Ever get frustrated with your medical record system or get frustrated with your Windows computer and opted to travel with your iPad instead? Perhaps your patients got confused with your pages and pages of discharge instructions? The common thread is that many of these lack user experience design.

In the past, the design for good user experience (UX) and user interfaces (UI) distinguished Apple’s iPhone from the multi-button Blackberry, Windows Mobile phones, and dumbphones of the past.

Unfortunately, many electronic medical record systems don’t yet leverage good user experience design techniques.

Pharmacists, physicians, nurses, and other healthcare providers want to create things — apps, products, and websites — to help their patients and colleagues. If they want these tools to be used, UX and usability should be in the forefront of their mind.

iMedicalApps sat down with Amy Cueva, founder & chief experience officer of Mad*Pow, an experience design agency specializing in healthcare. In our interview, Amy shares insider tips on how to create compelling medical apps that people will want to use.

iMedicalApps: Why is design and user experience such an important part of creating a product?

Amy Cueva: Design is a powerful thing. It can improve the human condition. Designers by nature are inspired by empathy for their fellow human, and so I think emotion matters. In business and in services [like medicine], when it comes to delivering care, we can become so used to feeling the same pain point again and again and squelching the emotions that we aren’t activated by or motivated by that emotion any more. And so, we might not try to change things. [But] emotion is important. The patient’s emotion can indicate that they are at risk or that something is going wrong. So a lot of things we [at Mad*Pow] do with clients is inspire that empathy.

iMedicalApps: So how does this apply to us doctors and healthcare providers?

Amy Cueva: I receive letters from doctors saying, “Help me! I’m using these 8 systems. The usability is horrendous. How do I bounce between these systems?” Doctors become data entry specialists instead of helping [patients] provide better care. Technology can become a barrier. They’re hoping I can do something about it, and I wish I could, but [it won’t happen] unless the companies [providing the systems] begin to invite doctors and nurses into the design process on a consistent basis.

Doctors are often excluded [in the product design process]. I have empathy for doctors – the technology they use should aid them, not frustrate them. It should be a conduit for better care delivery. That is the vision we need to deliver on. But doctors are not invited to the table. Many assume they’re busy, or stereotype doctors as people who don’t want to collaborate, or view them as being so institutionalized in the system, the way things are, that they assume they will not be able to think [creatively]. But they are the victims of the technology they’re using!


iMedicalApps: I can definitely see that happening. And even with nurses, a lot of devices & apps don’t fit optimally in their workflow. So I’m getting the sense that we providers should be part of the design process. What kinds of things should we keep in mind when designing apps or workflows?

Amy Cueva: One thing big is “WIFFM” (what’s in it for me)? Businesses [and providers] look through their own lens. But for the end user [the doctor and patient]–what’s in it for them? You shouldn’t assume you know what’s valuable to them, but get to the core of what’s meaningful to them. You can make a really bad solution usable, but if it doesn’t provide real value, it won’t get used.

Basically, the core philosophy is to involve the people who use your solutions in the process of creating them. Even if you used to be [a practicing doctor or patient,] a member of the target audience, now you know too much, and that’s a handicap, because you assume that people think the way you do. You have to talk to [doctors and patients about] what motivates them, and how your solution [app, website, etc] fits in their ecosystem, how it can connect with existing resources, how data should flow in, how it should flow out, and any entities that your solution should cooperate with. Involve outsiders in the process of creation and not only involve them, but also learn how it fits into their ecosystem. And don’t just talk to them once. Involve them in the design process, & run things by them. Iterate.

iMedicalApps: But sometimes even medical professionals shy away from things like sketching and drawing!

Amy Cueva: If you can draw a square, line, squiggly line, you can draw! We even have our stakeholders draw.


iMedicalApps: You alluded to how healthcare professionals and doctors may assume they know everything there is about their patient to make informed design decisions. Why can’t we assume that?

Amy Cueva: Patients aren’t defined by their condition. You can’t just say, “Hey you need to eat better, reduce your BMI, and increase your activity level.” You need to know what matters to me [the patient] in my life. What are my struggles? What are my aspirations? If you can tie health goals into things we [patients] care about, then we can make lasting changes.

iMedicalApps: Are there any references or resources we should use?

Amy Cueva: Our conference focuses on design and health, so that’s the perfect place to start. You can also read up on “Design Thinking.” You don’t need a designer necessarily to come up with a good design, but you can leverage participatory design, research methods, validation methods, and design thinking. Stanford has free online courses! Designers are so open, you could take them for coffee and have a productive discussion.

iMedicalApps: Speaking of which, how can we find good UX designers to work with?

Amy Cueva: You can post on Craigslist. There are groups like IXDA, UXPA, and they have LinkedIn groups, and you can post questions to the groups. “I have a need for freelancer. I have a project.”


iMedicalApps: Have any favorite tools? How do you work?

Amy Cueva: I love my whiteboard. If I have to figure out something , I stand in front of it. It’s like a blank canvas. In my Stanford MedicineX talk, my first step was drawing it out on a whiteboard. I also use pencil and paper. At Mad*Pow, instead of Omnigraffle or Fireworks, we’re doing Sketch to Code. We design once, and the code can shift no matter what device.

iMedicalApps: Thanks, Amy. This was an incredible chat into the mind of a healthcare product designer.

About Amy

  • Amy Cueva, founder & chief experience officer of Mad*Pow, an experience design agency that specializes in healthcare. Amy crafts human-centered designs in her work for clients like the New England Journal of Medicine, Aetna, Partners Healthcare, and McKesson. Her design team creates digital experiences and streamlined processes using research-based methods.
  • She has presented at numerous conferences such as Health 2.0, HIMSS, the Center for Connected Health Symposium, and most recently launched HxD, the Healthcare Experience Design conference — which will be held next in Brooklyn in 2014 in conjunction with Health 2.0’s Health Refactored conference.

About the conference

  • Health 2.0 recently held their annual conference in Silicon Valley, bringing together business leaders and entrepreneurs along with physicians, empowered patients, and nurses making headlines with their new apps and software. The Health 2.0 organization has, since 2007, held conventions throughout the world, established local grassroots chapters of health technology enthusiasts, and provided media coverage of emerging companies and products.

Steven Chan, M.D., M.B.A., is a resident physician at the University of California, Davis Health System, researching mobile technology, psychiatry & human behavior. Steve previously worked as a software & web engineer & designer at Microsoft & UC Berkeley. Reach him at @StevenChanMD or www.stevenchanMD.com.