UX Case study : Understanding a wicked problem, the French Public Healthcare system

Ironhack — Project 1 : Wicked problem

Picture by @jonathanborba : https://unsplash.com/photos/dJzJkNdp9wc

1. Overview

Our client was the Public Healthcare system.

2. Problem Statement

This was the initial brief :

3. Users & Audience

Our users were public healthcare professionals in general. Our interviewees were people we were friends with, or people who kindly accepted to answer our questions even if we had never met them. We chose to interview different actors of the healthcare system, to have varied inputs concerning the global situation of the system. We interviewed two nurses, a psychologist, a director of the Caisse d’Assurance Maladie, an ergotherapeut, and an inspecting pharmacist at ARS. Their age range was from the twenties to the sixties.

4. Roles & Responsibilities

The Team

We worked as a team with my Ironhack comrades : Dahyun, Eloïse, Morgane and Victoire. We are all studying UX/UI Design.

What was my specific role?

Working remotely, we collaborated at every step of the project and took every decision together, until we presented our work, which is the only moment when we split the work. Nevertheless, we enjoyed the fact that everyone of us had her special talent and for example, Eloïse took care of most of the illustrations, when some of us focused more on the writing.

How did I collaborate with the rest of the team?

I felt more comfortable when writing, synthesizing or organizing the information, but I enjoyed every step of the process.

5. Scope & Constraints

We had a strict timeline, eight days, considering we didn’t spend all of our time on the project. Every step of the process was strictly timed.

  • We had to succeed in interviewing the people who are experiencing the greatest difficulties and facing the worst problems, but in covid times, these people are busy saving lives so we could not interview them.
  • We carried out each step of this research as a team, and in a very limited time. There were a lot of debates and we had to shorten them quickly so we didn’t fall behind.

6. Our process

Secondary Research

We read articles and surveys found on the internet. I focused on news articles concerning the access to public healthcare during this sanitary crisis, because I think this crisis reveals the flaws of the system, so I decided to take it into account.

What were the insights?

Since the beginning of the Covid crisis, people are postponing their doctors’ appointments, or their care is postponed, and it is a very critical problem especially for cancer patients (increased risk of mortality), chronic illnesses like diabetes (increased risk of arteritis and amputation), gynecological appointments (pregnancy or chronic illnesses). After the present crisis, there might be a secondary crisis, because of the postponed health problems. Covid revealed how fragile and insufficient our Healthcare Public system is. It has been very deteriorated during the past twenty years, because it passed from one of the first positions in the world, to the sixteenth.

  • lack of budget
  • lack of digital and material tools
  • lack of healthcare workers
  • disorganization
  • lack of communication between reality and government, between professionals because of a lack of time, and between patients and professionals, also because of a lack of time
  • inequality in the access to Public Healthcare because of medical desert in the countryside (hard to find specialists)
  • low salaries
  • overload
  • burn out
  • mental health greatly damaged for professionals and patients

Primary Research

Once we sorted out the information we had gathered between team members, using post-its on Mural, we prepared our interview guide together. Each of us wrote ten questions and then we chose together the most relevant ones and narrowed it down to 14 questions.

What are the insights from primary research ?

The big insight from our primary research is that the public healthcare system is very disorganized and has terrible lack of means and workers, which causes suffering for both workers and patients. Burn out for workers, suffering of not doing their job properly, and mistreatments and violence for patients, who are hurt sometimes morally, sometimes physically, by late diagnosis, medical mistakes, failed or badly done acts of medicine, lack of care for their mental health, lack of support, lack of information.

Affinity diagram

  • Covid
  • Inequalities
  • Organization
  • Psychological support
  • Material and financial problems
  • Training
  • it would facilitate communication between caregivers and from caregiver to patient
  • and thus improve the geographical inequality of access to care
  • it would improve organization
  • it would relieve the already overburdened mind of caregivers,
  • provide a material solution in an environment lacking modern tools,
  • and, to finish, it would facilitate access to information and perhaps free up time for training.

The Persona

The persona has been a good tool for empathy, but also for synthesis. Gathering similar points of view from our different interviews allowed us to see what was most common and agreed upon as pain points, and to classify this information to differentiate motivations, needs, goals, beliefs and frustrations. We came up with this sum-up:

Picture by @bermixstudio: https://unsplash.com/photos/yWYiNNK_tOI

User Journey

Ideation

7. Outcomes & Lessons

The lack of budget for Public Healthcare causes a tremendous chain of terrible consequences. Patients suffer involuntary violent treatment during medical acts, because healthcare workers are tired, do things too fast, and sometimes it results in unnecessary pain or trauma. This violence can also be psychological. For example a patient who suffered from avc cried on his last hospitalization day because he was not ready to go home and didn’t feel autonomous and safe, but he had to leave the hospital anyway because he used all the hospital days normally dedicated to this illness, even though in his case, he would have needed more. But nothing could be done and nobody could even reassure him when he was crying.

Our solution

Drawings by Eloïse Merian

Lessons

Knowing when to vote

One thing I would have done differently, if I could go back in time, is to propose a voting system for each disagreement. Debate is sometimes inevitable, but it takes time. A solution that might have worked out would have been to time the debate and then take a vote on each decision. This may seem procedural, but we all agreed, in hindsight, that this method would have been preferable.

How to stay on course

I also understood how easily you can lose direction, when you are going too fast and not taking the time to take a step back and check if you stayed aligned with your brief and your problem statement. An easy and powerful way to keep it in mind always, is, as we learned too late, to write it down and pin it at the top of every board, of every digital tool, at each and every step of your process. This is the most efficient way not to lose sight of it.

My teammates are also on Medium!

They took care of the very nice illustrations presented in this article, made from a template found on Google Slides. The talented drawings illustrating our solution were made by Eloïse.

UX/UI Designer, cinephile, author, singer and pastry fan

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