Differences to Consider Between Clinical and Home Environments: User Research

Several of our group recently presented at the 2011 Plastics in Medical Devices Conference, in Huron, Ohio. Here’s what Carolynn Johnson had to say on the importance of conducting Design Research as healthcare moves from the clinical environment to home healthcare:

As healthcare moves from the realm of the clinical setting, in which medical professionals are always on hand when patients are present, to the home health care sphere, it is absolutely vital that user research be given due diligence. The home environment is spectacularly different from the clinical environment, not just in the physical dissimilarities, but also in terms of the scenarios of use in those environments and with regards to the users’ and the caregivers’ goals and aspirations. All of which result in very disparate patient or caregiver interactions with the tools required to maintain a medical condition.

Key takeaways

A home medical device - the Omnipod from Insulet Once in the home, the patient’s goals will change. Clinical settings are about acute treatment – the patient may be in cardiac arrest or in acute renal failure – home healthcare is about management of a condition. And more to the point, it’s about managing that condition in such a way that the patient … pardon me, “the user” can live life as normally as possible, rather than living as “the patient”.
A crying child -- a common home distraction Once the medical tools move to the home sphere, the distractions and interruptions that surround the patient will be very different, and quite probably, more demanding, than those encountered in the hospitals and other clinical sites.
A confused looking person reading an instruction book. Novices users will be completing critical medical tasks in unsupervised settings – gone will be the days when the medical professional changes the insertion site for an infusion pump, but also gone will be the days when the patient completes these tasks under the watchful eye of the medical professional who will catch any mistakes and omissions that may take place.
Children taking apart a printer Failure modes that were never even considered in the clinical environment may be encountered in the home

However, manufacturers that are accustomed to doing research in a clinical environment will encounter a drastically different research landscape as they move into home health care research.

The Home Health Care Research Landscape

  • In clinical environments, research participation may be easier to establish; simply identify those patients with the condition that you wish to study.  Patients in the hospital have already given consent for treatment and for the data collection to support that treatment.
  • Data collection protocols already exist in clinical settings, and many of these protocols are so well practiced by medical professionals as to have become engrained behavior – think of the nurse taking a patient’s vitals.
  • Patients in the hospital expect observation and data collection – whether it is the nurse coming in to check vitals or the doctors looking over the patient’s chart.
  • Within clinical settings, there is generally organizational support from management already in place for research goals, and these organizations have a good understanding of their legal standing with regards to data collection.

Once in the home, none of this is true.  Once the patients are released, they will have to be convinced to participate in the research project, via monetary or other incentives. Patients and their caregivers will need to be taught how to collect the data of interest, or data collection will need to be unobtrusive and/or automatic—which may also mitigate issues of participants fabricating data due to forgetfulness or embarrassment. Moreover, those conducting the research will need to be sure to understand their own legal standing with regards to the research and data being collected.

Nonetheless, the value of the research far outweighs these concerns. Manufactures that fail to study and understand their users in environments outside the clinical realm will likely create tools that are either not adopted by users who have a choice in what they use—think of the wide range on insulin pumps available on the market—or will only grudgingly be adopted by those who have no choice, which may lead to poorer maintenance on the part of the patient who finds these interactions to be unintuitive, cumbersome, or even just too off-putting to deal with.

Image Credits:

Insulin Pump: Omnipod Insulin Pump by Alan Levine | Public Domain

Crying Child: Photo by Arwan Sutanto on Unsplash

Reading Instructions: “Confused” by CollegeDegrees360 is licensed under CC BY-SA 2.0

Disassembly: Nick taking apart a monitor by QFamily is licensed under  CC BY-SA 2.0

Featured Photo: Martha Dominguez de Gouveia on Unsplash merged with photo by Francesca Tosolini on Unsplash