Using Digital Ethnography as a tool for Primary Research in Healthcare Experience Design (UX)

The world of healthcare has changed forever due to Covid-19 and the resulting lockdown regulations. Many routine face-to-face doctor-patient interactions have been evolved, changing the workflows of almost every healthcare professionnal.

While it has always been a best practice for Healthcare UX Researchers to conduct primary research in-person, the new reality is forcing a rapid transformation into remote UX design research methodologies such as Digital Ethnography.

This article will provide a high-level look at the digital-transformation of primary research in healthcare UX design, specifically at outpatient practices. It will touch on some best practices from ethnographic research and will address several pain-points with workarounds adopted by some UX researchers.

Finally, it will highlight opportunities for improved primary research offered by digital ethnography.

The Digital Transformation of Healthcare Research

Since the beginning of Covid lockdowns, many companies have transitioned to fully remote work-mode. While the face-to-face component is still present in medicine, outpatient medical practices have undergone a digital transformation of their own.

For instance, parking lots have become new waiting rooms. With medical offices looking to prevent spread, they ask patients to wait in their cars and fill out the necessary paperwork with mobile apps. These same apps also notify patients when they are ready to be seen.

With the explosion in telehealth, doctor to patient video interviews are becoming more common and are increasingly replacing in-person appointments. The patient and the doctor conduct the entire “visit” online through the web or phone. Even if the visit is in-person, restrictions increasingly allow one person to enter a practice at a time.

This means that a UX researcher and a patient cannot be present in the same room simultaneously. This new constraint is marking the end of onsite primary research in healthcare. Increasingly, UX Researchers are faced with the new challenge of gathering primary research remotely.

Challenges with traditional UX Primary Research approaches

Traditionally, primary research is still considered the best practice for gathering data to create user personas, journey maps, and identify opportunities for new features.

For UX Researchers, traditional primary research involves being synchronous with the research subject. Jobs to be done typically include:

Going onsite to the practice (ethnographic research).
Building an understanding with subject matter experts (SMEs) and conducting user interviews.
Shadowing specialists during core workflows.
Taking notes and pictures of the working environment.
Observing each role at the practice and capturing their entire workflow in context.

Primary research in healthcare contexts has never been easy to conduct, primarily because:

Doctors and medical staff are extremely busy, so booking a few days to visit can be a significant challenge.
Medical staff are constantly working with a heavy workload. This makes it difficult to find space in their hectic schedules to be synchronous with them.
Finally, some medical specialities deal with highly vulnerable and sensitive issues. The practice needs to preserve patients' comfort and privacy which limits access for UX researchers.

These are just some of the more significant challenges faced by user experience researchers who do primary research with medical practitioners.

The limitations of using video calls or user interviews for primary research in healthcare

With the onset of Covid, many researchers adopted Zoom style video interviews to compensate for their inability to do in-person, observational research.

While video interviews can help with some remote data gathering, it is only fair to note the constraints this technology has for user research:

Video interview pain points

Although everyone seems to be using video conferencing platforms now, this doesn't mean everyone is proficient or comfortable using them.

Technical glitches, internet connection, and even video conference (lack of) information security features can hinder a successful video call.

Interview Pain Points

Relying on first-hand accounts is not as accurate as observations. The interview subject is often so accustomed to their process that they have difficulty articulating their full step-by-step workflow detail. Without the proper details, there will be workflow gaps in the research notes.

Subjects sometimes become distracted through the interview or get interrupted to perform a task or answer a question. This is a common occurrence in medical practices where the SMEs are constantly dealing with questions and notifications.

Field note taking Pain Points

Note-taking is a skill and not one quickly developed. While it is best to capture a discussion’s core points, the details are the key to a meaningful user journey.

Many electronic tools are becoming available that use natural language processing. However, most are not optimized for medical vocabulary and acronyms. Refining poorly transcribed notes diminish the benefits of the technology.

The benefits of Digital Ethnography for UX primary research in Healthcare

Although there isn't an optimal solution for replacing human-to-human interaction, this new, remote work-environment provides opportunities for digital ethnographic research. Furthermore, given that it is a contactless research solution, it minimises any risk, particularly in dealing with at-risk patients.

Digital ethnography offers the following opportunities to UX researchers doing primary research in healthcare:

Eliminates time and expenses associated with onsite travel: It takes a couple of days to immerse fully in an environment and observe all roles. Time spent on site, and the expense for driving/flying, lodging, and meals are involved. While it is still preferable to be onsite for primary research, the silver lining does involve time and costs associated with the commute. With everyone starting to add an online component to their operations, connecting with research participants asynchronously over mobile has become commonplace.

Works on a larger scale: With nearly everyone adopting some form of digital interaction, opportunities to connect with interview subjects in difficult-to-reach locations and those in different time zones become a reality.

Works asynchronously: There is an opportunity to gather information from many subjects at the same time. The flexibility offered by digital ethnography makes it easier to accommodate everyone’s schedule, including time pressed, hard to reach healthcare professionals.

The advantages of using a Digital Ethnography platform for primary research

With the ongoing uncertainty posed by Covid, it is increasingly likely that remote, contactless user research in healthcare is here to stay. Given the limitations of Zoom style video interviews, investing in a dedicated digital ethnography platform can transform the quality and quantity of user research that can be done remotely.

In addition to capturing primary research data in video and photos, digital ethnography apps allow user experience researchers to do the following while working remotely:

Capture mood in real-time: While onsite observations offer some insight into the subject’s emotional states, it isn’t easy to track how a person feels at each step of their workflow. While interviews can uncover some of this information, reflection may not be accurate. Digital ethnography apps that offer researchers the opportunity to do longitudinal, in-the-moment research can provide a solution.

View the environment through the subject's lens: Empower the user to share their surroundings through pictures and videos captured in context and in the moment. Context is key to ethnographic studies, and context captured through the eyes of the subject is even more powerful.

Capture, store, and quickly filter through qualitative data: Modern digital ethnography platforms feature powerful dashboards that seamlessly collate context rich research data. Participant uploads are displayed in real time. Powerful filters combined with automated video transcription make it easy to search and filter both text and video data.

Interact and probe in-the-moment: Digital ethnography research can be unmoderated or moderated. For moderated studies, social networking style comments and push notifications enable the UX researcher to interact with participants in the moment. This can be extremely powerful at getting under the skin of what the participant is feeling and experiencing.

Save time analysing video: Automated video transcription and keyword analysis tools make it easy to analyse video at scale. You also have the opportunity to search, replay and rewatch specific video parts which can be a huge time saver. Well transcribed, timestamped videos can save hours when gleaning data for a journey map. Tagging capabilities make it easy to code and categorise data.

Why you need to evolve your primary research

As our world continues to change, new opportunities will arise in every sector. UX design is no different. Purpose built, digital ethnography tools can be an excellent asset to help UX Designers with primary research.

While the healthcare industry continues its rapid digital transformation to adapt to today’s challenges, digital ethnography enables UX Researchers to similarly evolve and evolve to the changes that lie ahead.