Speaker 1: This presentation is from UX Australia 2015 held in Sydney. For more presentations from this and other conferences, please visit uxaustralia.com.au.
Donna: I'd like to introduce Belinda and Dina.
Dina: Sorry.
Donna: Who are going to talk about how they have used a bunch of different user research methods within some projects. We have got five nice twenty minute talks through this slot now so a bunch of nice, faster. Welcome, thank you.
Dina: Thank you. Bell and I are doing a bit of a tag team today. My name is Dina Goebel. I am from Bupa medical division from Bupa Australia. I am the programme delivery manager and this year or last year, I should say, we started to step forward and look into providing services in the GP clinic space. It is a new area for us, as Bupa is a broad based health and care company. We have dental, optical, fees and medicals, aged care, health insurance but we haven't worked in the GP clinic space.
Last year, we wanted to open our first GP clinic and they are open to all members of the public. We want to explore opportunities of how we could coordinate and integrate a new healthcare pathway for our customers. We wanted to deliver much more thorough consultations and a personalised experience where we wanted to streamline service delivery within the GP clinics because innovation in healthcare is part of our purpose. Bupa's focus is on achieving exceptional customer and business ROI through understanding customer needs and the customer experience and we use this to inform our design and our decisions of our business. Our customer centred approach is a core enabler in achieving our purpose of healthier, longer, and happier lives and we want to become a true health and care partner which is loved by customers.
In opening our first general practice last year in Sydney, our initial customer experience design profile was developed by our medical office, by the doctors. They have a great deal of experience, of course, in clinical, hospital, and GP practice but it wasn't enough to create an innovative customer experience. We wanted to compliment the skills that they had professionally with customer insights with customer experience feedback to create a much more holistic design solution for the business going forward. It was a good starting point but the untapped potential was to get beyond what was a complex knowledge driven ecosystem. You can imagine, healthcare has been designed by the healthcare professionals not the customer designers, and it was very difficult to understand what customers really wanted form their GP experience. When was the last time someone actually asked you, how was your last doctor's visit? I don't think we ever get asked that. To make a difference in our services, I really required a customer-led design and wanted to ensure that our service was personalised because our patients are our customers and it is a slightly different mindset to how the health system has worked to date.
As a first stage, we engaged our internal CX design team and I talked to all of our stakeholders to understand the gaps in our knowledge of taking forward a business with this perspective. We decided that we needed to explore external insights so that could really drive a stronger development and then validation of our CVP and that we could develop a customer and patient experience throughout the whole life cycle. It was by bringing together the medical knowledge and the customer insights knowledge that we could really look to understand customers needs. What their initial needs were, what they wanted for service delivery, and how they exit that life cycle and to understand and capture the moments of delight, pain points, moments of truth, opportunities, and how all of that could come together to build and cement a strong customer relationship for advocacy and differentiation of a Bupa experience.
I am the business, so we have asked our researchers, Tobias and Tobias, to have a look at an area that has not been previously explored and Belinda will take you through how they do it. Thanks.
Belinda: Thanks Dina. Hi, I am Belinda from Tobias and Tobias. We are a strategic design consultancy. We have offices in London and Sydney. Finding out what customers really think is what we do. We know good design can provide an advantage. Human-centred design is a way of solving problems, providing strategy and innovating, and puts understanding people at the heart of design. We also believe at Tobias and Tobias that making products and services people love, enabling them to achieve the outcomes that they want can help make the world a better place. In Bupa we are very fortunate to have a client who thinks the same way. Bupa have deep experience and medical expertise, so our challenge was how to support them with insights from the patients perspective. We have all been a patient and there is undoubtedly fabulous practitioners out there that people love but customer service, as Deena was saying, is not what you immediately associate with the GP clinic appointment. At least, not in a good way. That is what this research project was all about. To define what good looks like.
What is the ideal customer experience for customer visits? How do we research this, given the sensitive nature of the subject matter? We do a lot of ethnographic research to deeply understand what people really think and feel and do in relation to a particular product or service. Often, by going out into the field and observing and talking to people in context but understandably, this approach wouldn't have worked given the confidential and sensitive nature of a health consultation so we needed insight into people's GP experiences and we needed research methods to overcome not being able to talk to them in context. To kickoff, we needed to know who to talk to. Together through a stakeholder, a focus and scope workshop, we defined our research cohort as people with high frequency usage who either have a chronic condition, who have recently moved, or had recently had a child. Frequency was really important to us because we wanted to talk to people who had had a lot of recent experience with GP's.
We then settled on four research methods. A cumulative approach. This was to build a rich and detailed picture of a person's healthcare journey. I conducted two hour, deep dive discussions with each participant, starting with metaphor elicitation. This technique is really effective because metaphors are so tied up with our creation of meaning. We use as many as six metaphors while speaking and we use them so often that they are practically invisible. Because they are below the meaning of one thing onto something, not literally related, we are asking our brains to recognise what we know and apply it to something new. This has a kind of scaffold effect. Creating a network of analogies in a rich and new meaning. Common metaphors are often visual, visceral, and vivid and are a shortcut to complex meaning. I will show you a few examples. This is one I use. Using a sledgehammer to crack a nut. This homework is a breeze. That is what my son says. I took her words to heart. Some healthcare ones you might be familiar with, battling with heart disease. Fighting cancer and I had the life sucked out of me. One from this research was quite ironic, that doctor has made me sick.
They create really powerful and memorable images in your mind and we use this image-based technique of metaphor elicitation to tap into them using images as a metaphor for people's experiences, we provided the candidate with a choice of images to choose from to create their healthcare story. They created a collage of images to represent something to them and then they described to me why they chose them and what they mean to them. It is a way of using images to create meaning and also to tap into emotions that are not normally accessed in an interview situation. It helps circumvent that kind of self-reporting that adheres to what people think you want to hear rather then their emotive and unconscious responses, which is what you really want.
An example of how this worked in this research was when one participant chose an image of water. She described it to me as something she loves. It is health-giving, she drinks it, she swims in it, which eases her pain for her condition, chronic arthritis. She thought it was something she could do for herself to help feel in control of her condition. It was also natural which was very important to her and she just loved everything associated with water. Another participant chose the same image of water and related to me how it represented how overwhelmed she felt with her condition and coping with her life with diabetes. It was all too much. Very different interpretations of the same image but both very rich in there emotive content, there storytelling and there insight. Particularly in relation to how in control they felt in their health journey and how important that was to them. That was the first twenty minutes and that really got things going. People opened up. It turns out, people love talking about their healthcare journeys.
Now, I can see that this slide has got the wrong image which must have happened in the technology transfer we just did but never mind. I will just tell you about it. The next exercise, to keep it focused, was high level story clouds. This is a rapid question and answer session and it allowed us to put the responses in context from the beginning, in a step progression, in a really time effective way. The method is simply to give a question card to the participant to read aloud and then they have one minute to answer. It keeps it quick and there are ten question cards. That was pretty straight forward. It gave us a great sense of people's health journeys in the greater healthcare ecosystem and where general practise fits into that. Sometimes this broke out into longer discussions where major breakdowns and pain points were identified. Sorry about the slide.
We then move swiftly on to journey mapping. This is a deep dive into a very detailed recall of every stage of the most recent GP appointment and this took the bulk of the two hour sessions. We started with triggers and the reason for the appointment and we looked into every detail of that and then we moved on to how did they choose the doctor, what were all the considerations and every detail about that. Then, onto how they booked, what happened at reception, what they thought of the waiting room, consultation, acting on the advice, and beyond. Having started with, very candidly, with metaphor elicitation, the open and emotive responses continued, they were in the mood. We managed to capture everything from what they thought of the smell, the parking, the receptionists, the walls, the floors, and of course, the GP. It became a way for people to compare their various experiences, good and bad and remember what it was like. What they liked and why and what they disliked and why. That was really valuable for us in creating solutions that were detailed and actionable.
The last exercise we conducted was the exercise word association. This is a simple ten-minute exercise, an emotive response to the idea of Bupa providing GP services and then choosing intensity cards, the ones at the back of the room, to describe their reactions. This allowed us to test the water and sense a range of reactions that the offer might elicit on first encounter and to understand where that was coming from.
Having accumulated a large amount of data on post-it notes, we went to work to make sense of it all. We did the usual things, we mapped the common themes, we did a lot of analysis and then synthesis. We were able to pull out design principles and insights and turn those into areas of opportunity. These were mapped against the journey stages and further delineated into work streams of environment, people, processes, and artefacts. This makes it possible for Bupa to create an excellent customer experience formed by evidence. Also a great contributor to the success of this project was the in-house customer insights team and customer experience team and their commitment to coming along to the deep-dive sessions. They often acted as the, in the observer role. That enabled them to hear the feedback verbatim. We also had daily debriefs with stakeholders and the aim was to involve all the stakeholders as frequently and as much as possible to transfer that benefit of achieving empathy for real customers as we could. This worked really well because when we start talking about potential solutions, everyone knows where it is coming from and has the customer in mind.
That was very quickly running through our entire project but it is back to Deena to talk about where we went from here.
Dina: It was great that the Tobias and Tobias team were able to put together and articulate their findings in a terrific series of infographics which replicate the customer journey. These articulated key aspects of the design outcomes for and areas for improvement in the emotive stages of the customer experience during their GP visit. I was delighted they were able to achieve, not only in Australian-first research in this area for us, but developed QA debrief process which we are able to utilise across our organisation. I don't know, for those who have or have not worked with corporates before, there are so many stakeholders and you need to repeat the message continuously and easily so all the different types of stakeholders can understand where you are trying to go with this new business.
With our internal CX team, we decided to separate the findings into the people, environment, artefacts, and process groups and this was further split into short term and long term activation programmes and business unit specific debrief papers were developed. Along with the Tobias and Tobias team, we then engaged the various business streams to conduct these debriefs. This included a brief for the properties team and their architects, hence one of the designs that they have started to come up with for our new GP clinics going forward. We had debriefs for the HR team which included the medical office, recruitment and training teams. A debrief pack for marketing and operations and then we have compiled a series of process innovation summaries which included the IS and the future state components. IN this way, we were able to engage the entire organisation to be constantly developing our general practise services in a way that was customer focused and consistent. We now have a set of clearly defined CX design principles that can be applied to any of our Bupa medical opportunities and have a roadmap to achieve a refined CVP with an ideal future state.
Critical to the program's success was also putting in place a feedback and voice of the customer mechanism which was also established in parallel to capture feedback on the experience of the clinics, provide metrics into a system, and evaluating what was working well and what needs focus for improvement and to track these over time. It has really been a pleasure to develop a new customer focused business from ground zero. This is a start-up entity for our organisation and that designing this we have been able to build it on the back of customer design perspective. We are now assessing the findings from this unique research to see how we can use these learnings across the rest of our broader health services businesses.
Thank you for allowing us to share our project with you.
Speaker 1: We hope you liked this presentation from UX Australia 215. For more presentations from this and other conferences please visit, uxaustralia.com.au.