In this webinar, the panel discuss how we can work to optimise patient engagement and adopt inclusive practices, to improve digital health evidence.
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Professor Henry Potts, Professor of Health Informatics, University College London
Dr Paulina Bondaronek, Principal Behavioural Insights Advisor, Department of Health and Social Care
Rochelle Gold, Head of User Research, NHS Digital
Jonathan Knight, CEO, Tefogo
We’ve summarised the key themes from the discussion:
The importance of user research in digital health
Rochelle Gold leads a team of 90 user researchers at NHS Digital. She shared that often when talking about the word “user” people might just think just about patients and the public, but users include everyone that works in health and care too. It is important to look at everyone that’s interacting with a service to understand their needs and behaviours. Everyone working in health and care wants to deliver better/good care for people and user-centred design bridges the gap between the intent and the actuality of care.
Jonathan Knight is CEO of Tefogo, creators of Compassly, an app that makes assessing clinical competencies simple and efficient. It supports healthcare workers in their professional development, helping them prove skills throughout their careers and it gives hospitals assurance and vital insights into the clinical skill mix of their workforce. Jonathan has been undertaking user research from the start of Tefogo’s journey. He shared that any good health tech company needs to be solving the right problem and needs to truly understand that problem, and that the biggest realisations Tefogo have had come from the considerations of the users. Getting up close with the situation and the problems is the best research you can do.
Doing user research in practice
Jonathan shared that user research can be frustrating at times as you always want to do and find out more. In his experience, it’s possible to use every interaction to do a small amount of user research. This helps in gaining a breadth of views and can be surprisingly easy to accomplish through use of video calls. In his experience he has found people to be remarkably generous with their time and he would encourage all innovators to find a good NHS partner for research, suggesting that the AHSN network and DigitalHealth.London can help with this.
As a specific example of the importance of always keeping the user in mind, Jonathan shared that he had once spent a lot of time thinking about the approach for a particular product and was convinced that he had the right answer so had stopped listening to users. But it soon became clear that the product worked in acute services but not in community and mental health – this took time and money to correct.
Rochelle commented that resource is an issue when it comes to user research. While they have 90 user researchers in their team, this is still not enough for the number of products and services. Health and care has tight budgets and often the question is asked whether it is ethical to spend money on user research when the rest of the system is so strapped for cash. But Rochelle believes that it wouldn’t be ethical to bring in products that don’t work in context and that ultimately take time away from frontline staff at scale. User research is imperative, and it is about investing in the short term to save in the long term.
Rochelle commented that currently they are commissioned to do user research to validate a solution, but this is not where user research should start – it should start with the user’s needs. NHS Login was developed in this way through levels of in-depth interviews and iterative codesign with users to build a prototype.
The effect of Covid-19 on user research
For Rochelle, when the Covid-19 pandemic began, they pivoted very quickly to remote operations. This was beneficial as users were having to adapt to using solutions in their own homes anyway, so the context of the research was relevant. It also helped to widen the geographical sample and include those who couldn’t travel, as well as being cheaper to run. They built relationships with community groups or “seldom listened to groups” who had the most barriers to accessing care, the idea being that if they were able to remove the barriers for these groups, that would remove them for all users. Rochelle noted that when doing research with community groups you need to make sure it is an ongoing relationship and provide them with feedback.
Building on this, Jonathan commented that they embrace the advocates and early-adopters for their product but also reach the seldom listened to groups. As an SME it is also important to realise that you may not ever be able to reach all users, but you can reach as many as possible.
Both panellists agreed that people who are critical are often the people who have the most barriers to using a product and are the people who you learn the most from.
Meet the user where they are
When speaking to multiple users it can be important to avoid any influence from colleagues of different levels. Jonathan suggested providing opportunities to take part separately and to give options for anonymous feedback by simply leaving forms in a communal room.
Rochelle agreed on the importance of meeting the user where they are and shared the value of, where appropriate, bringing a relevant team member with you, for example when talking to a clinician bringing a clinician from your side to the discussion.
In terms of the user research itself, Rochelle advised to never ask people what they want or need but to make observations instead. This could mean asking a participant to guide you through their use of a product. The preparation and the analysis are the most important stages in this process.
Working in partnership with academics
Rochelle felt that there is a transition to be made between academic user research and user research. There is a big difference in pace, but this doesn’t mean that user research, while it may only take two weeks, is less rigorous than academic research. Jonathan identified collaborating with academic as something he would like to do but accessing this has proven to be difficult.