Snehal Khatavkar
Design researcher. Design strategist
Re-designing the Healthcare Power of Attorney Process
A patient-centered approach to design a scalable, and adaptable process to increase patient engagement.
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CONTEXT + PROBLEM
Dealing with Covid-19 taught us that most people are unprepared for unexpected
situations like sickness, accidents, and surgeries.
A healthcare power of attorney is a legal document allowing individuals to appoint a trusted person to make medical decisions on their behalf in critical situations. It serves as a crucial preventative tool, allowing you to maintain control even when you can't speak for yourself.
UChicago Medicines current HPOA form
CHALLENGE
UCM Health System faces significant challenges in effectively communicating the importance of healthcare power of attorney documents and managing them efficiently.
Despite playing a crucial role in ensuring patient
autonomy and delivering relevant care, currently only 6% of patient population has appointed a Healthcare Power of Attorney (HPOA).
Ask from UCM
Encourage healthy and critical care patients both to appoint a Healthcare Power of Attorney.
Design a digital first process from a paper based process to integrate completed forms into the patients electronic health records.
Design a replicable workflow to scale across UCM clinics.
10+
Reviewed secondary research articles and resources looking for barriers and good practices.
90+
responses to a survey to understand the perceptions, and knowledge of the general public about HPOA.
5
interviews with patients and non-patients to understand their perceptions and experiences with HPOA
2
visits to clinics where we carried out contextual inquiry with doctors and medical assistants (MAs), to understand their perspective.
20
think-aloud tests to understand the problems of the HPOA form itself.
RESEARCH
I developed a research plan along with research tools like interview protocol, survey design to conduct generative and evaluative research to explore patient and staff needs, potential barriers to completing and integrating a (HPOA) into the EHR.
RESEARCH FINDINGS
The existing process at UCM is underdeveloped with limited protocols which reduces patient engagement and delays
documents from reflecting in the patient's electronic health records
Staff needs
Single point dependency weakens the system
Relying on a single individual’s knowledge for checking and uploading forms to the patient portal creates a bottleneck, causing potential delays.
"I'm the only one who knows how to scan the forms" - MA
HPOA is not prioritized in the current workflow
Physicians and MAs must gather patient medical histories quickly to stay on schedule, often deprioritizing questions about HPOA.
“I need to take the weight, temperature, pain scale, blood pressure, review patient history... All in 5 minutes to keep the doctor on time.” - MA
HPOA is only introduced to 65+ and critical care population
Protocols for introducing the topic are limited to end-of-life situations or elderly patients and does not include younger population.
"I do ask elderly patients about HPOA" - MA
Research survey with 81 participants revealed
Individuals find it difficult to establish relevance and urgency of having an HPOA in the pink of health
Patient needs
Patients do not understand the process for procuring and filing an HPOA
58% didn’t know the process of filing an HPOA and
54% participants that knew about HPOAs,
didn't know where to get one.
Users deem HPOA unimportant
(66%) Sixty-six percent of people aware of healthcare power of attorney (HPOA) do not consider it a priority.
Lack of knowledge
40% of our survey sample had never heard of an HPOA, who is eligible for filling one and when is it used
ANALYSIS + SYNTHESIS
To synthesize the research findings I created current state journey maps, process flows and service blueprints documenting the end-to-end HPOA process.
“ I haven't filled one out because I'm still under the delusion that I'm never going to be incapacitated to the point that someone else will need to make health care decisions for me. I still believe that I'm going to be healthy my whole life and then die peacefully in my sleep after my 110th surprise birthday party, which ended at 2am. I'm half-kidding, but yes, it's mostly out of not wanting to believe that "it" (i.e., a horrible disease or terrible accident) is going to happen to me, despite all of the evidence to the contrary that it happens to lots and lots and lots of people..” - participant
SOLUTION
The goal is to make the process simple and regular so that patients are aware of it, normalize it, and can easily complete it.
01
Simplified workflow for increased clarity and access
02
Communication strategy for
Increased awareness through Repetition and Resonance
03
Scalability for Implementation through monitoring and control
Ideal patient experience with a digital + physical submission process
After finalizing the key strategies, I constructed an experience model of the entire patient journey to demonstrate how our proposal increases awareness, simplifies the process, and identifies critical touchpoints.
Click on the image for details
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Service blueprint : A guide for implementation
I developed a service blueprint to integrate all the recommendations in one place and guide the implementation process.
PROJECT DETAILS
Client
UChicago Medicine
Duration
January - May 2023
Methods
Qualitative and quantitative research
Prototype and testing
My Role
Design Researcher
Design Strategist
Team
Brayan Pabon
Dennis Seigert
Nishant Srikant
Shirin Navgire
Yiwen Teng
Instructors
Kim Erwin
Click on the image for details
Communication strategy : Re-designed HPOA form
Refined information architecture to improve information flow for patient understanding and access to patient information.
Created Frankenstein prototypes to improve information flow. Refined prototypes through 2 rounds of A/B testing.
