Live Well with Diabetes

Methods: User Testing | Secondary Research | Guerilla Interviews

The diabetes section of My Doctor Online was intended to be a comprehensive resource for Spanish-speaking Kaiser Permanente patients. The information would inform patients about their diabetes care at KP in a culturally responsive way and provide them access to important clinical data.

This research project was intended to identify usability issues before launching the website. However, we ran into recruiting challenges that ended up providing valuable insight into our Spanish-speaking patient base.

At a Glance

Project Team

• Lead UX Researcher: My role
• Clinical Lead
• Business Analyst
• Designer

Goal of the Project

• Determine whether patients understand how to access their A1C hemoglobin lab results
• Figure out if patients understand how to interpret their lab results
• Identify any additional usability issues on the website.

Outcomes

• Informed strategy on implementing for in-person and community outreach touch-points to distribute products to Spanish-speaking patients
• Redesigned the lab result display
• Provided actionable recommendations for future design iterations

Stakeholder Interviews: Determining Research Scope

This was the first opportunity for the La Salud Permanente team (LSP) to gather direct patient feedback. The Diabetes section was far into the design phase when I joined the team. When meeting with the LSP team, their learning interests were as follows

1. Evaluate the overall usability of the product.

2. Determine whether patients understand how to access their A1C lab results.

3. Find whether patients could properly interpret their A1C lab results.

Developing the Study

Given the product team was looking primarily for user testing feedback, I focused on working with clinical implementation teams to lay out scenarios for how patients might access and use this product.

Example

A doctor refers a patient to the website to view their A1C lab results after they have had a blood sugar analysis completed.

Recruiting Struggles

Due to HIPPA laws, we had to be mindful of our recruiting methods. We approached recruiting in two ways

1. Secure Messages via KP.org: Partnering clinicians would send a message to patients who had diabetes in their panels.

2. Health Education Classes: Spanish-speaking patients who went to classes about diabetes were invited to participate.

Unfortunately, we had a difficult time finding Spanish-speaking patients who had diabetes and used the internet.

“I’m sorry. None of my patients responded. Only 1 of the 17 secure messages sent were opened.” - Kaiser Permanente clinician.

Rethinking the Study

Our recruiting struggles left me to adjust the needs of our research temporarily. We needed to get a better understanding of why were having a hard time reaching out to Spanish-speakers who had a KP.org account.

Secondary Research We found quantitative research about internet usage in the U.S for Spanish-speaking individuals. We also utilized existing Kaiser Permanente research to our benefit.

Patient Interviews at Community Health Fairs We decided to join three community health fairs organized by Kaiser Permanente to speak with patients directly. Our conversations were about internet usage in their daily lives, in particular at home.

Usability Study After giving more time to our initial recruiting methods and recruiting through the health fairs we were able to run our initial user testing.

Key Findings

Secondary Research

• KP Spanish-speaking patients are on average less likely to have an active KP.org account.
• Usability issues were a strong cause of lower rates Spanish registration rates for KP.org accounts

Community Outreach

• Many individuals used the internet (several exclusively on mobile) and almost all patients had someone at home who used the internet.
• Many patients did not know about KP.org accounts or didn’t understand the benefits.

User Testing

• Many patients did not realize there was additional content below the fold.
• Patients were unable to find their lab results.
• Patients did not properly interpret their lab results.

Outcomes

• We implemented more hands-on community touch-points to help Spanish-speaking patients become active on KP.org and to share the Live Well With Diabetes product.
• Began discovery of methods to facilitate better communication caregiver support between English-dominant clinicians/caregivers and Spanish-dominant patients.
• The overall design needed to be simplified and the UI copy needed to be more direct.