Duration
14 Weeks
Team Members
Addy Fu
Vanessa Huang
Amy Kim
Leanne Wei
My Role
UX Research
Research synthesis
System mapping
Behavioral framework design
Project management
Brief
Using the Surgeon General's advisory on "The Loneliness Epidemic," we aim to gain insights on how healthcare providers, senior care providers, volunteers, as well as regional, city, state, and federal entities, currently experience and attempt to identify, mitigate, and implement solutions to improve the experience of social disconnection for vulnerable seniors.
Outcome
Our final design solution was a series of analytic tools and software centered around enabling doctors to treat cases of loneliness.
Notably, some of our framework tools we developed was used by Dr. Christiana Shoushtari (MD MPH, Fellow at Oak Street Health) in her doctoral thesis: "Addressing Loneliness at Oak Street Health: A Proposed Pilot Intervention."
Secondary Research
The loneliness epidemic is a society-wide challenge that touches upon many different ecosystems. Starting with the Surgeon General's 2023 report on the Loneliness Epidemic, our research turned into a deep dive of psychology, aging, social interaction, policy, healthcare, community, and other topics in social innovation.
Challenges
Loneliness is Subjective
Loneliness manifests differently for everyone and is hard to identify. Distressingly, lonely seniors don’t speak about their loneliness or outright don't know that it is something worth talking about.
It's Difficult to Seek or Access Help
People aren't on the lookout for things like loneliness and accessing treatment either informal or professional are both difficult.
There's No Clear Way to Measure or Communicate
As with mental health, loneliness is stigmatized. Individuals often fear being perceived as weak, emotional, or insignificant for expressing their feelings of isolation, discouraging people from seeking support or even acknowledging their loneliness.
Research Objective
Clarify the policies and practices of healthcare and other service providers that interact with seniors to identify and address social disconnect and isolation
Identify other formal or informal communities, groups, organizations and services that engage with seniors and can influence and impact their day-to-day lives.
Subject Matter Experts
Dr. Christiana Shoushtari MD
Physician, Oak Street Health
Kenny O'Neil
Healthtech consultant, Ernst and Young
Jennifer Noonan
Social worker, position leader for CVSHealth Behavioral Health
Diana Siebenaler
Director of Experiential Design, OSH
Justin Hunt
Digital health, Oak Street Health
Manika Kosaraju
Oak Street Health
Rebecca Murray
Clinical supervisor, Oak Street Health
Sean Gallivan
Advanced UX researcher, Aetna
Nikki Bussard
Service design principal
Nardo Manaloto
Technology, Kaiser Permanente
Findings
Primary care providers aren’t trained to diagnose loneliness or don’t consider it within their job scope.
Existing solutions are inaccessible, unknown to, or incorrectly applied by doctors.
No real metrics or communication channels for tracking the recovery process of loneliness.
Difficult to advocate for novel solutions in healthcare.
This blueprint outlines the scope of our solution, detailing exactly what our goals were, how we wanted to fit into the existing ecosystem, and how we were going to leverage it.
Building this let us see how many moving parts intersected the loneliness epidemic from a health perspective alone,
Aging and activities of daily living
This is a framework centered around Activities of Daily Living (ADLs): key indicators of an individual’s autonomy and ability to seek social interaction. This is a more flexible way of looking at aging than simply counting years.
Based on the ADL / IADL Questionnaire and HRSN Screening Tool, we created a classification system using physical and psychological elements as criteria.
Behavior Continuum
We then placed the metrics on a series of continuums to identify patterns that can indicate someone who is vulnerable to social isolation.
Intended simply as a tool to build user profiles, this turned into a potent framework in its own right, allowing care providers are able to get actionable insights for developing targeted interventions.
Senior Archetypes
Using the behavioral continuums, we created several behavioral archetypes based on common patterns.
These archetypes are extremely realistic and were received extremely well by the doctors we worked with.
In fact, the archetypes shown here were used in a presentation by Christiana Shoushtari (MD MPH, provider and Fellow for Valuebased Health Care Leadership Program at Oak Street Health)- "Addressing Loneliness at Oak Street Health: A Proposed Pilot Intervention".
We mapped the relationships/touchpoints that a senior interacts with in their day-to-day life based on our findings from the sticky note exercise with our stakeholders.
This map paints a clear picture of how different parties impact a senior’s life. Each node presents a possible lead where our solution can be implemented. It also informs us on what community resources are most important to pursue when developing our database.
I drew a service blueprint outlining a routine clinic visit. This gave me an understanding of the process, both from the perspective of the front to end patient experience and the back to front cross channel logistics that doctors and nurses need to move for even a simple checkup. We focused on what is happening below the surface that the users cannot see and sought opportunities for intervention.
Solution
Staffing and Training
Hire social workers and care coordinators, who are trained to handle these kinds of cases, to work alongside doctors. Train physicians in bedside manner to make patients more comfortable to share their feelings.
Implement Screening Methods
Create tools and protocols for screening loneliness in patients that can be used in various touchpoints throughout the patient experience during a patient visit.
Curate Helpful Resources and Connections
Curate a database of community organizations, public programs, and mental health support that we can form connections with and be leveraged to treat for loneliness.
Track patient progress and ensure follow-up
Rely on the extra staff or create software tools to track the patient's recovery journey and collect metrics. Adjust treatment plans as necessary and use successful cases to advocate for further funding.
A TOOL FOR DOCTORS
Detect and manage cases of loneliness.
A DATABASE OF PUBLIC PROGRAMS AND RESOURCES
The database will contain vetted community organizations, charities, professional mental care, and other helpful groups that doctors can contact and refer their patients to.
PATIENT NAVIGATION
The patient can stay on top of their treatment plan with an accompanying app which, after partnering with rideshare programs, can handle travel and logistics.
Impact
🔬 Framework adopted in doctoral research
The Behavioral Continuum and Senior Archetypes were used by Dr. Christiana Shoushtari (MD MPH, Fellow at Oak Street Health) in her doctoral thesis: "Addressing Loneliness at Oak Street Health: A Proposed Pilot Intervention."
Next Steps
Talk to Seniors
My biggest regret in this project is not being able to work directly with the people we wanted to help. It's a major blind spot in our design, which received praised from a top-down clinician's perspective but is missing a bottom-up point of view from seniors themselves.
Success Metrics
Design the system for tracking patient progress. Doctors need to understand patient recovery, be able to adjust the treatment plan, and be able to present clear metrics to other stakeholders in the healthcare ecosystem.
Community Outreach
Speak to community organizations and mental healthcare.
Post Script
Boiled down, this project was an exercise in wayfinding. When confronted with a broad, societal problem, it's easy to get lost and fall into design traps. Obviously we just need to throw together some kind of app or chatbot, right? That's the exact type of artifact we were trained to produce, but that line of thinking was exactly the kind of thing exacerbating the problem.
We needed to figure out the root problem, but also recognize that a solution had to be ground in reality. Who had the power to address this kind of issue? What resources could we bring to bear? How much were people willing to spend on a solution and how much was really needed? It was fun exploring this space, figuring out what questions needed to be asked, and building towards the answers.
Key Takeaways
Design for the system, leverage institutional resources but also account for limitations
Build your research tools and visually communicate complex topics
Craft your questions to get the answers you need
