The US Department of Health and Human Services (HHS) and the Indian Health Service (IHS) were looking to modernize their 40+-year-old Health IT system and wanted to understand how it could better meet the needs of American Indian and Native Alaskan patients.
Identifying the Health IT needs for a national healthcare system spanning across multiple states, covering multiple healthcare specialties and departments, is a daunting task. Leading a team of 3 researchers and designers, I collaborated with stakeholders, subject matter experts, and community liaisons to focus the research and findings on the unique characteristics of the IHS—remote locations, tribal sovereignty and membership, poor health outcomes, multi-generational health records, among many other aspects.
Field and Remote Research
In collaboration with community liaisons from the IHS, the National Board of Indian Health (NIHB), and Coforma project partner Regenstrief, our team conducted interviews and workshops with almost 150 staff members and patients. This cohort included staff in 30 different high-level roles between providers, clinical support staff, and administration, in 40 healthcare facilities spread across the U.S. In-person research was conducted during site visits to reservation and urban health care facilities in California, Arizona, North Carolina, Montana, South Dakota, and Alaska.
Research activities focused on common workflows, how technology is and could be used, and how it might help mitigate pain points.
Synthesis and Findings
Research findings were synthesized in the form of 7 ideal-scenario service blueprints centered on common health outcomes of American Indian and Alaska Native communities, and covering many levels of service; 14 role-based archetypes for staff; and an ecosystem of IHS facilities.
The work above aimed to give context to the Health IT needs we heard during field research. We also delivered a list of 240 use cases extracted from these materials to help the IHS ensure Health IT solutions covered as many of these unique needs as possible.
VIEW DELIVERABLES AT HHS.GOV
Part 1 | Call for Human-Centered Design
Part 2 | I/T/U Ecosystem, Facilities and Archetypes
Part 3 | Service Blueprint: Pregnancy
Part 4 | Service Blueprint: Guardianship of Grandchildren
Part 5 | Service Blueprint: Suicide Ideation
Part 6 | Service Blueprint: ATV Accident
Part 7 | Service Blueprint: Recovering from Opioid Addiction
Part 8 | Service Blueprint: Diabetes Comorbidities
Part 9 | Service Blueprint: Caring for a Loved One
Part 10 | Use Cases
Part 11 | Bibliography
The research conducted, a Fast Company Innovation Awards 2020 finalist, is currently being used by the IHS to help define and configure Health IT solutions and ensure they are tailored to the needs of American Indian and Alaska Native people.
Context setting for Service Blueprint
Snapshot of Service Blueprint moment
Set of archetypes (or personas) for IHS—because of IHS’s focus on primary care, the high-level purpose of this project, and common needs and pain points, some specialties and roles were bundled into a single archetype.
Primary Care Provider archetype
Health IT requirements for the IHS were extracted from the service blueprints and archetypes in the form of use cases.