‘Witnessing health. Impactful research in the NHS’ NUX talk by Rochelle Gold
The latest NUX Leeds event on Thursday 27th September, was hosted, as usual, at SimpleUsability. Rochelle Gold, a user researcher for NHS digital came to present and talk about ‘Witnessing health. Impactful research in the NHS’.
Rochelle began the talk touching upon the current pressure which that NHS is under to move towards a paperless system by 2020. She explained that patients would not be forced to use digital NHS but it would be an option for them.
‘What is digital health?’ was Rochelle’s next question. Suggestions from the audience were those such as access to medical records, use of wearable’s, being able to book appointments online through NHS Choices, ordering prescriptions online and the possibility of consultations via Skype. The wide scope of services that could be included in a digital NHS means there are many user needs to be incorporated.
Following this discussion, Rochelle went on to talk about the research that she and her team are performing to gather these user needs, including some of the barriers and challenges they face in such a complex and diverse environment and their approach to researching across different user groups.
Barriers to research
One barrier to research is a simple one of language. Most research within the NHS is clinical, so when users are approached to help they may not offer to help because they are unsure of the value.
Another barrier lies around experience, expertise and ego. Most medical professionals work face-to-face with patients every day so many feel they are well versed in what they need, and see little value in research led from outside perspective.
Finally, but most importantly, uncovering user needs is difficult to do without exposing private health information. This is because patients’ user needs are intertwined with their personal health situation and needs, and medical staffs’ needs are often intertwined with their patients’ health situations. As user researchers, we respect users’ privacy and right to anonymity so this presents a challenge to research design and process.
Approach to research
There are two broad groups for user needs research within the NHS. The first is the clinical team including practitioners, nurses, administration and the second group is the patients. Both of these groups have different things to consider when carrying out research.
Rochelle’s advice approach is to go to them. Observe them in their environment. Immerse yourself into their context. By doing these things, she explained, you will start to experience what they experience every day. After being asked to take part in some online research one practitioner responded, “I haven’t been in my office in days [so have not accessed my computer in as many days].” This was just one example Rochelle gave of the value of contextual research in the practitioners environment. If practitioners aren’t using their offices, and therefore unable to use their computers, how is it they will benefit from a digital NHS?
The last tip for carrying out research in a clinical setting was to build relationships with key people, to get them on the team. This helps break down some of the barriers to research. Once one person understands the value of user research they can explain it and recommend it to their colleagues, and help the research team get access to different people and locations for research.
Rochelle explained that the user group ‘patients’ encompasses everyone in the country, it is important to focus on a specific group at any one time. Their recent work has been on key groups such as the elderly and those with long term conditions who may struggle more to engage with a digital NHS.
Similar to the clinician group, Rochelle said they aim go to the patients, whether it be at their home, at the doctor’s surgery or in community centres in order to carry out research where people as comfortable as possible.
When planning research with patients it’s important to remember that their medical conditions may inhibit their ability to travel to you. It may mean you need to consider what times of the day are best for them.
As user needs are entwined with personal health situations, these personal details may arise during a research session. Researchers must be aware of this possibility, and consider it in planning who performs the research session and who is appropriate to observe. Recordings should only be used with the participants consent and it’s important to consider whether they are at all necessary as it is important to retain the participant’s confidentiality.
Rochelle’s ending before talking questions from the audience was to remember your purpose when carrying out sensitive research. The purpose of user research for NHS digital is to improve services for people, people’s health and families. There is “no such thing as hard to reach users.
In summary, when carrying out user research about healthcare, go to whoever your users may be. This will allow you to observe the user in their environment, experiencing things that they may experience every day. Carefully consider whether recordings are necessary as users may talk about sensitive topics which you must be prepared for. These may be private and may reveal the users identity affecting their confidentially. Last of all, do not be afraid to talk to users about their health as the purpose is to understand their needs and make improvements to the services available.