From Touchpoints to Journeys: Putting End Users at the Heart of Digital Health Innovations
This article was originally published by OpenBoxes
User-friendly environments are all around us. In interior design, designers work to bring balanced energy, functionality, and harmonization into a space. For example, in a hospital, an interior designer would provide a wheelchair ramp to make it easier to navigate the building.
These same principles are making their way into digital spaces through user experience (UX) design. In the tech industry, UX design is a buzzword that continues to thrive as companies shift their focus to creating user-centric products. Through UX design, companies provide meaningful and frictionless digital products that facilitate positive interactions and experiences for users. In both interior design and UX design, the end goal is the same—to create an accessible, relevant, and user-friendly experience.
Why health care UX?
UX design is specifically driving value in digital health and shaping the future of health care worldwide. One of the companies currently integrating UX design in health care is OpenBoxes, an open-source Logistics Management Information System designed for health systems in low-resource settings. It has adopted UX design in its software as part of its continued effort to remain free and accessible to anyone who desires to implement it.
Prince Wishmid, a pharmacist at the largest nongovernmental health care provider in Haiti, Zanmi Lasante, shared their experience using the software to track inventory. “OpenBoxes helps us manage all the products we need and understand consumption. If you have current consumption, you will have a good number of orders and meet the needs of patients.”
This digital health global good is helping organizations meet their health care supply needs by managing and tracking the movement, consumption, and storage of supplies. Yet, OpenBoxes wants to move beyond developing product features and focus on providing relevant and intuitive experiences to its users.
The challenge
Since OpenBoxes’s inception, identifying the quantity and location of health care supplies has posed challenges for administrators using the software. Tools embedded in the OpenBoxes software were created to help users carry out administrative tasks. However, the tools were not designed to respond to the increasing configurability and complexity of health care information systems. For example, the tools relied on imported data from Excel spreadsheets, but these spreadsheets often contained outdated information or were missing key fields, partly due to not clearly marking the required fields. These gaps meant that new administrators had difficulty setting up a functioning and responsive system. Poor first-time user experience put off users and prompted them to switch to an alternative user-friendly, for-profit software.
Despite these challenges, many OpenBoxes innovators have shied away from advancing UX design and tended to focus on the application’s basic functionality by developing additional features. There are various reasons that may explain this, including pressure to meet a funder’s deadline to release an updated product or funding models that restrict how funds must be used. Regardless, this approach has only benefited tech-savvy users, who more easily adapt to new technology, and has left others behind.
While the OpenBoxes team has long understood the value of improving user experience, they have also recognized the limitations to growing in this area. “User experience improvements have been at the top of my priority list for a long time. But it has not been easy to find funding to work on it. Unfortunately, there aren’t many granting organizations that consider the specific needs of open-source software,” said Justin Miranda, Lead Developer at OpenBoxes.
Bridging the gap between developers and users
That all changed in 2021 when OpenBoxes received a $60,000 grant from Digital Square’s Notice E funding cycle. Digital Square is a PATH-led initiative that is advancing digitally enabled health services around the world to help close the health equity gap. Under Notice E, Digital Square aims to improve digital commoditization of health tools as stand-alone, interoperable, open-source software products that are “shelf ready.” Shelf readiness stems from the need to ensure that digital health global goods can be deployed as stand-alone products to meet users’ primary data needs of a tool.
The funding from Digital Square has enabled OpenBoxes to focus on several improvements that will make it easier for new, nontechnical users to install and configure the software. The most important feature of a Logistics Management Information System is to provide accurate inventory information by defining the quantity of a particular product in a specified location. Therefore, the team focused on product- and location-based improvements during the first round of optimizations.
Kelsey Nagel, a product manager at Partners in Health, echoed this need to improve user experience and the potential benefits these improvements can bring. “Since administrators tend to be our most tech-savvy users, we don’t prioritize making things easy for them. Instead, we assume they will figure it out. But, as an OpenBoxes administrator myself, sometimes it can be frustrating. I’m so excited that we can make these key processes work more smoothly. I’m excited about the improved Excel imports in particular—this will save so much data entry time for implementers,” she said.
One of these optimizations launched this past April 2022 when OpenBoxes released an in-app support function. The initiative added a “?” button on every screen, which directed users to helpful articles that answered questions commonly asked by administrators, procurement managers, and warehouse users. It was initially rolled out in Haiti, Liberia, Malawi, and Sierra Leone and led to articles in English, French, and Haitian Creole.
Beyond funding, Digital Square provided technical assistance to help the OpenBoxes team create a roadmap to undergo a user interface overhaul. As a result, OpenBoxes is moving forward with strong momentum and has engaged its first-ever usability expert. This UX professional has developed and implemented new design features to optimize the user experience. They will also stay on after the grant cycle to create a style guide for OpenBoxes, to help ensure sustained success.
“Having a usability expert has been a game-changer. Now, we have the expertise to make real progress and are committed to finding the funding to keep it going,” explained Miranda.
Digital Square support
Global goods have been tailored to the needs of various business domains within the health system, including supply chains, program monitoring and evaluation, health information systems, disease surveillance, and health insurance. Beyond focusing on advancing global goods, Digital Square strives to ensure that these solutions are shelf-ready upon implementation.
“As more innovations develop, there is a need to adequately disaggregate and design for the end user. We work to respond to developer needs and implementer challenges and country priorities to promote a unified and simplified common deployment pattern for equitable health technologies,” said Carl Fourie, Digital Square’s Deputy Director of Global Goods.
The technical team at Digital Square works with global goods developers to support shelf readiness by providing resources and technical assistance, and facilitating community engagement. In addition, Digital Square aims to ensure these global goods for health remain relevant to different users across the digital health spectrum of care.
About Digital Square: Digital Square is a PATH-led initiative funded by the United States Agency for International Development, the Bill & Melinda Gates Foundation, and a consortium of other partners. Since its inception in 2016, Digital Square has raised more than $100 million from 15 investors to catalyze a range of digital health investments—working with ministries of health around the world to align adaptable, interoperable digital technologies with local health needs.
Digital Square’s coalitions, resources, and its portfolio of mature digital public goods for health (global goods) support large-scale, high-quality, sustainable implementations of digital health interventions. The Digital Square team brings together a robust and diverse skillset to play a leading role in digital health transformation efforts designed to close the health equity gap around the world.
Photo Credit: The image on the blog homepage for this blog post is credited to Ali Pierson, Partners in Health.