UX and Healthcare: Q&A with Dave Cooksey

Having all of the answers can be said to solve all your problems. But what if these answers become lost in an ever evolving haystack? Arguably, systems and architectures are truly the invaluable assets to any industry, especially healthcare. Creating order amongst the rapidly expanding collection of content, and making complex circumstances clear is vital in creating a smooth and efficient user experience.

Believing in a human-centric approach to technology is something Dave Cooksey, an experience designer, holds true to his design practice. By combining research, information architecture, and interaction design, we dive into Cooksey’s world to understand how the healthcare industry could be using tech to improve the user’s experience.

Can you tell me about the intersection of UX and healthcare and how they mesh together?

The issue about healthcare is that information is overwhelming, and it’s going to continue to grow massively. Consider all the information that a doctor or nurse has to interact with day to day — everything from the electronic health record system, paper records, billing system, medication management, patient education materials to teach patients about treatments and conditions — it’s overwhelming.

The amount of information and the complexity of all those systems interacting—you need someone to step back and try to make using information as easy as possible because for a doctor, you have only a few minutes to answer a question when you’re about to see a patient or when you’re with a patient. And when you are the patient, your time to ask questions is even more limited. So the information has got to be usable. It needs to be clear and it needs to deliver what the user needs, regardless if that is a doctor, nurse, or patient.

Evidence is crucial in matters of diagnosis and treatment, but the system itself and the delivery of that information is equally as important.

Another phrase I’ve heard a lot in the last couple of years is this whole digital health revolution, that health care is trying to digitize and “step forward”. But it’s not as digital or as advanced as it could be, compared to fields like mass mobility, or transportation. Why do you think that is?

I think that, at least in the United States, it’s hard to transform something that is extremely complex, from a systems view. There are so many complex systems that are interacting in healthcare that it’s very hard to pinpoint where the information is coming from and where it's going.

Also, if you’re going to digitize it, privacy is a concern. A lot of things are still on paper because of fears around data security and personal information.

You also have the fact that it’s very rare in healthcare to have something handled by one person. This means that teams of people have to collaborate, which results in a more complex design space. But designers have the right skills to promote collaboration within their teams and with the people they design for.

I think when a person hears buzzwords such as ‘digitization’ or ‘digital revolutions’ they already have their own preconceptions. Everything is revolutionizing right now and everything is disrupting to the point that the words take on new meanings and it becomes really difficult.

I don’t like disruption as a term because it is fear-based; at least the way I see business people using it. “You better be innovative. You better be prepared to shake things up.” This is not the right message for many who work in healthcare.

I think it is better to say, “You need to be close to your consumer” and, “You need to understand technology”. This is crucial... look at bookstores in America and Amazon or taxi services and Lyft and Uber. These companies have disrupted their industries. From the position of fear, we could focus on those who lost out in that disruption. However, you could flip it around and see these from the position of creation. Then it becomes fun to think you're breaking something. I live in Philadelphia and I’m glad there’s Lyft because the taxis were horrible. But now I've noticed the taxis are getting better in Philadelphia because of the disruption brought by ridesharing.

So if we’re talking about disruptive as creative change, then that’s great. I will say, though, that I don’t hear the word disruptive used in reference to healthcare in this manner very much.

Health care is fundamentally emotional because it’s about people at the end of the day. And that’s why, a good user experience is important. But do you think it’s as integrated as it could be? What is it doing right and what could it be doing better?

I think if you take a design approach, thinking about the issues in healthcare today, you will notice that better patient outcomes may not be the only solution that people are solving for. In the United States particularly, I think profit is another one, resulting in a natural tension.

As a designer working in this space, what you need to be aware of is, while you might be focusing on trying to make people's lives better through information, there could be other goals in conflict with this.


You can see this with air travel, for example. I’ve flown since the 70s and I remember when regulations began easing up on airlines. If you take a flight now, it’s very obvious that they are trying to squeeze every single dollar that they can out of you. I just think the issue of personal space alone is enough to say that this is really not very customer friendly, and it is not very humane to put people on an eight hour flight, and feed them very little. You have to pay to pick a seat, pay to board early, and pay to bring a bag. It’s a fee model, and the air industry is loathed for it. But their shareholders love them for it.

The desire to maximize profit as much as possible can lead to really poor user experiences. I think that's fascinating. I think we’re getting to the point in the conversation where we’re butting up against ethics. A lot of people are talking about this for a good reason, right? And it’s not just about my comfort when flying. Technology has allowed us to create these conversations. Twitter is a great example, where people are organizing and trying to change these things. Maybe one day, there’ll be a revolution in the air.

What is the future of healthcare and what are upcoming trends you see happening in the next 5 to 10 years concerning UX and healthcare?

I think in healthcare what gives me hope is to see clinicians, like doctors, nurses, pharmacists, and other experts in the field, forming relationships with designers and technologists to make a better experiences based on patient outcomes.

We designers ask a lot of questions, and experts like doctors may not want that, which is a challenge. It’s also very hard for us sometimes to get in to the actual environment where care takes place. But we're needed desperately to move the focus beyond technology, which has unfortunately led to the horrible state of health record systems, which is a leading factor in doctor burnout.

Some institutions are trying to change that, setting up innovation centers. They’re bringing in people who are not clinicians or technologists who have a human-focused or user-centered approach to challenge assumptions and to focus on the user. I give props to anybody that works in healthcare innovation because it's challenging, but really needed.