interaction design for hospital ethnic minority

1. embrace comforting
patient journey
Jackson CHOI // MDes Interaction Design // 2011
1

2. Content
First published 2011
01:: Introduction
(c) 2011 Copyright
02:: Research and Analysis
Designed by
Jackson CHOI Chi Kit - Pok Oi Hospital
- Ethnic Minority Group
- What were being done
Project Tutors
- Patient Journey Analysis
Prof. Xin Xiang Yang
Michael LAI
Tequila CHAN
03:: Project Insights
All right reserved. No part of this report may be reprinted
04:: Project Statement
or reproduced or utilized in any form or by any electronic,
05:: Interaction Model
mechanical, or other means, now known or hereafter invented,
including photocopying and recording, or in any information 06:: Task of Design Items
storage or retrieval system, without permission in writing from the
authors. 07:: System Diagram
08:: Experience Strategy
09:: Designing the programme
- Concept video
- Proposed Patient Journey
- Digital Device User Interface
MDes - Graphic Design Items
Interaction Design 10:: Conclusion
School of Design 11:: Self Reflection
12:: References
13:: Appendix
14:: Special Thanks
2 3

3. 01:: Introduction
This was a collaboration project initiated by Pok Oi Hospital under the New Territories
West Cluster of Hospital Authority of Hong Kong. The project aimed to seek for
opportunities of improving the service of hospital through interaction design. The
executive brief was wide opened, extends from the informatics of in patient records,
to navigation system of hospital, from patient services of special clinics to medical
experience of ethnic minority, and even to pressure management of medical caregivers.
This was also my Capstone Project for the programme MDes Interaction Design by
Hong Kong Polytechnic University. It demonstrated the knowledge and various skills of
interaction design acquired in this programme.
This report documented the project development of the project titled “Embrace -
comforting Medical Experience for Ethnic Minority”, from initial research and analysis
stage, to idea generation and concept execution. By understanding the problems and
difficulties faced by the target group, insights were identified and relevant solutions were
suggested accordingly. It was expected that this report could serve as a proposal for
further development and execution for the benefit of improving the medical care services
for Ethnic Minority Group.
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4. PROJECT SCHEDULE
Research & Rationalization Concept Development Final Presentation to POH:
P6 P6 Finalized design proposals
Patient Journey refinement with project video, final
Primary Research design items.
Interaction Model
Interview with doctors, nurses
and management from A&ED Experience Strategies
and SOPD. Scenario Development Show Time:
P5 P5 Finalized design proposals
Interview with social workers with project video, final
Concept Refinement design items.
and programme coordinators
from local NGOs. System Diagrams
Final Presentation
Directional Research Synthesis & Feedback & P4 P4 Rehearsal:
Evaluation Final patient journey, Final
Problem Statement Translation concept of digital devices
and objectives Evaluation and graphic items.
Patient Journey
Analysis workshop in
POH
Concept Presentation:
Infection Workshop in P3 P3 Interaction Model, Task
POH Analysis, Patient Journey
Secondary Research Analysis, Key interface.
Interview with Scenario confirmation
Good practices of other health
care institutions and emerging doctors, nurses and UI Design
communication technologies. management from
Production of graphic
A&ED and SOPD.
design items: Q&A Initial Concept:
poster, graphic posters P2 Analysis if existing
P2 Production of project Interaction Model, Task
Shadowing and Analysis, Initial concept of
patient observation in video Interaction Model.
SOPD and A&ED Task Analysis
identifying the
Medical check event activities and routines Project Proposal:
P1 by SSCEM P1 Research Report, problm
statement, objectives.
0 1 2 3 4 5 6 7 8 9 10 11 Schedule (week)
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5. 02:: Research and Analysis
POK OI HOSPITAL
Pok Oi Hospital was established in 1919, and has been serving as an important hospital
for the local Yuen Long community for 90 years. The design of the hospital adopts
the “FINE” principle: Family-based, Information Technology Driven, Networking with
Community and a Green & Healing Environment.
The hospital closely monitors population growth and needs of local residents,
continuously update her health care services, demonstrating her spirit of
20%
“We Love We Care We Serve”
ETHNIC MINORITY GROUP
patient population In Pok Oi Hospital, Target Audiences of this project are Pakistani and Nepalese ladies who are living with her
Ethnic Minority family and children. Usually they are non English and Cantonese speaker and are closely
Groups occupy attached to their own community. This means that they can only acquire information from
20% of the patient the naive community and seldom have the chance to communicate with local citizens.
population. Among
them, a lot of the
Pakistani and
Their knowledge towards local medical system comes from either the words of mouth
Nepalese housewives from family and friends, or from the activities organized by NGOs and the hospital. They
cannot speak English spend most of their time on house works and love watching TV drama and movies.
or Cantonese.
Difficulties that Ethnic Minorities face in Hong Kong
From a research done by local social service organization, Social Service Centre for
Ethnic Minority SSCEM, language is one of the most important components in building
up relationships, as Cantonese is the main spoken language in Hong Kong but due to the
main language spoken at Pakistanis home is Urdu, not many of them are fluent in speak
Cantonese. This also further relates to difficulties to access service provided and may
lead to isolation as a result they stay with their own people as a group and hinder their
integration.
Extensive interviews, observation and survey had been conducted in the research
process so as to collect opinion and views towards medical experience of EM patients
in different perspectives: the medical care professionals from the hospital, social
workers and programme coordinators from NGOs and EM patients in the real hospital
environment.
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6. Interviews with practitioners focused on investigating daily routine of health care
services provided by POH, what challenges were faced by the hospital and what
were being done to improve it. Patients did not understand the local standard
health care process which led to misunderstanding, misuse and even abuse of
current medical system. Frontline care givers usually did not understand language
such as Urdu and Hindi, that in many time made communication impossible.
”
Interview with social workers from NGOs gathered information about the
difficulties of patients in the channels of communication and how they can
acquire useful medical care information. NGOs had done a lot facilitating smooth
experience with collaboration with hospital, such as hospital visits and health care
seminars. However language is still a big problem and barrier during actual patient
journey.
Observation and shadowing of EM patients are conducted in both Accident
and Emergency Department (A&ED) and Special Out Patient Department
(SOPD). Totally 12 patients were shadowed in their patient journey and
interviewed afterward. Important incidents were observed, and useful views were
collected. Basically they were satisfied with the overall medical experience, but
communication barrier seemed to be a common concern of them all.
Findings and quotes were listed below for quick references:
“
(Top) Social worker
and programme
coordinators from a
local NGO, SSCEM.
(Middle) Health care
Seminar organized
by SSCEM in
“For effectiveness, activities with interaction will be collaboration with
better because there is direct response and effect United Christian
Nethersole
on their understanding. Even a talk in Urdu may Community Health
not sound related to them. But for activities, they Service on topic
Cervical Cancer.
can associate to their health issue and daily life.” (Bottom) Health
Check activity
organized by SSCEM
Patient’s emotion: Nervous, frustration, stress, for Pakistani and
Nepalese ladies.
uneasy, no patient. Sometimes this is caused by
not understanding the system. Sometimes it is a
general sense of discrimination derived from other
occasions.
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7. “Interpreters are in charge of the conversation. If they
are family member, they answer to the questions of
doctors without asking the patient! They may think
that they know the patient’s condition well enough. It
is doubted if they will translate all conversation to the
patient.”
“
“Doctor may assume that EM patient
couldn’t understand and then cut off some
of the relevant information.”
“Communication can raise the tolerance of patient.”
“Someone who can speak URDU should be employed
”
in hospital to do occasion translation.”
(Top) Shadowing of
EM patient, father
accompanying “In hospital , is always waiting and waiting. I have
his sick child in
the triage station.
brought newspaper to kill time.”
(Middle) Shadowing
and observing the
EM patient, father “EM ladies love TV drama and movies. If you can
accompanying his
sick daughter in
make video by Khalid Khan, your work will be very
doctor consultation popular.”
room. (Bottom)
Evaluation focus
group with medical
care givers discussing “How can service providers comfort the patient if they
the project concept
cannot voice out their needs and feelings?”
and design items.
“Without interpreter, they cannot explain themselves
fully, and have phobia, and prefer not go to the
hospital.”
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8. DIFFICULTIES
Ethnic minorities are facing various difficulties in terms of language, cultural,
and emotional issues in medical service in POH.
Language
Filipino kagipitan
Pakistani ‫یماگنہ‬
Indonesian darurat
Hong Kong emergency / 急症
Cultural
Names – different system, names are difficult to pronounce
Food – some foods are forbidden for certain religions, eg. Alcohol
Religions – perception & belief, and the ways seeing diseases
Festivals and special dates
“How can medical Customs – nudity is strictly prohibited
caregivers comfort the Emotional
Being ignored in the process
patient if they cannot Sense of Discrimination by lacking the ability to communicate in local
language
Stressed and lost - not knowing what is happening in the journey and what
voice out their needs and others are talking about their own health
feelings?”
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9. SOME QUESTIONS WHAT WERE BEING DONE
Questions to answer in this project may be: The hospital
COME Project, Care Optimization for Minor Ethnicity
How can a service provider realize the difficulties of patient? // Dialogue Book
And how EM patient can get the quality of service like other patients? // Standard Response Cue Card
How to let people voice out their concerns? // Translation Guidelines
// Identification bracelet to include basic patient information for easy
Communication problems may lead to emotional problem. But good identification, and prevent misidentification
communication raises the tolerance of patients. Professional interpreters can be reserved and arranged in the expenses of the
hospital
Community Health Centre
// Ethnic Minority Corner in with exhibition and help desk
“Core information is The NGOs
// Orientation programme: organized guided hospital visits and support group meetings
important for sickness; // Health check activities with first hand interaction
// Common and special topic seminars
// Escort and interpretation services
Not-so-core information may // Information dissemination
influence the experience.” Ethnic Minority Group
// Get information through word of mouth of Friends and Family
// See doctor together with English / Cantonese speaking family members and friends
// Get assistance from NGO social workers and volunteers
Things have been done for the EM patients,
but why they did not come through?
For example the dialogue book with different languages are printed and placed in
A&E Department’s consultation room. But they are not introduced to the frontline
practitioners. Many of them does not aware the existence of the documents and even
they know the dialogue books, they are not being used.
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10. Conflicts between hospital and patient
Hospital Said Patient Said
// They don’t show up in appointed date // Why I need to wait for 4 hours?
// They don’t understand medical instructions // I get Panadol for all illnesses
// They forget to bring medical reports // I need to bring along my kids to the hospital
// They may use identity of someone else just to or else no one is taking care of them
save money // Doctors are exaggerating my illness
// Difficult to use telephone reservation system
// I am lost in hospital
“This is an integrated problem of medical
service that requires the facilitation
”I am not familiar with medical terms,
for minority group to blend in to the
and always get into the middle of the
mainstream medical system, and how
fight about diagnosis and treatment
can the system cater for special needs
between doctor and patient!”
of the group.”
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11. DESIGN CHALLENGES
// To breakthrough language barrier
Notes to consider
Waste Analysis
// To communicate effective medical
Identifying waste as a part of the analysis of the current state
map is important to help you assess which steps add value to the
information and instruction
patient process, and where waste occurs. On the current state
map identify where waste occurs, what type of waste it is and
consider waste related to the longest stages of the process. There // To educate EM patients coping with local
are several types of waste that exist in patient journeys.
medical system
Value and Non Value Added Activity
By identifying those activities that do not add value to the patient
or have no clinical value, and by seeking to reduce or eliminate
them from the patient journey, it is possible to provide a service
that is more responsive to the patient and reduces waits and
delays.
Value adding activities are those activities that in the eyes of the
patient make the service they are receiving valuable. e.g. the
taking of an x-ray to enable diagnosis, closure of a wound in A&E.
20 21

12. PATIENT JOURNEY ANALYSIS
It is important to understand how patients
proceed through the care delivery system.
The best way to achieve this is through
process mapping. Process maps are an
effective way to identify constraints and
bottlenecks, and unnecessary process
steps.
Process mapping is a useful diagnostic
tool for determining where problems
Registration Triage Doctor Follow-up Lab Tests Shroff Pharmacy
lie. Understanding the process from the Consultation instruction Office
patient perspective is essential if patient
focussed service improvements are to be
Communicate
made.
through provide express exchange of listen to listen to provide listen to
interpreter information information information instruction instruction information instruction
1. Source of Medical Information - Incomplete &
either from words of mouth of family ineffective
and friends or for activities and seminars interpretation
organized by NGOs. However EM
patients may not get update information
from local citizens, and they are not keen
on reading printed materials. Professional Husband or Children
Interpreter Friends
2. Accompanies during visit to
hospital - always accompanied by
family members or friends who can
speak English and/or Cantonese. They
will act as interpreters for the EM ladies. Source of
They are very much relied on this indirect Medical
communication which sometime may be Information Support group Word of Mouth
inaccurate and misunderstanding. Seminars Referral
Workshops Recommandation
NGO & Hospital Printed Materials Family & Friends
3. Professional Interpreters - If time
allows such as patients of Special Out EM Patient
Patient Department, interpretation will be
arranged in the expenses of the hospital.
But this may not be available in A&ED.
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13. Scenario 01:
TAMANG, Parbati, bring her little son,
to Special Out Patient Department SOPD
...... ....??
35min
TAMANG, Parbati accompanies by her In Nurse Station, the little son 35 minutes later, call to doctor During consultation, the son don’t
little son, age of 9. confirm identity in English. consultation understand medical terms, and
cannot translate
....?? What is the problem?
This patient story illustrates two main problems in a typical
patient journey. It is not uncommon for EM ladies to
bring along with their little children to the hospital as their
interpreters. However although the small children may be
growing up and studying in local school, and they can speak
English and even Cantonese, they are usually too small to
understand medical conditions and not to mention those
Holter test (ECG) instruction in Nurse explain the instruction in Little son goes to Pharmacy for
complicated medical terms. This may leads to inaccurate
Chinese English to the boy. Little son goes to medication
translation and severe danger.
Pharmacy for medication
Also medical instruction is always in Chinese and sometimes
in English. There is no native language instruction
materials. It is very rare to have information and instructions
translated in Urdu or Hindi. It would be very difficult for
EM patients to remember and review those important
instructions and precautions.
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14. Scenario 02:
GURUNG, Manju, bring her husband
to Accident & Emergency Department A&ED
...., ... ...., ... ... ,....
? . ....., . Ms. GoRonge
? . ....., . . ,..... .
??
1hr
GURUNG, Manju accompanies by her In Triage Station, the husband is 1 hour later, call to doctor Husband talking to doctor as if he is
husband to the registration.. doing the talking in English. consultation the patient, without asking his wife’s
feedback.
?
What is the problem?
This patient story illustrates the fact that the adult family
member to dominate the whole conversation with
the doctor and nurse without asking feedbacks from the
patient herself as if they knows everything about her health
condition. The patient has no clue about what they are
talking about her, and the frustration and confusion will
Nurse treatment with instruction in Husband goes to Shroff Office and Pharmacy accumulate.
English. for medication
Also there is a tendency for the doctors and nurses to talk
solely to the interpreter instead of the patient. There is case
that when the nurse knows one family member can speak
Cantonese, she will talk fully in Cantonese about the
medical instruction of a lab test disregard the fact that the
language level is actually quite low.
26 27

15. Stress Points
Different levels of communication are
required during the patient journey,
from quantitative to qualitative, from
pronunciation of their names, to duration
and dates, to expression of sickness and
evaluation of pain.
Stress and anxiety accumulate when the
patients cannot express themselves, and
could not comprehend the diagnosis about
their own health, cannot read instructions, Registration Triage Doctor Follow-up Lab Tests Shroff Pharmacy
Consultation instruction / Office
confuse about what practitioners are treatment
discussing.
Patient will also feel frustrated when they Nature of provide express exchange of listen to listen to provide listen to
information information information instruction instruction information instruction
are not sure about what is going to happen Communication
in the next step of patient journey.
Symptoms
Intensity
Evaluation Emotion
Qualitative Symptoms
Emotion Expression
Expression Intrusive
treatment
Quantitative Identity Duration Frequency Identity Identity Payment Identity
certification Position Duration Procedures Procedures Schedule
BP readings Family health Duration Actions Quantity
history Cautions
Schedule
28 29

16. Wasted Time
In current patient journey, nearly 2/3 of
the time spent in hospital is pure waiting.
Patients have to wait for preliminary
examination in triage station, and then wait
for doctor consultation. If they need to
do lab test before diagnosis, they have to
queue up for lab test and wait the result.
At last they need to wait for getting their
medication.
The waiting could last for a few hours, in Registration Triage Doctor Follow-up Lab Tests Shroff Pharmacy
extreme case a day. In between productive Consultation instruction / Office
activities are nonproductive waiting hours. treatment
Patients has nothing to do for their health.
Steps
Time Spent
30 31

17. “How can we help
them to overcome
?
this communication
barrier?”
“What if both patients and caregivers could easily
express themselves and understand each other?“
“How can patients
make better use of this
wasted time? ”
“What if patients could express their concerns and
acquire useful information while waiting?”
32 33

18. 03:: Project Insights
Insights / Quotes
1. Build confidence for EM patients and let them express.
“Without interpreter, they cannot explain themselves
fully, have phobia, and prefer not go to the hospital.”
~ Ms. Samaira Rehmat, SSCEM
2. Let the patient take control of the journey.
“Doctor and nurse tend to talk to interpreters instead
of to EM patient”
~ from observation in shadowing.
3. Prevent inaccurate translation.
“I don’t really understand those difficult medical terms.
Sometimes I need to call my daddy to do further
interpretation.”
~ A little Pakistani boy
4. Make use of the waiting time.
“In hospital , is always waiting, waiting. I have brought
newspaper to kill time.”
~ GURUNG, Sujan
5. To create consistent contact point for adherence.
“One patient to many people in various steps of the
journey”
34 35

19. 04:: Project Statement
“Let em patients
This project aims to provide Ethnic Minority patients
with comforting Medical Experience. It empowers
them with effective tools to communicate their own
health condition without relying on interpreters.
communicate embrace is an innovative communication system consists of digital devices, keyword
Q&A aids and graphic posters that allow users to communicate their own health
condition without relying on interpreters. The objectives are to overcome language
barrier, build confidence for EM patients to express and take control of the journey, to
their own health
communicate accurate medical information and instruction, to make use of the waiting
time, and to create consistent contact point for adherence.
condition without
relying on e = ethnic
interpreters.”
m = minority
ii =
36 37

20. 05:: Interaction Model
patient journey
Registration Triage Doctor Treatment & Lab Tests Shroff Office Pharmacy
Consultation instruction
embrace system provide identify express understand execute provide understand
document medical health instruction instruction information instruction
Interactive communication condition problem
tools, voice translation,
info videos and graphic
keyword Q&A posters
watch video and
Interactive
Information
while waiting
external source of
medical information
support group word of mouth
seminars & workshops friends’ referral
printed materials recommendation
NGO & Hospital Family & Friends
EM Patient
38 39

21. 06:: Task of Design Items
Registration Triage Doctor Treatment & Lab Tests Shroff Office Pharmacy
Consultation instruction
Confirm CMS Database
Doctor Device Ask Symptoms Symptoms Give Consultation Data
instruction
Confirm
Print-out Print-out
Treatment
Instruction Instruction
Voice Voice Voice
Translation Translation Translation
Patient Device
Input symptoms Family Health History Return Device
and health Allergy
id descriptions FAQ Questions
Alert & Notification (queue time)
Useful Information
Q&A Poster Keywords Poster (Point & Answer, Point and Ask)
Lobby Poster Show compassion of hospital. Introduction to Embrace system
40 41

22. 07:: System Diagram
01: embrace patient device user interface design is written with patients’ native
language. The interface uses metaphor of a patient journey that guide users along
the way and input necessary health information.
id
02: embrace doctor device user interface. Input of patient is translated
automatically into English for the care-givers. Text speech and voice interpretation
function is also available for in-depth diagnosis.
Patient Device Doctor Device
03: Q&A poster consists of keywords of lab-test, allergy, pain scale, numbers,
duration and body figure diagrams for basic exchange of health information.
04: Graphic posters present quotes from patients about their concerns and
difficulties in their medical experience. This shows the compassion of a caring
medical service provider.
Q&A Poster
Graphic Posters
42 43

23. 08:: Experience Strategy
embrace system aims to create a comforting medical experience for ethnic minority
patients. From my project analysis, the keys are to create a platform and interface so
that all users can communicate with their own languages but yet the information can
be transferred and translated. Also patients can make go use of their waiting time for
preparing themselves for consultation and treatments.
} {
Experience Strategies Design Objectives
1. I want to express my sickness 1. Graphic and digital Q&A tools
2. Guide me, don’t test me 2. Short learning curve & easy to use
3. I have the control 3. Simple task and information flow
4. Help me learn the system 4. Embed with useful information
44 45

24. 09:: Designing the System
46 47

25. Proposed patient journey
... ,....
. ,..... .
wait wait
embrace
id id id
GURUNG, Manju goes to hospital by While waiting, Manju explores In Triage Station, nurse checks input of Manju. While waiting for the consultation, Manju
herself. In Registration, She receives the device and starts to input and they try to communicate with the help of follows the guide of device and inputs more
an embrace device as patient ID. info. keywords on Q&A poster. Voice translation health info and check useful info while
function is available in needs. waiting.
...., .... ...., ....
1hr . ....., .....,....
,. ... . . ....., .....,....
,. ... .
id id
1 hour later, id device notifies her to In Consultation Room, input of Manju shows up In Nurse Station, nurse explains instruction Id device is returned after use.
doctor consultation on doctor’s device facilitating further consultation. to patient with help of embrace tools. Final
Manju answers doctors questions with Q&A poster. instruction is printed. Id device is returned.
Voice translation is available on device in needs.
48 49

26. Concept Video Storyboard
In Pok Oi Hospital, Ethnic Minority Groups occupy 20% of Among them, a lot of the Pakistani and Nepalese Their knowledge towards local medical system comes
the patient population. housewives cannot speak English or Cantonese. from either the words of mouth from family and friends,
or from the activities organized by NGOs and the hospital. So what are the problems? Every time EM patients come to hospital, they need to However adult family members always dominate the
be accompanied by friends, family and even their small conversation with health care professionals without
children as their interpreters. actually asking for feedback from the patients. (Isolation)
50 51

27. Even worse, due to their lack of medical knowledge, small Some patients will choose not going to the hospital if there How can we help them to overcome this communication Different levels of communication are required during the
children can hardly translate difficult medical terms and is no accompany available. This could seriously jeopardize barrier? patient journey, from quantitative to qualitative,
medical instruction for their parents. (Inaccuracy) the health of patient.
from pronunciation of their names, to duration and dates, Stress and anxiety accumulate when the patients cannot In current patient journey, nearly 2/3 of the time spent in How can patients make better use of this wasted time?
to expression of sickness and evaluation of pain. express themselves, and could not comprehend the hospital is pure waiting.
diagnosis about their own health.
What if patients could express their concerns and acquire What if both patients and caregivers could easily express Embrace is an innovative system that will enhance the It empowers them with effective tools communicating their
useful information while waiting? themselves and understand each other? medical experiences of Ethnic Minority. own health condition, without relying on interpreters.
52 53

28. Embrace consists of networked portable devices used by Patients input their health conditions and questions in Q&A posters have keywords for effective communication suggested lab tests and numeric answers.
the patients and the doctors. their native language, and the input will be displayed in such as pain scale, allergy,
English in the doctors’ device.
Meet Satta, a Pakistani lady, goes to A&E Department for After registration, Satta gets her own portable embrace The device invites her to input her symptoms before the After a while, the device calls her to go to Triage station for
the first time device showing her patient ticket number. triage calls. She expresses her fever and identifies related preliminary check up.
symptoms on the list.
After triage, while waiting in the lobby, she checks By then the device acquires for her health and allergy She also highlights questions she wants to ask the doctor.
approximately how long she has to wait for doctor history. As the questions are in her native language, she
consultation. feels confident to express herself.
54 55

29. Being new to the hospital, Satta clicks into the information and various medical services provided by the hospital in In the waiting lobby, there are posters with quotes of
section and learns about process of the patient journey promotion videos. She feels secured and is more prepared patient concerns in Urdu. She feels that the hospital has
for coming steps. great compassion for her needs and difficulties.
At this time, the device calls her to see the doctor. In consultation room, her symptoms and health history are The doctor reads her basic inputs. . Based on Satta’s condition, related questions have been
already shown on doctor’s device. shortlisted
Speech button is available for asking those questions in For in-depth diagnosis, voice translation in the device When the doctor asks about her headache, Satta points to The doctor then indicates suggested lab test with Q&A
Urdu when needed. comes in handy. the pain scale on the Q&A poster to express the severity poster.
and tell when it began.
56 57

30. In the process, the doctor uses confirm buttons to confirm Then, Satta moves to nurse station, where the nurse Similar functions help Satta going through the rest of her from lab test to Pharmacy.
all useful inputs to the CMS for the patient record. prints out lab-test instructions in Urdu, and explains to her journey,
clearly.
With embrace, Satta has better control over her patient
journey, she could express her health conditions
effectively, learn about important medical instructions, and
she is emotionally more engaged.
58 59

31. DIGITAL DEVICE USER INTERFACE
Patient Digital Device
information triage doctor treatment lab test shroff pharmacy
Digital devices use patient journey as the metaphor for user interface design. The
interface is named after information, triage, consultation, treatment, lab test, shroff and
pharmacy. Interface will be in their native language. The flow of information map to the
actual patient journey which help guiding the input of health information respectively.
Inputs of patient will upload onto the system, and they will be displayed on doctor’s
device in English. Text speech function and voice translation will be available for in-depth
conversation.
Doctor Digital Device
patient id symptoms instruction questions translation
60 61

32. GRAPHIC DESIGN ITEMS
embrace
lab test Symptoms
Q&A poster
blood test rashes
radiology itching
Q&A Poster
gastric endoscopy diarrhoea The poster is designed to assist simple Q&A conversation between patient and
caregivers. The poster is visually divided into four areas: Allergy, suggested lab tests,
glucrose test Sneezing pain scale and numeric answers. The poster is bilingual with Urdu and English. Obviously
Urdu words are in larger size for the use of EM patients when words in English is smaller
holter test ECG running nose for frequent users such as doctors and nurses.
abdominal pain
Users can use it for questions and answers by simply pointing to the key words and
numbers. Content can be updated easily through editing and reprinting. Posters for
different departments may be different depending on the need and requirement.
allergic to
The poster will be placed in consultation rooms, triage station and nurse stations where
peanuts
conversation is conducted.
egg
pollen
latex
0 1 2 3 4 5 6 7 8 9 10
/ / / / /
year / month / day / hours / minutes
/ / / / / / /
Monday / Tuesday / Wednesday / Thursday / Friday / Saturaday / Sunday
0 1 2 3 4 5 6 7 8 9 10 11 12
62 63

33. Promotional Poster
The posters use quotes for EM patients as the theme message. This is a gesture showing
the compassion of the hospital for Ethnic Minority Group, and say we understand your
feeling, your difficulties and requirements.
The poster will be placed in lobby areas, waiting rooms and NGO service centres. They
act as promotional items promoting the newly established embrace system. It will also be
used as a means to call for contribution and ideas
64 65

34. ROLLOUT SCHEDULE
The system is suggested to be rollout in four phases.
Phase 1 will be an introductory stage promoting the concept of mutual 1 phase 1 // Jan 2012 3 phase 3 // Jan 2013
assistance in medical care activities. Graphic posters will be posted in lobby
areas demonstrating the compassion of hospital for Ethnic Minority group, Implement Q&A posters for Test run of digital devices for
and acting as a bridge to invite target users to contribute to the establishment A&E Department and SOPD patient and doctors
of the new initiative, such as codesign workshops and common questions in
patient journey.
Roll out graphic posters in Usability tests with
Q&A posters will be rollout in selected departments. They can directly help hospital and NGOs for promotion stakeholders and evaluation
users to accomplish simple task of expressing their own health condition. and invitation for attachment workshops
Phase 2 will present information videos showcasing health care services of
the hospital which serve to increase the transparency of patient journey. This is
proved to be important in building up the trust and confident of users.
Extensive brainstorming workshops and codesign workshop will be conducted
2 phase 2 // May 2012 4 phase 4 // May 2013
with stakeholders including patients, frontline practitioners and management.
This is critical for creating a relevant system that can actually improve the Information videos showcase Rollout Digital
system for all users. in hospital and on online platform communication tools for
patient and doctor in connection
to CMS
Phase 3 will rollout beta digital devices in selected departments for test run. Braninstorming
Feedback will be collected for revision and improvement. The information flow Workshops for consolidating
and accuracy of communication will be monitored and evaluated carefully. medical information from Constant feedback from
Usability test will be done in real location. stakeholders skateholder
Phase 4 will have all items implemented for a holistic patient journey. Digital
devices will play an important role in the journey. Information will be linked to
the CMS for official patient record. Constant feedback will be collect and this
will be a looping process for best outcome .
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35. 10:: Conclusion
The project solutions were designed based on thorough research and study of current
patient journey, and how stakeholders interact with each other in the process. Patients’
difficulties and requirements were observed and analysis in this two months project. With
the contribution of frontline medical care professional and management, opportunities
are opened in terms of practicality in real hospital context. Also the inputs from social
workers and programme coordinators from NGOs help understanding the characteristic
and behaviour of the target group.
The project addressed two major opportunities enhancing the medical experience of
Ethnic Minority group:
1. Help them to overcome the communication barrier
2. Patients make better use of the waiting time
The project focused on providing solutions for the above design opportunities. No
fictional technology was employed. User capability was taken into consideration, and
the solutions ranged from low-tech graphic posters to mid-tech digital input devices, no
more complicated than an ordinary ATM machine. The key features took advantage of
back-end translation and voice translation that helped seamless communication. Users
did not have to worry about the technology but just enjoy the benefits from it.
I have confident that the proposed system can answer to the project statement:
”Providing Ethnic Minority patients with comforting
Medical Experience. It empowers them with effective
tools to communicate their own health condition
without relying on interpreters.”
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36. 11:: Self Reflection 12:: References
“ This was a wonderful design experience. All stakeholders were contributing all
they have to the success of the project. The hospital colleagues tried their best
to give green lights to my numerous request of observation and shadowing of
EM patients, and also gave their time for interviews, discussion and evaluation
workshops! Without their generous support, the project could not be as real
and solid as it is now.
Difficulties that Ethnic Minorities face in Hong Kong, SSCEM
http://www.sscem.org/napalese.php?page=page_8
Translation guidelines
http://ntwc.home/view.asp?pcat=CIR-NTWC-ADMINIn NTWC Intranet
>Service Divisions > Administration > Policies / Manuals / Circulars &
Guidelines
Colleagues from NGOs spent many of their time in organizing activities wth EM
Standard Response Cue Card (HAHO), http//hohbfsmc2/bssd/cuecard.html
people, explaining their characteristics and introducing existing works done
catering the specific needs of them.
Information sheets (HAHO), Multilingual Phrase book for Emergencies (HKSAR)
The project began with a bigger scope addressing both language issues as
Song L, Chui WC, Lau CP, Cheung BM. , A 3-year study of medication
well as cultural concerns of EM patient. As the project developed, the focus
incidents in an acute general hospital. Department of Medicine, University of
was narrowed down to the actual patient journey in the hospital. This turned Hong Kong.
the project from a solve-all-problems approach to a project solving a specific http://www.ncbi.nlm.nih.gov/pubmed/18315775
design problem, from a social-based project to an interaction design based
project. The scope is more manageable for a two-month project, from research
Understanding the Patient Journey - Process Mapping
to design proposal. Also this addressed to the major issues that really affected
http://www.scotland.gov.uk/Resource/Doc/141079/0036023.pdf
the medical experience of Ethnic Minority group.
Effects of a mobile phone short message service on antiretroviral treatment
After all the hard work done for this project, I feel satisfied with the final adherence in Kenya (WelTel Kenya1): a randomised trial.
”
outcome and design solutions. It is the best project I have done in this Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya.
programme, and thanks for the guidance my project supervisors. http://www.ncbi.nlm.nih.gov/pubmed/21071074
Inspiring scientists to be more patient-sensitive
http://www.ideo.com/work/laboratory-posters/
~ Jackson CHOI
Kobo eReader Touch Edition review -- Engadget
http://www.engadget.com/2011/06/13/kobo-ereader-touch-edition-review/
Talking The Talk: Verbally Lets The Speech Disabled Communicate Using The
iPad (For Free)
http://techcrunch.com/
Fuji Xerox Exhibits Color Electronic Paper w/ Optical Writing System
http://techon.nikkeibp.co.jp/english/NEWS_EN/20071206/143736/
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37. 13:: Appendix
School of Design, MDES in Interaction Design
Master student: Mr. Choi Chi Kit, Jackson
Medical Experience of Ethnic Minority Group
Aims
Master programme of School of Design on Hong Kong Polytechnic University is working collaboratively with
Pok Oi Hospital on an interaction design project about improving medical experience of ethnic minority
group. The project requires research and analysis towards existing medical experience in target point of
School of Design, MDES in Interaction Design
view in order to discover opportunities of improvement.
Target group of research is Nepalese and Pakistani lady who are living with their family and children. The
Medical Experience of Ethnic Minority Group interview will focus on the medical experiences of target group in areas such as needs, difficulties,
A collaboration project of Hong Kong Polytechnic University and Pok Oi Hospital aims at expectations and performances.
improving medical experience of ethnic minority group.
Questionnaire
Your name: ___________________________________
Patient Journey Research 1. How many times have you use this service in Pok Oi hospital? (This or last visit)
We want your health care journey to be smooth, effective, error free, well communicated
and respectful of your choices. We would like to better understand your perspective on our 2. How long does it take to go through the whole patient journey?
From To
health services. The interview will focus on the medical experiences in areas such as
needs, difficulties, expectations and performances. 3 What procedures have 4. How will you value your medical experience?
you go through?
 Negative Positive
We will not ask or record detailed information about your medical treatment or results –
Booking
rather we want to know about how the health system works and communicates
Registration
information to you and how you feel about your experience. Participation in this project is
Triage
entirely your choice.
Queue
Doctor Consultation
About Patient Privacy Lab test
All information you give as part of the project will be treated in the strictest. Any information Wait for report
that might identify you will not be disclosed without your consent. Steps will be taken to Diagnosis
honor your privacy and autonomy. The data and its analysis will be reported to participants Confirm treatment
of this collaboration project and in a design report at completion of the Project. Pharmacy
Medical Instruction
Payment
Discharge
Contact: Others
Student Name: Choi Chi Kit, Jackson Project Supervisor: Prof. Xin Xiang Yang
Student Number: 10612896g Mobile: 6573 0189
Mobile: 9684 9374 Email: sdxin@polyu.edu.hk
Email: Jackson.choi@polyu.edu.hk
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38. 14:: Special Thanks
Pok Oi Hospital Support Service Centre for Ethnic
Dr. LEE Sun Woon, Hospital Chief Executive, Minorities (SSCEM)
POH Ms. Eden Lam, Registered social worker
Ms. Louisa LEUNG, Manager Q&S Division Ms. Ruth KONG, Registered social worker
Ms. Yedda Li, Q&SD Ms. Samaira Rehmat, Programme
Coordinator
Community Health Centre POH Ms. Anam ISHTIAQ, Programme Coordinator
Rita Kong
Molly CHAN Christian Action
Ms. Nargis Shafqat, Community Worker
Special Out Patient Department POH Ms. Janice Chan Hei Man, Registered Social
Worker
Ms. Kitty Woo Chun Ching, Department
Operation Manager
Ms. Ng Sau yee Hong Kong Christian Service
The Hong Kong Jockey Club Community
Project Grant: Integrated Service Centre
Accident & Emergency Department POH
for Local South Asians (ISSA)
Dr. ONG Kim-lian, Consultant
Ms. LIMBU Sita, Programme Worker
Dr. Lau Chu Leung, Assistant Consultant
Ms. Phoebe Wong, Project Leader
Mr. Wong King Pong, Manager
HKSKH Lady Maclehose Centre
Quality & Risk Management Division
Multi-lingual Interpretation Service
Ms. Ho Kim Kum, Hospital Manager
Ms. Mona Mishra, Interpreter
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