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GWENDOLYN GOH

Patient Referral

Improving patient care with an intuitive patient referral platform designed for General Practitioners and healthcare providers at Tan Tock Seng Hospital.

Client

Tan Tock Seng Hospital

Project duration

3 month (2023)

Team members

1 lead UI / UX Designer (me)
1 UI / UX Designer

Context

Tan Tock Seng Hospital is one of the largest multi-disciplinary hospitals in Singapore operating for over 179 years. The hospital works closely with primary and community care partners to provide quality health care services to the population. One of such programs is the referral process between General Practitioners and the hospital.

The challenge

General Practitioners initiate the referral process when a patient requires specialised medical attention. Receiving thousands of referral every month, the hospital struggled to process these referrals efficiently, leading to delays in patient treatment:

  • Physical referral forms are easily misplaced

  • General Practitioners were not providing enough patient details

  • Lack of visibility into the referral flow

Starting off with a design brief

To start every one off on the right track, I created a design brief that documents the initial assumptions, hard facts, goals and relevant information about this project.

Interviewing users

To learn more about the existing process and challenges faced by each user group, we interviewed over 25 users, including General Practitioners, Clinic Assistants, Call Centre Operators, Patient Service Associates and Specialists.

To be fully prepared for the interviews, I created a stakeholder interview plan documenting the research goals for each user group and planned the questions accordingly.

Stakeholder interview plan

Notes and observations recorded and grouped in an Affinity Map

From the stakeholder interviews, our key insights are:

General Practitioners & Clinic Assistants

Lack visibility into the referral process to respond to patients

  • Lack visibility into the referral process to respond to patients

  • Lacks details about patient diagnosis for follow-up

  • Finds it difficult to liaise on patient appointment via calls and fax

  • Lack visibility into the referral process to respond to patients

  • Lacks details about patient diagnosis for follow-up

  • Finds it difficult to liaise on patient appointment via calls and fax

Lacks details about patient diagnosis for follow-up

Finds it difficult to liaise on patient appointment via calls and fax

Call Centre Operators

Frequent of back and forth due to incorrect referral form filling

  • Frequent of back and forth due to incorrect referral form filling

  • Needs an easy way to organise referrals by urgency

  • Difficult to reschedule appointments as ideal time is unclear

  • Frequent of back and forth due to incorrect referral form filling

  • Needs an easy way to organise referrals by urgency

  • Difficult to reschedule appointments as ideal time is unclear

Needs an easy way to organise referrals by urgency

Difficult to reschedule appointments as ideal time is unclear

Specialists & Assistants

Concern over incorrect appointment scheduling by Call Centre

  • Concern over incorrect appointment scheduling by Call Centre

  • Form requirements differ significantly across specialist clinics

  • Insufficient patient details provided by General Practitioners

  • Concern over incorrect appointment scheduling by Call Centre

  • Form requirements differ significantly across specialist clinics

  • Insufficient patient details provided by General Practitioners

Form requirements differ significantly across specialist clinics

Insufficient patient details provided by General Practitioners

Empathising with users

To better empathise with users, we crafted personas of our target audience and created journey maps to visualise the process that users go through to accomplish their goals.

Understanding the referral process

From the interviews, we realised that the referral workflow is a complex process involving many different parties. To visualise the existing process and identify opportunities for improvement, we created a few process flows detailing the series of steps users will take to complete a referral.

A high-level process flow of creating referrals

Framing the challenge

Next, we proceeded to frame HMW statements to help us focus on the right problems to solve.

How might we...

Help GPs create referrals with the correct information?

  1. Help GPs create referrals with the correct information?

  2. Help users schedule patient appointments efficiently?

  3. Help users follow-up on referrals on time?

  1. Help GPs create referrals with the correct information?

  2. Help users schedule patient appointments efficiently?

  3. Help users follow-up on referrals on time?

Help users schedule patient appointments efficiently?

Help users follow-up on referrals on time?

Brainstorming, Dot Voting & Crazy 8’s

We held a brainstorming session where participants were given time to generate as many ideas as they could, focusing on quantity instead of quality.

To further encourage idea generation, we did a Crazy 8’s exercise where participants are given 8 minutes to sketch 8 ideas each.

Prototyping & validating solution

After understanding the problem space, we proceeded to design the high fidelity mockups and conduct usability testing on them. We conducted 1-1 usability testings with over 20 users from 5 different user groups.

An example of a task we gave users

From the sessions, we observed:

General Practitioners & Clinic Assistants

Too many mandatory fields, GPs may lack required information

  • Too many mandatory fields, GPs may lack required information

  • Referral status is helpful, but status description can be clearer

  • Tendency to assign referrals as fast track for faster appointments.

  • Too many mandatory fields, GPs may lack required information

  • Referral status is helpful, but status description can be clearer

  • Tendency to assign referrals as fast track for faster appointments.

Referral status is helpful, but status description can be clearer

Tendency to assign referrals as fast track for faster appointments.

Call Centre Operators

To avoid double work, needs to identify who is handling the referrals

  • To avoid double work, needs to identify who is handling the referrals

  • Status description should be similar to the terms they are using

  • Needs an option to send routine referrals for triaging

  • To avoid double work, needs to identify who is handling the referrals

  • Status description should be similar to the terms they are using

  • Needs an option to send routine referrals for triaging

Status description should be similar to the terms they are using

Needs an option to send routine referrals for triaging

Specialists & Assistants

Requires clearer indication on referral recency

  • Requires clearer indication on referral recency

  • Recommended appointment period is very useful

  • Needs a way to edit or cancel appointment if patient does not attend

  • Requires clearer indication on referral recency

  • Recommended appointment period is very useful

  • Needs a way to edit or cancel appointment if patient does not attend

Recommended appointment period is very useful

Needs a way to edit or cancel appointment if patient does not attend

The final solution

For General Practitioners & Clinic Assistants

A step by step referral creation flow that guides General Practitioners on the correct information to provide while minimising the amount of data entry with auto fill.

For Contact Centre Operators

Clear prioritisation of task load with the flexibility to send referrals for triaging. With Specialists’ indications of suggested appointment period, Contact Centre Operators can schedule appointments more accurately.

For Specialists & Assistants

A streamlined process of updating patient attendance and medical records. General Practitioners are kept updated automatically without the need for back and forth emails.

For System Administrators

Track and manage all referrals, view vital statistics and customise forms to meet department-specific form requirements.

Outcomes and learnings

The successful launch of the pilot project has connected over 30 clinics to 5 specialist departments at Tan Tock Seng Hospital. With the success of the pilot, the National Health Group has awarded Accredify to proceed with the next phase of the project.

A key lesson I’ve learned is the importance of starting a user roles permission matrix early. With several user roles and differing permissions, the matrix will not only assist designers in screen designs, but also facilitate a smoother handover to developers.

Overall, I am happy that the platform we’ve designed bridged the gaps between the users and facilitated the flow of crucial information to minimise delays in patient treatment.

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