industry healthcare
skills design research & strategy, ux design, ui design
collaborators Jonah Arnheim, Tyler Martin, Center for Healthcare Innovation
time frame 3 months
URO-AID is a scheduling optimization survey outreach protocol and dashboard that helps hospital administrators better gauge how to help patients get to their appointments, and give them a human connection that promotes action.
scheduling optimization
Schedulers call patients and ask questions given by the risk assessment survey (right). Data from that survey instantaneously flows into schedule-optimization software that suggests a date and time for an appointment, presented on a dynamic calendar (center).
Survey in action - collects information that informs the likelihood to show up to appointments and uses the language of behavioral economics to promote appointment attendance.
recapturing patient drop-offs
This dashboard organizes and prioritizes patients for hospital schedulers to assess patient barriers to making appointments in order to facilitate an easy call-back system. Our team found that calling patients increased their sense of urgency to make their appointment or reschedule if they had missed one.
the problem
In Penn Medicine's Urology Department, patients diagnosed with microscopic hematuria, one of the primary symptoms of bladder cancer, miss their new patient appointments at a rate of 30%, delaying their cancer diagnosis months or even years. This issue is contributing to the stagnation of bladder cancer mortality rates in the US, even in the face of ever increasing technology and decreasing mortality rates in other cancers.
background
Microscopic hematuria is the symptom of having small amounts of blood in the urine, not visible to the naked eye. In 5-16% of cases, microscopic hematuria leads to bladder cancer. Of patients diagnosed with microscopic hematuria at Penn Medicine, about 30% of them are missing their appointments.
Steven and Karen are two of those people - Karen scheduled a month in advance, and since her hematuria was invisible, she let the appointment slip her mind. Steven figured his cardiac diagnosis was far more pressing than blood in his urine - ignoring a symptom that led to a bladder cancer diagnosis.We found that patients with microscopic hematuria lack urgency.
Urology is perceived to fall low on a patient’s hierarchy of priorities under other medical conditions and life events, and that the further out patients scheduled an appointment, the more likely they were to miss it.
For our first pilot, we sent all new microhematuria patients an explanation of their symptoms, the statistics on bladder cancer, and a calendar with the date of their appointment circled. Over the course of the 60 days of this pilot, only a minor uptick in appointment completion was noted.
refined solution
Using a new algorithm and our series of front-end prototypes, we ran mock simulations with staff to test how quickly they could identify and retain high-risk patients. Our dashboard solution aims to raise urology on the patient’s perceived hierarchy by calling patients one week before their appointment or after they’ve recently missed an appointment, identifying their barriers, and making it clear that it is important with words and actions how important it is to make their appointment. Our pilots showed the effectiveness of calling: patients who had no-showed asked to reschedule with urology before they would have taken the initiative themselves. A week out, we were able to identify if patients had caregivers, and use the language of behavioral economics to encourage action. Engaging patients from dropping out of the diagnosis pipeline proved effective as one step to treating bladder cancer in a more timely fashion.
