Diagnosing the problem
It’s essential first to understand the problems space. Clarity around the problem cascades into identifying the solution and informs the framework for the initial product build. Typically, there are different visions and perspectives on the problems. Technology stakeholders focus on problems related to HIPAA compliance, security, and infrastructure. Business stakeholders are keen to focus on user experience and business process dependencies. Meanwhile, executives may prioritize performance and ROI.
It is critical to ensure stakeholders and business are aligned which is often a challenge for large organizations.
For healthcare in general, there are a wide variety of stakeholders to engage with including:
Providers: Physicians, nurse practitioners, physician assistants, group medical officers, chief medical officers
Operators: Schedulers, recruiters, credentialers
Executives: CTO, CIO, CPO, CMO
When designing a new application, there are many methods to identify organizational challenges and opportunities for improvement to create that alignment.
In this instance, conducting a Lean Requirements workshop is ideal. The workshop provides an opportunity for the team to voice ideas and concerns while extracting the fundamental needs and requirements for the application.
Discovery phase
In the case of our client, the initial findings led the team to engage in a robust discovery phase to thoroughly investigate and understand the organization’s current state.
Activities in the discovery phase included:
Story mapping workshops with stakeholders
Interviewing end-users
Conducting surveys
Creating service blueprints
User testing with prototypes
Discovery: The Pain Points
The company had gone through a period of rapid growth with several mergers and acquisitions.
They had not yet achieved full process and system integration across the business.
Teams were dispersed geographically and were using different channels to communicate that weren't always secure such as an out-of-the-box text messaging system, text messages (i.e., SMS and iMessage, telephone (i.e., landline and mobile) and ersistent chat applications (i.e., WhatsApp, Slack, AIM, Teams).
Various user groups had different preferences for communication tools.
Company-wide, inter-facility, inter-team communications were fragmented.
Messaging patterns were not consistent. Messages could easily be missed, mixed up, or duplicated.
Communication tools lacked features for tracking, group messaging, and broadcasting.
Demands of the scheduling process were not supported. (For instance, instead of being able to send one group message to book one shift, the schedulers needed to reach out to each doctor individually via a specific channel.)
Providers (our physician community) are spread throughout the country. They work varying shifts. Communicating with them is a challenge. Overall, our ability to communicate with our physicians securely was very limited.
- Senior VP of Information Technology
Many messages contained time-sensitive and confidential or protected information.
Completing tasks for onboarding and scheduling required multiple touchpoints across multiple applications.
Tracking and traceability were inherently manual and challenging.
There were many areas of risk for compliance and security issues.
User roles and interaction patterns were complex.
Internal vs. external users
Operations vs. clinicians
New vs. existing
1-to-1
1-to-many public (group)
1-to-many private (broadcast)
The service blueprint generated clearly outlined the complex communication system of users, tools, and processes in existence.
We exposed common themes (epics) and features (stories) that provide the most value for the business and its users for the initial release (MVP).
Both functional and non-functional feature requirements were identified such as:
Direct, group and broadcast messaging
Read receipts
Sharing of attachments
Company directory
Integrations with existing tools (scheduling, onboarding)
Automated messaging
Reminders
Tasks lists
HIPAA compliance
Security (encryption, authentication)
Mobile apps (iOS, Android)
With a good understanding of the problem space and our end-to-end service map in hand, we began exploring the solution space with confidence.
