Service design

Exploring how services can work for users

This report was written as part of a wider piece of work, around creating a collaborative health information system.

What we did

We started sketching early on to better understand what kinds of health and personal data is recorded about patients and what it looks like.

A lot of the data is displayed in text so we also started experimenting by writing text in different tones. Sketches with drawings and words was a useful way for us to explore the problem space through making.

Sketch exploring activity-based communication Sketch exploring differrent interfaces for video-calling
Images: Exploratory sketches

Alongside this more playful work, we were referring to the user research. As a team, we discussed the research in weekly meetings and drew more insights from the research.

This is when we started to draw out our experience map, which helped us to describe someone's life with a collaborative health information system.

The experience map

Experience mapping is a useful way to understand how services work in the real world. The collaborative health information system is not a single application or website but a set of tools and information that will come together in different ways to create a service for patients, carers, clinicians and healthcare workers.

Designing a flexible service like this is more than simply a set of pages, screens or components; it's important to understand how information should move around, what different users will need at different moments, and how the experience of using the service will change as a person's life becomes more or less complicated. It's also useful to consider different points of a person's engagement: how they begin to use it, and why; the most complex and difficult moments they are likely to experience; and - in this care - what happens when someone dies, or gets better.

To see what would be most useful, we used the insights from the user research and from there constructed a map of what one person's experience with health and social care might look like in the last phases of life.

We plotted their gradual decline with heart failure and Alzheimer's, and how that would impact on the quantity of health data they had and who was caring for them. We then attached the user research insights into particular moments on the map where we felt a different kind of collaborative information system could help.

Mike's health care journey

Here are some extracts from the experience map.

We started by understanding more about Mike. Looking at his life and habits, it was obvious he wouldn't have much motivation to look at his health records or actively manage his health information when he was well.

So it was more realistic to begin his interactions with the service at the point of his first diagnosis.

Experience map introduction: A diagram introducing Mike
Experience map introduction: A diagram introducing Mike

After Mike's initial diagnosis with heart disease, he manages most of his own interactions with health and social care, but as his care plan changes, family members become more involved.

Experience map: Mike’s first diagnosis. A diagram showing the information and advice available to Mike and the treatment he receives as he is given his first diagnosis
Experience map: Mike’s first diagnosis. A diagram showing the information and advice available to Mike and the treatment he receives as he is given his first diagnosis.

As Mike begins to have more tests and his medication changes, his wife Carol receives access to the service, so she can chase test results, see when Mike's next appointment will be, and keep track of new prescriptions.

Experience map: Mike’s family get involved. A diagram showing the information and support used by Mike and his wife as she becomes more involved in his care.
Experience map: Mike’s family get involved. A diagram showing the information and support used by Mike and his wife as she becomes more involved in his care.

When Mike is admitted to hospital following a complication, the frequency of new information about him increases and more clinicians are involved in his care. Up-to-date, accurate information is essential for everyone, including Mike and Carol.

Experience map: Mike’s first hospitalisation. A diagram showing the clinical team and hospital staff and the information they add to for Mike’s care.
Experience map: Mike’s first hospitalisation. A diagram showing the clinical team and hospital staff and the information they add to for Mike’s care.

A while later, Mike is diagnosed with a second illness. Carol needs more support from their daughter Lix, and Liz wants to keep track of chages to Mike's care plan.

As Mike's condition worsens, his medication becomes more complex and he begins to receive palliative care.

Experience map: Mike receives an additional diagnosis. A diagram showing that Mike’s medications, treatment and support increases with an additional diagnosis and decline in health.
Experience map: Mike receives an additional diagnosis. A diagram showing that Mike’s medications, treatment and support increases with an additional diagnosis and decline in health.

Mike is still living at home and is becoming more dependent on Carol. One day, while going to the bathroom, he falls at the top of the stairs. Carol calls an ambulance and Mike is taken to hospital.

Experience map: Mike’s condition worsens. A diagram showing the multidisciplinary team and information required to support Mike in hospital.
Experience map: Mike’s condition worsens. A diagram showing the multidisciplinary team and information required to support Mike in hospital.

Developing the experience map has shown some of the most important parts of the service to design, and illustrated some of the most complex permissions and data flows. This has formed the basis of the prototyping.