24/7 Symptom Management Service for High Risk Patients

November 2017 ~ June 2018
Service strategy
Memorial Sloan Kettering begun to explore the possibility of connecting more vulnerable patient population through digital touch points while they are at home, away from our eyes. Newly developed analytical capability could identify cohort of patients who are likely to have urgent care center visits that are potentially preventable with at home or outpatient interventions. Hypothesis: With digital tools to report daily status and a team of clinicians monitoring reports real time, we can help our most vulnerable patients manage their symptoms better while they are at home. How should we architect digital services to make this hypothesis to reality, and scale while not losing the benefits of primary oncology care model?
Lead Designer within a team of designers (service, product, behavioral scientist), physicians, nurses, clinical operations staff members, engineers and project managers.

Problem: access

At Memorial Sloan Kettering, an oncologist team has a primary responsibility of patient care. In this model, a patient sees the primary oncologist throughout his care (unlike some other hospitals where patient can see any oncologist who are available at the moment). While patients can develop deep relationship with the primary oncology team (This is important to patients, and clinical outcomes), patient’s access to care is limited. Patients get to report their symptoms during appointment time, which is usually days or weeks after it happened. Sometimes for acute symptoms, patients wait to call their doctors until symptom develops to a critical problem, since they do not want to bother their doctors.



Idea: change in care model

To provide access to clinicians while patients are at home, there needs to be a team of clinicians who can monitor patients status and apply interventions 24/7. Using digital tools, we can minimize the interruption to patients life minimal. Asking are you doing ok? If the answer is yes, life goes on. If a patient says slight fever, a clinician can react right away, in a much more proactive fashion (than patient showing up at urgent care center with much higher fever)

^ Service model changes



Challenge: scale while not losing the benefit of relationship

The benefits are so obvious. Patients can stay home (staying more time at home leads to higher patient satisfaction), symptoms can be addressed early, less treatment courses being canceled because of severe symptoms. However, implementing a new model of care scared many of us because of the fear of losing benefits of close relationship between patients and primary oncologist.



Change management: Transformation principles

Design team who seeded this idea to the institution wanted to make sure that we are bringing positive changes into the organization, and created transformation principles with our leadership. It helped the project team stay on track throughout the development.

^ Transformation principles helped people think differently, and the institution manage changes when the impact of change was at scale.



Solution: Digital service framework

I created a service interaction architecture that explains the value exchange between key actors in this care model. Connected with digital tools, patient and the monitoring team can communicate daily care needs, monitoring team and the primary oncologist can coordinate. Patient and primary oncologist can leverage the data that have been collected in between appointments when they meet in person.

^ Defined what tools do we need, the role of each tool, and feature sets to enable the service and add value to each players in the service.



Implementation: Orchestrating efforts with stories

The future that we have been dreaming through this project requires multi-level changes: building a new care team (recruiting, new job description), connecting/modifying a dozen technology systems, changing culture, and communicating it to patients and the organization. It was a big challenge to coordinate the efforts, and I proposed to tackle this challenge with a lens of desired experience, rather than operational challenges to make sure we stay focused on the key value we are creating.


^ Considering feasibilities at each phase, I have proposed what experience can be created. We knew the first day we’d launch the pilot, we won’t be able to use seamless text based interaction, but we will be using a survey system that the institution already has. The experience from day 1 won’t be what we have dreamed of, but this way we keep our minds to the future.



Bringing empathy to the table at a systemic level

Throughout the development phase, we wanted to make sure that we are capturing diverse perspective of key actors in the service: Patient, monitoring care team, primary oncologist team, and the institution. Each has needs, pain points, and relationships with other parties. We did empathy mapping for each one to understand the interplay of them.


^ Cancer care is an orchestrated efforts with interconnected parties. We have looked at key players in the future scenarios and each player’s actions and values in this program.

Stay focused on patients

Upon building a foundational understanding of the interplay, we also wanted to make sure that we are designing a service that is built with patients at the center. We have asked physicians to pick patient cases who might have benefited from this type of program the most. We invited clinicians, operations staffs to discuss missed opportunities to inform the service creation.


We also met with a few patients who are in active chemotherapy. We listened to their experience at home, times when they missed having access to clinical staff members, how they are tracking their symptoms and what they do with the information.

^ Interviews with patients and caregivers who are in active chemotherapy.

Brining ideas to life

Many sketches, prototypes, mockups have been made throughout the project to facilitate discussions among the project team. We mainly sketched patient side experience, and the central team’s experience as those were two major opportunities to make changes.





  • Workshop – research (stakeholder interview, dealer interview, customer interview) – current state customer journey – concept framework


  • as a design lead in the project, managed multiple designers, scope, project plan …


  • spread design role in large healthcare organization


  • First pilot program have been launched in October 2018 with 3 participating clinics

Care Transformation Powered by Digital Services

May ~ November 2016 (7 month)
Vision & strategic service recommendations
How will cancer research, healthcare, technology and society change in 10 years, and what is the impact of the changes at Memorial Sloan Kettering Cancer Center? Aging society, technology disruptions, consumer-driven markets and breakthroughs in cancer research suggests Memorial Sloan Kettering, an over 100-year old brick and mortal institution, to be more accessible and nimble. Breakthroughs in cancer research allow early detection of disease, and shift cancer as more chronic illness, meaning more and more people will be more engaged with preventive care and/or managing cancer as a condition to live with. As an institution whose focus has been treatment of cancer, how might we leverage digital technology to deliver cancer care outside of our physical boundary, and expand our reach to those who are beyond diagnosis & treatment in their care continuum? How might we develop a flexible and robust foundation of technology that can support evolving organizational needs & dynamics of cancer care? I led the effort to deliver answers to this question with team of designers and technologists at Memorial Sloan Kettering.
> Senior UX Designer (Project lead)
    UX Designer
    Project manager
    Visual Designer
    Design Researcher

in collaboration with teams institution wide

Care Transformation Vision

“Be bold.” was the guideline that was give to me when I met José Baselga, chief medical officer at Sloan Kettering with the proposal of digital strategy project. To stay truth to this ask, we focused on the future – where society, medicine and technology are heading to rather than what are current efforts that are happening within the institution. Prevailing consumer technology and artificial intelligence, rising power of consumers, healthcare reform, advancement in cancer research are all pushing cancer care center to think of new ways to deliver cancer care in digital ara, and cancer care will be different experience in 10 years.

2016 MSKCC vision posters

^  As part of the final deliverables,  the team have suggested three digital service concepts that can strategically move MSK from where we are now to where we want to head to in 10 years. Service concepts ware described as future scenario (a story of a patient and her journey) so that the human experience design can lead the development of our future.



Trend based collective intelligence

We started our discussion with 5 possible future stories that have components of upcoming trends in technology, society and medicine. Through a workshop with colleagues from across the institution, we discussed possibilities, pitfalls and excitement to refine future scenarios.

2016 MSKCC approach

^ Building scenarios based on trends: To foresee more probable and relevant future experience, the team has gathered trends in healthcare, technology and society that are relevant to cancer care and pictured future scenarios; Combine “high demand of oncologists” (healthcare) + “aging population” (society) + “drone” (technology) = what future scenario can you draw?


^ Supporting organizational goals: Design team made sure that the scenarios we brought to the workshop maps well with the growth strategy of the institution.



Additional Research

We have looked at other cancer institutions and their digital tools (patient portals) against the lens of functionalities. In parallel, we have looked at other digital services outside of healthcare to benchmark user experience.

  • How are other hospitals utilizing digital touch points in their care?
  • What are other examples outside of healthcare that engage their customers a way that we aspire?
  • What do we learn from examples in and out of healthcare?




^ Competitive Analysis: Analyzed 6 patient portals (3 top hospital enterprise solutions, 2 cancer care focused solutions and 1 homegrown portal) as well as digital service experience outside of healthcare that materialized and delivered the experience that we desire through our digital patient care.

Additionally, technology team analyzed current technology infrastructure and the gap between current  capability and our desired future.


Final Concepts & Recommendations



^ Strategic services: Analyzing trends, related internal initiatives, our team suggested 3 strategic digital services that can transform patient care at MSK across all patient journey from prevention and wellness period to during cancer treatment to survivorship.



^ Future scenarios: (Sample) Digital service can connect disconnected parties through digital and provide values for every connected party. The scenarios were put together to juxtaposed experience and benefits of patients and the institution, along with evidence (trends, related projects), capabilities to build, return on experience and challenges.

  • Workshop (vision, ideation) – competitive analysis – SME interviews – Analysis & concepts – Final deliverable


  • led the project from planning to delivering final report


  • learning complex hospital system in a short period of time


  • The final suggestions were well received by senior management at Memorial Sloan Kettering Cancer Center
  • Two of the three suggested services are being developed into new capabilities and offerings at the institution.

Digital Playbook for Memorial Sloan Kettering Cancer Center

May 2016 ~ November 2016
Digital Playbook

How do we embrace digital technology to amplify our reach beyond our patient care in most efficient and impactful ways? What makes digital services successful at Memorial Sloan Kettering, and other industries? Taking best practices from both internally and externally, we have created playbook to guide creators, stakeholders and project sponsors within the institution to make informed decisions when they are embarking on a journey of creating digital services.

Lead Designer

Why playbook?

There are many teams building digital tools and systems for patients as well as staff members. This guiding principles are made so that all those efforts are set up for success, and working towards greater vision of digital patient care.

How it’s made

This playbook is crafted based on two things; One is the collective voices of people within the institution – the vision, challenges that they have experienced over the past decade, and what could have worked better considering the unique environment at MSK. The other is the best practices of digital services that offer great user experience and systemic lift leveraging digital technology in various industries. Interviews with 18 internal creators, end-users of systems and leaders internally, and books and articles that are well respected in digital technology field have been the ingredients of this playbook.


Play rules!

The roadshow & impact

We took the materials to marketing, engineering, strategists and other builders to share the words so that they can start utilizing our learnings. How-tos and specific resources are added to make it more concrete. We have seen it being used in people’s thinking in projects (engineer’s are referring to this “remember to think how this data is being used in clinic!” during patient portal dev meeting)


Surgical patient family waiting room status board

November 2017 ~ June 2018
Design research
Product design (Zaplin sepc to Dev)
With the advancement of medical technology, more surgeries are done in outpatient settings. Memorial Sloan Kettering, has opened an outpatient surgical center in early 2016. In many cases, patients come with family members who would wait in the waiting lounge until the surgery is done, see patients while they are recovering and take them home. The lounge is thoughtfully set up with things to do while waiting for their loved one, with a status board that shows all surgical patients status throughout the day. The status board was on a big TV screen, and needed some beautification. Re-skin the status board.
Solo designer in collaboration with Health Informatics and Engineering team

Always, research

It was relatively simple ask, and I was starting from a safe place. The original look of the status board could be much enhanced with simple changes in spacing and swap of assests. I could have been changing the look of it, but I wanted to see it being used in the context, and talk to people who might have insights that I could not catch just by looking at the screen.

I visited the surgical center and observed family members who are waiting for their loved one’s operation to be finished. How often are they looking at the screen? How far away can they be from the screen? Additionally, I requested to talk to a floor receptionist and a nurse who is frequently interacting with the family members at the lounge. It was a day trip to the surgical center, and I have learned so much that I wouldn’t have learned just from the screen.


^  The view of the family waiting area (left) and a close up photo of the original status board (right).


Learning from research

  • The board gives a sense of visibility into patient’s status as a quick reference, but patients rely on staff for deeper insights (esp. nurses)
  • There are some misconception about the process when family members come as a visitor, and nurses minimize the gap (require changes in the label)
  • Other people’s progress or timeline does not provide meaningful information (the board looks like it’s a race! This view might be useful for operations manager.)
  • ‘Complete’ has an important distinction
  • ‘Ready for visitor’ triggers action, but other steps are informational
  • It’s hard to read from far away
  • Timestamps might provide higher clarity


Guiding Principles & Features

Based on what I have learned, I set some basic design principles that can guide me throughout the design iteration, and ideate features based on them.


Viewers need to be able to quickly identify who they are looking for, and they see the screen from across the room

  • Legible from a distance
  • Quick index to find who I am looking for (alphabetized)


Viewers need to understand where in the entire process the patient is and what each step means  

  • Individual focus (My patient’s status takes priority than how everyone is moving through)
  • Patient/family friendly language
  • Process indicator
  • Flashing for action queue
  • Timestamp


The design needs to fit for both portrait and landscape (for future implementation at other facilities), and accommodate 15 ~ 50 items in the list (average number of patients a day)

  • Flexible vertical spacing based on patient volume of the day


Design Iteration

I used a large conference room monitor to design. It was handy to check legibility from a distance, and see how it can feel when the design is live in the space.

^ Designing for large screen.

Final Design

^ Sample images of the screen. When there are 15 patients ~ 50 patients.

Design for staff facing tool

The original proposal was to change the look of the screen. However, to make the data more accurate, it needed to have a staff facing tool that a staff member can manually update the status of individual patients.

^ Sample screens of staff side tools.


See it in action!

^ The new design has been implemented and up and running.



  • Research – Design – Implementation


  • solo designer


  • scoping differently than what is originally asked


  • the design has been implemented
  • used modern tools (Sketch, Invision and Zaplin) to collaborate with development team, and the process was showcased as a best practice of collaboration

Care Coordination Research

October ~ November 2016 (2 month)
Research Synthesis: Opportunities

Cancer care is an art of orchestration. It requires collaborative efforts by physicians, nurses, office assistants, researchers as well as patients and their caregivers. Ironically, Design Innovation Group has been building empathy around patients and caregivers throughout years of work at Memorial Sloan Kettering, but was relatively lacking knowledge around inside of the door of our clinics. As service design lay its lens at not only to customer experience (patients in this case) but also the front stage and back stage, we needed a deep knowledge around people who are providing care and their coordination efforts. How do highly specialized individuals work together towards shared goals, and operationalize their intentions in clinic settings?

> Senior Designer (Project lead)
    Design researcher
    UX designer
    Visual Designer

Planning Research Objectives

  • Learn the workflow, attitudes & behaviors of clinicians and operations staff around communication, coordination and documentation.
  • Understand the needs and objectives of clinical teams in communicating amongst themselves and with patients.
  • Understand the landscape of tools (digital and non-digital) that clinician teams currently use to communicate with patients and with each other.
  • Map information flows and see where information lives, including tacit knowledge that is unrecorded.
  • Identify opportunities and ideas that could address needs and objectives, especially in line with strategic goals such as exploring virtual care

Field Research

We used research methodologies that can help us deep dive into the action of care coordination: observation (shadowing & contextual inquiries), interview with subject matter experts as well as people in the field.

For clinic observations, a team of designers visited 3 clinics. We interviewed clinic staff members including both clinical and non-clinical staff before or after the clinic day. When the clinic was running, we spread ourselves into multiple locations of a clinic (waiting area, staff desks, exam room) to be able to cross check what has been happening in multiple locations at a time of an event.

^  Our collective notes, artifacts, and photos were gathered in the project room for sense-making. What is a common theme and what opportunities can we find?


Making Sense of What We Learned

^ Synthesizing our learnings: We have documented roles, tools and workflows around care coordination based on what we were told, observed and collected to have shared understanding within the department of design innovation


Moving forward

^ Opportunity areas: The research ended with suggesting opportunity spaces based on clinic staff members’ behaviors, intentions and desires as well as from a systems perspective. Where can we make an greater impact to support clinical operations?

  • Planning & Recruiting – Field research (observations in clinics and physician offices, and interviews)  – Synthesis


  • led the project from planning to delivering final report


  • Translating our learnings of the subject’s complex nature into feasible opportunities


  • Influenced development and deployment of care coordination tools at MSKCC
  • Internally in the design group, opened to a new possibility of service design approach when service is provided by human beings with high degree of expertise, goals and emotions

Cancer Patient Journey Map

February ~ May (4 month)
Patient journey map


Build a base of shared understanding of cancer patients journey to be used as a foundation of building empathy and finding opportunities.

> Senior UX Designer
    UX Designer

Patient Journey Map

A customer journey map is a graphical narrative that describes a series of events, behavior and emotional status of customers who are interacting with a service. It is often used as a tool to look at a product or a service from customer’s perspective. It visualizes customer’s actions from start to finish, it’s often a great tool to surface blind spots and find opportunities.

This particular document is created in collaboration with a dozen designers at Design Innovation Group, who have been emerged in primary research for years of projects. It was a beginning of documenting our collective knowledge to be used for future reference and a design tool.



  • Illustrations to help picturing patient situations
  • Covering thoughts & emotional states, actions, and social dynamics
  • Based on interviews, observations with patients and caregivers

How we used it

The final journey map was shared by a team of designers at Design Innovation Group and utilized for many other projects. Some took it to map internal digital projects within the institution, so that we can see where the institution is falling short when considering the whole patient journey. Some took it to brainstorm on opportunity areas. It was also used as a learning tool for new hires to build a basic understanding of what patients go through.

  • Workshop – document


  • initiated and led the project


  • Used as a tool to look at our offerings from a patient’s perspective