patient owned medical records

My attempt to develop a patient-owned interoperable digital medical record system.. and my decision to move on

client



role



tools



methods

This was a personal startup project

Founder / User and Patient Experience / Business Strategy

Google Docs, Xtensio, Asana, Sketch

User, stakeholder and subject matter expert interviews, competitor analysis, user personas and proto-personas, customer journey maps, feature framework matrix, lo-fi sketches, sample wireframes on Sketch, pitch deck and lean canvas business plan

summary & problem 

I initially co-funded Kinect (kinecthub.com) with the intention of creating an ecosystem of charity donation, interoperable medical record and rewards system for good health choices. I left Kinect after 6 month while it was still in the research phase as I did not feel aligned with my co-founder’s decision to launch the company in Africa.

I then created Plexo Global with the view of developing a patient-owned interoperable digital medical record system in Australia and for the next 12 months continued to focus on understanding the feasibility, viability and desirability of the intended product. During this time, I dove deeply into user experience, blockchain technology, cybersecurity, legislation and management of health data, business development, branding and marketability.

The first step I took when we initially had the idea behind Kinect was to define our potential user groups and go out and talk to people that fitted these groups. I interviewed 10 young executives who use technology and donate to charity in order to understand how they do this and what they would improve about their donation experience. I also asked people questions regarding how they manage their personal health information and whether they would be likely to make better health choices if they were offered incentives to do so. I then compiled and analysed this research.

personas and proto-personas

I then created user personas and proto-personas for the Kinect use case trifecta in order to understand our user’s behaviours and goals and to better impart this understanding on stakeholders.

competitor analysis

white paper first draft, R&D

During this time, my co-founder had brought in a CEO who had experience in rolling out an electronic medical record in Africa. The tree of us had divided the research and had begun the process of writing the white paper. It had been my co-founder’s idea to roll the company out in Africa and I had remained open to this idea. However, it was during our research that I decided taking this project to Africa was not a journey I wanted to embark on. We were a pre-funding startup and myself and the new CEO had been bootstrapping us up until that point.

Throughout this journey, I was responsible for making decisions to do with the brand colours and logos for both companies. I worked closely with a graphic designer to define a brand identity for Kinect and later Plexo as I went off on my own.

pitch decks, lean canvas, customer journey maps

After going off on my own I needed to reframe the idea for an Australian market so I developed a lean canvas business plan in order to ensure Plexo maintained an adequate business focus and to identify potential opportunities within this new focus. I also produced a pitch deck for Plexo as an aid for discussions with potential stakeholders and to gage investor interest and developed customer journey maps in order to get a sense for user motivations, needs and pain points.

interviews

I spent the next few months interviewing doctors, potential users and key subject matter experts in order to understand the viability, feasibility and desirability of the hypothesised product. During this time, I found another co-founder who had been involved with the Australian Digital Health Agency and saw the potential for improvement in the medical record space.

feature framework matrix

My new co-founder and I identified key features and workshopped these using a feature framework matrix in order to better visualise what a potential MVP might look like.

flows and ai

As a result, I devised an iteration of the product flow in order to start cementing the product’s information architecture.

sketches & wireframes

I produced lo-fi sketches of product screens in order to start creating a rough representation of the main product features and designed a few sample screens using Sketch.

research insights

• Difficulties in teaching machines to read medical records



• Doctors view progress notes and other output as their intellectual property 



• Legacy players lack willingness to collaborate and share data



• Dilemma that if data is permanent and cannot be altered, what happens with mistakes and misdiagnoses become part of a person’s permanent record



• Realisation of just how difficult it would be to extract data for monetisation due to issues with complexity of de-identification and data management and storage laws 



• Lack of desirability of system amongst tech users - tech using potential early adopters already felt they had the systems they need



• Demographic of users amongst which system might be most desirable are not tech users so could not be early adopters



• In order to be viable, project needed to be honed with a focus on a single specialty (we lacked the passion for a specific specialty)
  

to sum it up

I was surprised to find that there is a cohort of doctors who consider the medical notes they produce as a result of a consultation to be their IP and how this poses a potential roadblock to patients owning their own medical records. 


Another surprising insight from my research was that, although the large legacy systems that dominate healthcare settings have the capability to open their API’s, they will not do so as they see not sharing data as beneficial to their business. 


Furthermore, the demographic that most need this tech and would therefore be considered early adopters are for the most part non-tech users. Building the system on the scale originally envisioned would have produced little return on investment. Through my research I found that most users that engage with their health electronically are doing so to achieve a specific task such as lose weight, track menstrual cycles, track blood sugar, track fitness progress. This demographic had no apparent interest in nor did they perceive having a need for an interoperable medical record. 



The combination of the sheer amount of systems to integrate with, the need to securely people’s health records and the need for added security when sharing health information, meant that this project was not feasible.

I particularly enjoyed learning about technology and data and trying to solve problems related to these. And of course, I loved the experience of going through the UX process to unravel the idea.

Anyone who's ever embarked on a startup journey will relate to how challenging it can be. 

There were two times in the course of this project that were particularly difficult and made for phenomenal learning experiences.

The first lesson was to stick to my guns and honour my values above all else. Six month in, I made the difficult decision to walk away from my idea and my stake in Kinect when I became certain that there was no way of reconciling the route my business partner was taking the business and our original vision down. Subsequently I decided to start from scratch on my own and eventually teamed up with another business partner.

The second most challenging moment was taking a good hard look at the insights from our research and acknowledging that the idea behind the business was, at that point in time, not viable, feasible or even desirable to a demographic that might adopt it.

In hindsight, and hindsight is a beautiful thing, I see this last point as the measure of success in this project. Had we not conducted such in-depth research and had we not listened to what it was trying to tell us, we might have continued down a dead end. 

Another big challenge was finding the right people to interview to gain that research and I overcame this by networking, networking, networking and cold contacting A LOT of people.

During this time we had no funding for the project so I essentially bootstrapped all business activities with my nursing wages while also completing a course in UX at Academy Xi in the first 3 months. This translated into 6-7 day work weeks for the duration of the project (and some financial debt at the end). 

other lessons

I learned that when trying to solve a problem within the healthcare sector with technology, it is especially important to have a narrow focus and start small. The siloed nature of healthcare technology inhibits the creation of a single large scale solution to tackle its lack of interoperability. Solving the problem on a smaller scale within a subsection of the healthcare system would have allowed for initial proof of concept and potential traction. For example, we could have chosen to concentrate on children that attend a particular clinic or the blue book for babies (newborn book record).

I learned about the complexities of managing and storing healthcare data, and how these are governed by the Privacy Act 1988 and the Privacy Principles Guidelines (APPs) and other international legislation.

I learned about how branding decisions influence the design process and a company’s digital presence.

other work