Problem Space
1
An acute need to accurately and efficiently triage patients with hip and knee pain as clinically operative or non-operative before they see a specialist provider.
2
Lack of timely access to all providers. Patients may need to wait months for a proper evaluation and diagnosis.
3
Providers lose the opportunity to intervene. This prevents them from providing care plans early on to slow down the progression of joint degeneration and engage patients in their own care.
"Nearly one third of all patient complaints for PCP office visits are related to musculoskeletal problems, of which the biggest portion is related to the hip and knee."
Solutions for Primary Care Physicians:
- Find the right provider to refer patients.
- Educate patients and providers alike to understand their care plan and advocate for patients.
- Joint Dx combines feedback directly from patients on their symptoms with standard X-rays to recommend treatment pathways.
“For orthopedic practices, there is a need to efficiently and accurately triage patients that can start non-operative care vs those that are candidates for surgery."
Solutions for Orthopaedic Practices:
- Designed with busy clinics in mind. Joint Dx is user-friendly to make triaging new patients efficient for clinic staff.
- Quickly and accurately schedule new patients into surgical or non-surgical providers
Potential systemic impacts in clinic work flows :
- Avoid or defer 15-30% of hip and knee replacement surgeries
- Decrease the overall cost of uncoordinated patient care pathways by 10x.
- Reduce a specialist appointment wait time by 1/2 in high volume clinics.
Research
Understanding the clinic flow and stakeholders
We shadowed the triage process of 2 orthopedic clinics to compare the similarities and differences between clinics.
This helped us identify key stakeholders within the clinic flow and each of their actions during an important touchpoint of the triage process.
From this, we compiled a comprehensive stakeholder list and mapped out where each of them make an impact in a customer journey map generalized based off our shadowing experiences at the clinics. Each stakeholder had specific needs they wanted to address throughout the process.
Key Pain Points
- Dislikes filling out forms and surveys which are taken as for each clinic
- Wants to expedite the time between getting a consult and receiving a form of treatment.
- Majority are indifferent to receiving extensive education.
- Pressured by hospital to drive revenue.
- Patients with high priority can’t be filtered quickly to be seen.
Ideal State:
- Less waiting time between each appointment.
- Less filling out paperwork.
- Less back and forth between different clinics to do testing.
- Patient reported outcomes are collected as a standardized performance measure and for insurance reimbursements
- An easy to use platform that centralizes x-ray and survey collection.
- Configure and adjust care pathway suggestions to each patient’s needs.
Market Research on Product Viability
Learnings
- Leveraging AI technology in X-rays along with personalized feedback to triage a patients with bone and joint health is yet to be fully adopted in the medical field
- There is still a lot of resistance to change in Orthopedics and Radiology.
- Our target product is unique in that it is trained and backed by some of the leaders in the field of Orthopedic Surgery giving the technology credibility and less bias.
- Every clinic is different, a successful product will have the ability to white label and customize features based off each clinic’s needs.
What are our goals for the MVP?
MVP Flow Map
Based off existing Electronic Health Record Software and talking with clinical staff, we identified the key features to develop and design to start a pilot with potential collaborators. Important design considerations we had in mind when we started:
- All patients entered for triaging should be displayed in one screen
- X-rays should be automatically sorted and reviewed.
- PROs should be easy to access and fill out for both patients and providers.
- There should be limited screens and navigation between each should be straightforward.
Initial Iterations
Our initial designs aimed to capture the key features that we outlined in our MVP flow map.
The goal with this round of designs was to give our users some visual reference to give additional feedback on how it could realistically be implemented in their current workflow without disrupting it.
Feedback
Main Dashboard
- All the essential information required for each patient is correct.
- Visually overcrowded, this makes navigation unfamiliar.
- X-rays being sent directly from the Radiologists into the system would be ideal.
- There is no direct way to edit patient information after creating.
Patient Reported Outcome Scores
- The most important score that doctors take into consideration is the “Overall Knee Health” the other three scores aren’t looked at in detail.
- The scores in red immediately draws attention but are not the ones that needs to be considered.
- Needs better visual hierarchy to distinguish Overall Knee Health from other scores.
After talking to the clinic they said that having patients fill out surveys before arriving to their clinic is ideal, but they don’t have any form collection established with their existing Electronic Health Record system so designing the PRO collection feature should be priority.
Things to consider when we are designing survey collection UI:
- Legibility for senior aged patients
- Accessibility across multiple devices
- Providers should have the option to edit submitted entries if incomplete or it contains misinformation
- PRO trendine analysis of patient history.
Impact
Currently we are piloting at an The Bone and Joint Center Clinic in Pittsburgh. A physician's assistant collects this information via an intake call to determine whether or not a caller is a candidate for surgery.
For Patients
Surveyed 10 patients and asked them to compare their experiences filling out forms on paper and online. 8 out of 10 of the patients preferred having a digital setup on the office tablets, stating better legibility and ease of use compared to the paper version of the form.
For Providers
With the information readily available, the average time it takes to evaluate a patient from beginning to end takes only approximately 5 minutes compared to having a patient having to come in for a 1+ hour appointment not knowing if they need surgery or not.
Clinical staff also praised "the ease of use for someone who isn't technically capable" which makes it quickly adaptable to different clinical settings.
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