Public Hospitals

FICTIONAL STUDY CASE

1. Overview

For our first project at Ironhack, we had to work in groups, and we decided that our Wicked Problem would be Public Hospitals.

As we know, technology is changing the way in which we interact with each other, and going through a pandemic situation has opened the door to many changes in a faster way. So, considering that the public system is going to incorporate technological solutions into major infrastructures, our experience as citizens should also adapt to that changes.

It is a reality that in most countries, you are likely to encounter some problems with public health. “For our project, we focus on the healthcare service in Spain, which is free for everyone¨.

According to our research data, we have identified overloaded primary care services, an aging population in need of additional care, and longer waiting lists than ever before. The average time to schedule an appointment with a primary care doctor is 6 days (Annual Report SNS — 2020–2021), and the satisfaction rating for the government Health App stands at 3.1/5 based on 7.42 thousand reviews on Google Play.
Lastly, the population’s evaluation of certain digital services — such as online appointments (rated 8.4 out of 10), access to clinical reports (7.9), electronic prescriptions (8.8), and telephone consultations with doctors (8.1) — was highly positive (Ministry of Health — Digital Health Strategy) (Annual Report SNS — 2020–2021).”

Hence, we aimed to focus on patients experiences and how they navigate through these situations. To achieve this, we conducted interviews that revealed various realities, all sharing a common feeling: frustration with the steps involved in public healthcare.

2. Users & audience

After analyzing that data and supporting it with additional research, we came across David. He currently lives in Spain, a country where public healthcare is free, and he frequently encounters the same challenges that nearly everyone faces in this matter:
- Difficulties in contacting the doctor through the correct channel and finding information,
- Requesting appointments through different sources,
- Accessing his medical history, and
- Rescheduling canceled appointments.

He finds the appointment process tedious; the public system logistics strain relationships with specialists. The government’s app is unclear, making it hard to identify features. Additionally, long waiting times exhaust and frustrate him with the system.

3. Problem statement

So as a public health patient, he needs to find a way to easily contact the specialists because the system is overwhelmed and it’s not possible to coordinate visits with doctors on time, and the process is inefficient.

4. Roles and responsabilities

I collaborated with Reyes and Thomas, and fortunately, working with them was incredibly smooth and enjoyable. Despite experiencing moments of disagreement, frustration, and the challenge of not knowing each other well initially, along with the differences in our schedules and backgrounds from different countries, we managed to share our ideas and thoughts. It was a rewarding challenge that accompanied our participation in a remote bootcamp.

Regarding tasks and responsibilities, as it was our first bootcamp project, we were all part of the same learning process and felt a bit nervous. Occasionally, we divided tasks to make individual progress, but ultimately, we collaborated collectively on everything.

5. Scope and constrains

Working with this particular wicked problem was a real challenge because there were many things to improve, and having to keep in mind that public services always have little investment was an important point to consider. Our limitation was basically that, and from the administrative perspective, there wasn’t much we could do other than trying to streamline and simplify processes in which the user faces complications and provide them with alternatives.

6. Process

So, keeping all this in mind, once we had information about the issue, knew our user, we were able to create a user journey to truly understand the steps our users take when scheduling an appointment, what their motivations and pain points were, and we obtained several questions that later served us to brainstormed possible solutions.
Starting from the moment the user does not feel well and wonders if he should go to the doctor until he manages to get an appointment with his regular doctor and he has to refer him to another specialist, lengthening waiting times and the patient’s discomfort.

Having analyzed our brainstorming and voted on what seemed most important to solve, we created an Eisenhower matrix and decided to prioritize:

• Creating a process where patients have the option to access telemedicine;
• Establishing a clear and simple process for scheduling an appointment, and;
• providing clear information about the waiting time they will face if they go to emergencies without a prior appointment.

This is an attempt to alleviate the congestion at the nearest health center or hospital, ensuring that people are not exposed to potential contagions and excessively long waiting times due to both the system and the staff being overwhelmed.

Certainly, in this process, we received some feedback that made us pause, rethink, and implement changes to enhance our solution. I believe it was beneficial for us as it taught us the importance of revisiting and adjusting elements that aren’t working, emphasizing the value of continuous iteration.

Having a clear idea of what we wanted to do, we created a new user flow to understand the step-by-step journey our user would take. At this point we thought carefully about the options we wanted to give the user and retraced our steps to correct errors, defining the process in three branches that are subdivided with information for each type of user:

- If the user needs to attend emergencies, they can verify which center is less crowded and attend there, which avoids long waits and also that the center collapse;
- If the user prefers to wait at home and be treated through telemedicine, once you confirm your information you can see the waiting time you have and also receive a notification when it is next so that you are attentive and ready to be treated.
- And if the situation is not very urgent, you can make an appointment with the doctor or specialist you prefer, thus avoiding going to the center to make an appointment and easing the administrative work of the centers.

We made sketches that we later combined, connected with arrows, rearranged, etc., until we defined the process that best addressed our problem, and then translated it into mid-fidelity wireframes. Once this process was completed, we conducted a concept testing, from which we gained more insights that we evaluated and applied when presenting the project.
Once the process was defined, we created the information that we wanted to provide and the sketches that allowed us to see our journey in a more visual way. We then went on to create a prototype in mid-fidelity wireframes, which show the complete process of our journey.

7. Outcomes and lessons

In conclusion, understanding that the public health system is overwhelmed, users must be aware that, with technological advancements and especially after experiencing a pandemic that forced us to radically change some processes, we need to update ourselves and contribute from our positions.

Sometimes, the symptoms we are experiencing might allow a description of them through a video call from the comfort of our homes, which could be a possible solution to the illness.
Additionally, considering that there are many cases where this isn’t applicable, implementing technology already used in Spain, such as providing information on how many patients are waiting in your health center, can help alleviate the anxiety and stress patients experience when thinking about going to the health center in case of illness.

Lastly, providing clear, simple, and intuitive processes for scheduling appointments allows us to relieve the administrative staff’s burden, both in phone and face-to-face interactions with people who cannot complete the process through the application or who lose a lot of time waiting for phone assistance and decide to go in person to schedule an appointment.

Personally as I mentioned before, I believe the most valuable learning experience for me was acquiring the skill of receiving feedback, analyzing it, and iterating. The experience of working in a group, especially with people you don’t know beyond having seen them in class, always makes you reconsider aspects of your personality and review your communication and reaction methods. Yet, it also highlights the beauty of sharing and learning from others, both from diverse cultures that provide different perspectives on the world and from the ideas, imagination, and everything people can contribute to a creative process.