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Timely

We designed Timely, a mobile app that automatically documents ambulance missions and tracks worker performance against benchmarks.



Timeframe

1 month (part-time)
Nov. 2014 – Dec. 2014

Team

Ron Kim, Michael Richardson, Natalie Salaets, Ming Zhang

My Contributions

Performed online ethnography
Led research synthesis
Established design objectives
Delegated work
Designed user interface
Incorporated feedback

Project Type

Course Project

Our research uncovered two opportunities

1: Help ambulance workers protect their careers

Roland

Roland loves his job of 10 years because he saves lives. Recently, his employer laid off many workers, and that makes him worried. He wants reassurance that he is doing a good job, and if he’s not, he wants help identifying how to improve.

Sharon

One day, Sharon wants to become a division chief. She knows how important the upcoming performance evaluation will be and wants to show how hard she’s been working. This time, she’s especially nervous. It took Sharon 20 minutes more to transport patients to the hospital during area flooding. Sharon wants to defend herself against legitimate instances of missed benchmarks.

2. Minimize the time it takes to throroughly document each mission

“I started out taking more than 10mins to write a full report, after a while I could get one done in 4-5mins, the city will force you to get better and faster because I can still remember my FTO telling me we had 911 calls waiting in our area and freaked out and wrote like a damn tornado.”
– Ambulance worker on an online forum

Manual documentation of up to 22 metrics per call takes up a large portion of their day. Ambulance workers feel rushed to complete it so that they can get back to saving lives.
Rushing reports can lead to missing information or errors, and this is an industry where reports are critical to maintain contracts with the city, get paid by insurances, and defend themselves in court.

We designed Timely, a mobile app that automatically documents each mission and uses the collected data to support ambulance workers.

How Timely Works

  1. During each ambulance mission, Timely runs in the background collecting GPS, weather, and traffic data. Timely combines its data with the Dispatch System data to paint a complete picture of the mission.
  2. [Optional] After the mission is over, the Ambulance Worker can write additional notes about the experience.
  3. The Ambulance Worker, the Supervisor, and Regulators can review Timely Performance Analytics.

Features

  • GPS automatically documents time-based metrics to save ambulance workers time.
  • Weather and traffic data can exonerate ambulance workers who missed benchmarks for legitimate reasons.
  • Real-time performance analytics allow ambulance workers to reflect on their past performance and identify areas for improvement.
  • Milestone awards help ambulance workers and their supervisors easily recognize steady performance and improvements.

Our UI Designs


How it all connects

Three Design Challenges

1. Make performance data relevant to ambulance workers and easy to interpret.

Focus on a very specific aspect for analytics: time per segment

Hide the zoning complexities that set different benchmark times based on distance from hospital

2. Avoid adding pressure on ambulance workers by designing a supportive environment.


Explain missed benchmarks with weather and traffic tags


Clarify context with user notes


Avoid competition amongst peers by making milestones personal


Do not use negative colors (like this red used in a previous prototype)


Show the percent of benchmarks met instead of time exceeding benchmark goals.


Focus on trends instead of single incidents

3. Find an appropriate balance of transparency and patient privacy.

Do not show a map to ambulance workers to protect the patient privacy.

On the left, you can see an earlier version of the prototype in which we used a map. The map would have provided more context for the call but it also would have given details about the patient’s location.

4-week Process

Research


Analysis of online EMT forums

We identified the challenges ambulance workers face in their own words.

Documentation defends ambulance workers from insurers withholding payment and lawsuits.

“Your billing, your company’s existence and your livelihood depend on good documentation. Insurers are looking for reasons not to pay the bills anymore.”

“Saying, ‘I can’t remember,’ is not going to work as a defense. Good documentation is what will shut down lawsuits”

Ambulance workers feel pressured to rush documentation.

“I started out taking more than 10mins to write a full report, after a while I could get one done in 4-5mins, the city will force you to get better and faster because I can still remember my FTO telling me we had 911 calls waiting in our area and freaked out and wrote like a damn tornado.”

EMS professions lacks job security.

“I can see the realities of [the EMS industry’s] extremely low entry requirements, lowest pay in the allied health industry, feeling extremely ‘disposable’ as an employee at many private companies”

Literature Review

We referenced the rules and regulations for ambulance providers set by Chicago and Los Angeles as well as industry best practices to nail down the details of benchmarks and required documentation.


Findings

  • There are specific time limits for transporting patients to a hospital based on zone.
  • Ambulance providers must document up to 22 metrics per call.
  • There is an opportunity to disseminate performance information directly to ambulance workers that is not currently encouraged by a city’s regulations.

“In 2006, the Institute of Medicine found that there was a widespread lack of accountability in EMS and provided three recommendations for EMS leaders:

1) Develop performance indicators;
2) Measure system performance;
3) Disseminate performance information.”

— How Good is Your Ambulance Service? Report, 2011

Timely Literature Review

Affinity Diagramming

We identified opportunities and design considerations.

During affinity diagramming, we reviewed and organized our research notes to identify trends, opportunities, and design considerations. We based the personas and visions on these insights.

Visioning


Ideation

I led the idea generation session in which each team member independently came up with 7-10 concepts before sharing. This approach helped us come up with 52 unique mobile app concepts that pulled from our unique backgrounds.

Impact-Feasibility Analysis

We narrowed the scope of the problem space using impact-feasibility analysis.

Each time we charted a concept on the Impact-Feasibility Chart, we had a conversation about how well the concept resolved the challenges that we discovered during research and implementation concerns.

Top 5 Visions

From the top 5 visions, we pursued the Reporting and Performance Evaluation visions.

We did not pursue:

Training: ambulance workers can experience multiple roles with emergency training simulations

Scheduling: shifts are scheduled based on availability and partner preferences, hours worked are tracked with NFC check-in

Communication: the ambulance’s location is shared in real-time with the person who called 911 and hospitals alerting them of incoming patients

Prototyping


Site Map Iterations

Peer reviews of the site map helped us to improve the visibility of the Milestone Badges.

Parallel Design

We prevented tunnel vision and get better feedback with side-by-side comparisons.

Twice-weekly Peer Reviews

We got peer feedback to make data visualizations easy to interpret.


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