The Future of Health Authority

Revamp Health

Developing strategies to motivate more people to sign a Healthcare Power of Attorney.

Client

UChicago Medicine

Duration

Jan 2023 - May 2023

Role

Design Strategist

Team

Dennis Siegert

Yiwen Teng

Nishanth Srikanth

Bryan Pabón

Snehal Khatavkar

Shirin Navgire

Design Tools

Figma

Adobe Suite (Main Tool)

Qualtrics Survey

Mural

Project Overview

Context

Currently, only 6% of patients at University of Chicago Medicine have a Healthcare Power of Attorney

A Healthcare Power of Attorney is an important document that allows a person to delegate another person (usually a trusted friend and family member) to have the power to make decisions to their care. However, not many patients are filling one out due to how complex the process is.

Problem Statement

While the University of Chicago Medicine has made efforts in the past to improve the rate of completion of HPOA, most of these have been disparate.

01. Lack of Awareness

40% of our survey sample had never heard of an HPOA

02. Not Seen as a Priority

Even with those who knew of HPOA's 66% didnt see it as a priority

03. Unaware of the Process

58% didnt know about the process of filing an HPOA

Patient Journey

User Need

Interventions to boost HPOA completion should align with the patient’s journey and their needs at each stage.

01. Prioritization of Information

Improving the HPOA form to highlight the priority of having an HPOA

02. Inclusive Messaging

Use posters and brochures with clear messaging to increase HPOA awareness and understanding.

03. Transparency

Having a better completion process to give patients a peace of mind

How Might We

Increase HPOA completion rate and help patients understand the importance of being prepared?

This involves understanding the patient journey and developing interventions so that patients can clearly understand the importance of having a Healthcare Power of Attorney

Project Overview

Design Solution 1

Redesign the HPOA form to assist patients in identifying and prioritizing key information.

Current Forms

The current Healthcare Power of Attorney forms are lengthy and overwhelming, discouraging patients from completing or starting them. Redesigning the form for better formatting is needed to address this issue.

General Form

Pages-from-powerofattorneyhealthcareform

Illinois State Form

University of Chicago Medicine Form

Our Redesign of the HPOA Form

01. Improving Readability

The character length was limited to 60 characters to improve readability. The font size was kept at 12 points. While 14 points is the standard, the font used, Gotham, has a tall X-height, making it appear larger than the point size.

02. Creating Sections

The sections were rearranged to improve the flow of the document. The sections were given clear dividers. Important information within each section was highlighted.

03. Placement for MRN (medical record number) Stickers

All pages that need to be scanned have a space to attach MRN Stickers, which is a unique identifier used to track patient information.

04. Highlighting Agent Contact Information

The designated agent's contact information has been highlighted with a box.

05. Showcase Amount of Pages Needed to be Scanned

The number of pages to be scanned was maintained (3 pages).

Creating a Conversation Guide

A conversation guide brochure supplements the form, with a focus on initiating the conversation with the healthcare decision maker.

Design Solution 2

Implementing clear, inclusive messaging will enhance HPOA awareness and understanding.

Poster 1

01. Messaging Strategy

The messaging strategy for this series focuses on addressing the importance of choosing a medical decision maker with simple text.

02. Relateable Imaging

The illustration is relatable and light-hearted which can catch the attentions of individuals.

03. Call to Action

The QR code is the call to action. This links to a downloadable version of the form thus encouraging people to fill one out.

04. Creating a Usecase

This body of text explains the importance of signing an HPOA by using the characters in the visual as a use case.

Poster 2

01. Relateable Imaging

The photograph is relatable and inclusive which can catch the attentions of individuals.

02. Messaging Strategy

The messaging strategy for this series focuses on addressing the importance of having a conversation with close ones.

03. Creating a Usecase

This body of text explains the importance of signing an HPOA and appointing a medical decision maker.

04. Call to Action

The QR code is the call to action. This links to a downloadable version of the form thus encouraging people to fill one out.

Creating Awareness Outside the Clinc

Brochure to spread awareness of HPOA

A conversation guide brochure, helping patients better understand the importance of an HPOA and know why it is needed.

Having an Illustrated Guide

01. Understanding Context

The headline focuses on setting the context.

02. Impactful Headlines

For each step, the headline explains the action to be done and the description provides relevant information.

03. Illustrations of Actions

The illustrations depict the corresponding steps while catching the attention of passers-by.

04. Call to Action

The QR code is the call to action. This links to a downloadable version of the form thus encouraging people to fill one out.

Design Solution 3

Developing a transparent HPOA completion process to enhance patient confidence

Creating Upload Guides

01. Making it Patient Centered

Reformatting the “How to upload guide” to be more patient centered, as well as to match the format used in the form.

02.Creating Detailed Information

The guide also includes more detailed information on which pages need to be scanned and the file formats to be used

Keeping Patients in the Loop

Patients often lack updates on their HPOA status. Automated texts and phone messages can inform them about upload status, approval, and processing times.

01. Automated Text Messages

Automated text messages inform patients of whether their HPOA has been uploaded, and approved and the time these processes usually take.

02. Further Sharing

The messages also prompt further sharing of HPOA forms.

Having a New Digital Platform

Incorporating a digital platform is essential for improving the process. Vynca, Koda, and Docusign are formats that can allow patients to submit the forms easily

Comparison of Platforms

Koda

Patients can send the digital form to their providers or upload it to MyChart
Patients can share the form with their chosen agent through the platform
UCM prepares a Guide for uploading to Mychart

Vynca

Patients can share the form with their chosen agent through the platform
Forms uploaded on VYNCA are fed directly into the provider's EHR

Docusign (Current Platform)

Patients can upload the digital form on Mychart
UCM prepares a Guide for uploading to Mychart

Project Process

Research Methods

Conducting research to investigate current problems, analyzing these insights, and synthesizing them to How Might We Statements

Quantitative Research

Secondary Research Through Articles

Qualitative Research

67 Participant Interviews

User Testing

Clinic Visits for user testing

Secondary Research Findings

Ethnic minorities, especially Black, Asian, and Latino groups, often struggle with advance care planning (ACP) and completing related documents. Educational efforts can help improve understanding and completion rates.

Mistrust of the healthcare system, particularly among Black individuals, adds another barrier to ACP engagement. Addressing literacy gaps and rebuilding trust through better care is crucial for equitable end-of-life planning.

Survey Methods

Through surveys, we were able to gain a better perspective of the Healthcare Power of Attorney, ultimately leading to the identification of areas of opportunity based on the survey results.

N= 81

20 Thinking Out Loud

Through rapid testing, we identified flow issues as well as visual appeal across multiple forms. The process involved gathering feedback from users who interacted with these forms, enabling us to understand their experiences and uncover any usability challenges.

General Form

10 of 20 in favor

Illinois State Form

8 of 20 in favor

UCM Form

2 of 20 in favor

Qualitative Interviews

6 Healthcare Professionals

67 UCM Participants

4 PCAB Board Members

Main Findings

Interviewing healthcare professionals provided valuable insights into the challenges they and their patients faced with HPOA form completion, revealing key obstacles and opportunities to improve the submission process.
The main barriers reported by professionals were a lack of knowledge and skills to carry out ACP, a certain fear of starting conversations about ACP, and a lack of time for discussions.

Prototype Development

Frankenstein Prototype

We used insights from the "Thinking Out Loud" research to create a prototype HPOA document by combining effective segments. This approach focused on elements that resonated with users and incorporated stakeholder input, resulting in a streamlined and practical HPOA vision.

Development of Communication Tools

After two rounds of user testing at the University of Chicago Medicine and three iterations, we created poster prototypes to raise awareness about HPOA forms. Feedback from staff and patients helped us refine the messaging for more effective educational tools.

User Testing and Feedback

UCM DACAM Visit

By conducting user testing we gained a comprehensive understanding of patient experiences and viewpoints. This real-world feedback enabled us to collect actionable data to inform solutions that improve healthcare outcomes and refine the phrasing of our HPOA communication tools to better resonate with users.

UCM DCAM First Visit

33 Participants

UCM DCAM Second Visit

32 Participants

Key Insights

Many participants preferred the messaging "A conversation we all must have" and "who is your person?" as it catches their attention makes them ask what the poster is about.
The imagery has a sense of relatability and inclusiveness, which was important for participants.

UCM DACAM Visit

We presented our findings to UCM staff, whose feedback refined the HPOA communications strategy and design. Their guidance helped us align the deliverables with clinical workflows, allowing our academic work to transition into an impactful program now implemented at UCM.

UCM River East Visit

UCM Staff

UCM DCAM

Goldblatt Pavillion UCM Staff

Key Insights

UCM staff assisted in adjusting the size and proportions of the communication tools to enhance visual impact.
Initially concerned about the visuals, UCM staff changed their stance after seeing insights from user testing and agreed to proceed with testing.
UCM staff approved our messaging in the communication tools, noting that it felt impactful.

Impact

Outcomes

9-Week Pilot Study

After presenting out findings to UCM, we were provided funding for a 9 week pilot study

Increase of 172 HPOA forms taken over 9 weeks

From moving more communication tools to having them by the waiting area, there was a high uptake of HPOA forms

Need of more direct patient engagement

From what we found of observations from the pilot study is that there is a need for receptionists and medical staff to ask if they have noticed the materials in the waiting room

Creating more Communication Tools through Behavioral Patterns

We found that many patients prefer to use postcards as engagement materials, as it allowed them to easily carry them in their bags and bring them home

Takeaways

Design implementation is essential in the healthcare field, and this project provided me with valuable insights into the healthcare system. Throughout the project, we conducted numerous interviews with patients and staff members at UCM to gain a deeper understanding of HPOA. It became evident that implementing changes in the healthcare system is a complex and challenging task, given the numerous barriers and pathways involved. However, despite the challenges, the experience was ultimately positive, as it shed light on the areas that require improvement and highlighted opportunities for positive change.

Future Steps

Moving forward, the next steps involve further exploration of the project within the healthcare system. It is crucial to incorporate a digital aspect into the system to streamline the process of signing an HPOA and effectively implementing it.