I was able to pick up everyone’s note-taking template and quickly amalgamate.
- Quick pivots. How to pivot very quickly, from a user experience project, to an experience project (while still meeting the SoW expectations). The unexpected late change in scope changed the ethnography sessions from focusing on the intranet as the one and only solution, to exploring all communication channels, communication breakdowns, and different communication forms and factors.
- Learning where to compromise and cope with scope creep. I had to work out how to manage the ever-evolving scope, and finish the work within the 12 week period. This included knowing when to raise risks and issues, negotiate on timelines for the deliverable (pushing out the review dates), bringing on other colleagues for help (the Capability Lead to assist with running the research sessions; another UXer for a day to help with the current-state heuristic analysis; a colleague to help create the graphs and format the insights tables for the survey analysis for 3 days; 2 analysts to help with co-facilitating small groups at the workshop and note-taking during ethnography sessions; and briefing the technology stream and MD on how to help with the workshops); and figuring out where to compromise (such as bubbling up the main insights of the survey, but not going into detail for every question).
Results
I delivered the research report to the key stakeholder, who loved all the detail and insights, and was really happy. She is intending to present the final recommendation to the board April 2019.
The timeline was extremely aggressive, and I wouldn’t want to leave the impression that this project is achievable in the timeline given. A lot of overtime was given, with negative impacts to my health. A lot of complexities were overcome, the research was expanded from user experience to customer experience which made the problem really interesting, and strong insights and recommendations were given, which is what I want to highlight in this portfolio piece.