Part 2: Whatever happened to discovery? Research in the digital health sector

Link to Part 1 “Whatever happened to discovery?

I’ve worked as a User Researcher in the healthcare sector for six years now. Many teams often talk about their discovery and profound understanding user needs, indeed it is a requirement for GDS and NHS.uk Service Standards.

From the many hundreds of research projects and thousands of interviews that I have seen, or been part of, real discovery research rarely happens, in my view.



Here are some issues that are routinely observed:

1 – It’s usually not for the want of trying by User Researchers, but there broadly is no culture of discovery. Programme management don’t acknowledge a need to understand users context, lifestyle, values, motivations, needs. Usually programme management are mandating digital teams deliver a thing committed by ‘VIP stakeholder / HIPPO’

2 – Also very few teams are working on research and solving “real problems” around a root cause. All the time is spent understanding and unpicking the consequences of previous projects, so it is almost impossible to get a new and proper greenfield discovery off the ground

3 – Everyone we work with is a patient, so everyone becomes “an expert user advocate”; there is an assumption that teams know users but often they are over confident and think that no discovery is required

4 – The same teams have usually been in place many years; collectively they assume they have user knowledge, a shared expertise, that means discovery is also not required

5 – When discovery happens, it is timeboxed to a few short weeks. Discovery at worst it is a 15-minute warm-up activity before showing some screenshots. This happens a lot

6 – Discovery scope is often limited to digital interactions only. Often discoveries are narrowed to a product channel/theme that is a focus of a new feature (e.g. can we discover what communication channel people want to receive alert messages on?)

7 – If real discovery is happening, which I don’t believe it is, sharing of this information more widely is not happening

8 – Discovery teams often get closed down if they don’t also come up with ‘a solution’


Making health discovery a bit better

To change the outcomes, we need to change the process and inputs.

Really good discovery should be ongoing ethnography, both tactical (e.g. thematic) and more strategic (e.g. longitudinal or lifestyle)

We need to be more honest about this, so when we are asked ‘who are our users’ and ‘what are their needs’.

If a proper discovery has not been completed in the last 18 months, the best answers too give are:

A) We don’t yet know as we’ve not done much discovery work recently

AA) We have documents needs and/or personas, but these are based only historical discovery evidence, subject matter expertise, and/or assumptions that may be wrong

Ideally teams would complete discovery, and continue to learning about users needs throughout service and product lifecycle.

While discussing a new urgent requirement, and whether discovery is needed it can be a difficult conversation. But it’s important to persist and champion this need to give the project and service users the best opportunity for a successful outcome.

Have you ever heard a Product Owner or Delivery manager say any of these phrases? If so then your user researcher/s have certainly done a great job in embedding a culture of research and discovery within the team.

AAA)

We are not our users

We are aware of our internal unconscious bias, cultural norms, that make us different to our users

We listen to users, but don’t judge user

We have empathy, not sympathy

We care about our users and we want them to have a great experience

We want our users to achieve their goal efficiently

We’ve actually met these people, a good cross-section

We spoke to the people who have abandoned/rejected using our service

We spent a decent amount of time in their environment

We observed them without interfering with their day

We understand their context, in a way that is broader than our service model

We enjoy talking about their pain points and underlying needs

We understand that their needs change from time to time

We learn about our users behaviour through qualitative and quantitative data

We regularly co-design with our end users


TL;DR

Working in a digital multidisciplinary team it is almost impossible to get a “real discovery” off the ground. It’s not just a commitment and funding issue, but a lack of understanding.

We need more programme directors who understand what a real discovery looks and can smells fake discovery a mile off.

Product teams need to get closer, immerse themselves, among insights about the lifestyles of end users to identify real needs and root cause problems.