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.

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

National Park Service. Visitor Experience for the Next Centennial

September ~ October 2014 (2 month)
Visitor journey map
Define the National Park Service’s visions for digital integration, visitor experience with digital and programs / projects to support the next generation of park visitor. A joint effort with the Accenture team.
Note: National Park Service will celebrate 100 years of serving America in 2016. Accenture has initiated this project as a gift to the celebration. And I am honored to be part of this project.
    Engagement Lead
    Service Design Lead
> Interaction Designer
    Visual Designer (Illustration)
    Accenture Federal

New York, San Francisco, Washington, San Jose, Chicago

Visitor Journey Map

2014 NPS journey

^  Final deliverable that illustrates future experience with digital integration

I was responsible for creating this map and here’s the process:


2014 NPS park visit 1

^ Research the National Park Service organization and the visitor experience. The Fjord team had the opportunity to visit Harpers Ferry and Gettysburg where we were treated to this amazing ranger tour. Dennis, a park ranger with 30+ years experience, knows the details and history of the park by heart, and his passion for it is infectious. We learned about the dreams and challenges of delivering ‘Power of Place’ by creating ‘Boundaryless Park’.


2014 NPS rumble crop


^ Generate ideas for visitor journey in the future with client at a workshop

(4 groups generate ideas for ideal visitor experience based on the personas that they developed)



^ The idea that came out of the workshop were then digitized by group facilitators. The Fjord team then talked through the ideas to construct the future visitor journey in a cohesive and polished way. I conceived a way to organize the information into a Google spreadsheet such that each row and column would function to support the story that we wanted to tell. (Simultaneously, 3 outstanding ideas are being developed into concepts. )



^ Based on the Google spreadsheet, I create a draft of customer journey map so that the visual designer can use as a reference. All components, information are near the final state at this point


2014 NPS step 4

^ A beautiful skin is applied
(by Service Design Lead)


Presented to client and incorporated feedback before the final submission.




^ Sample pages of the concept deliverable

(I collaborated with the Service Design Lead to develop the concept scripts. Then the visual designer illustrated the story.)

  • Research – workshop (vision, ideation) – visitor journey & concepts – capability & gap analysis


  • played a key and leading role on the project throughout all activities
  • supported the engagement leader facilitating the workshop, synthesized the workshop result, led creation of visitor journey, and participated in concept development


  • navigating through a low budget constraint and complex work structure


  • National Park Service is pleased with the deliverable and plans to implement
  • Accenture technology lab will be developing prototype
  • The journey map is mentioned as great examples of Fjord’s work internally

Marriott. Service Design for the Next Generation Travellers

July ~ September, 2014 (3 month)
Research summary
Competitive audit
Customer journey (current state)
Introduction of service design language for managing a customer experience that is supported by multiple channels.
Marriott’s customer service is unable to serve millennial travelers who are digital natives. In order to serve them in a cohesive and relevant way, Marriott enlisted Fjord’s vision and methodology to create an organizational change.

    Group Director Organization Evolution
    Business Design Lead
    Service Design Lead
    Visual Design Lead
> Interaction Design
    Visual Design
    Accenture Team

New York, San Francisco, Chicago

Research Summary


^ Executive summary page to narrate research findings

(I participated in the synthesis and summarizing of research findings)



^ Competitive analysis as part of research summary

I was responsible for the competitive analysis. Instead of comparing hotel chains, I constructed the research as inspirations and trends. I found key trends and examples that back up the trend from various industries including hospitality, retail, travel, technology and entertainment.

Current State Customer Journey Map


^ Customer journey map of current state to diagnose breakpoints

(I set the foundation of the document and then visual designer added skin)

Opportunity Areas


^ Part of final deliverable – future opportunities

(Final deliverables were created by the visual design lead. I constructed the foundation work through the following process:)

The process of creating both customer journey and opportunities deliverables



Synthesize existing Marriott research (there’s a lot.) and Fjord’s finding to construct a comprehensive map



^ From the customer journey of current state (focusing on breakpoints), build future opportunities with client



^ Generate consensus within the team through discussions and votes

(Side note, I did these drawings)



^ Create narratives to highlight future opportunities


 Hand over to visual designers for final touch

  • Research (primary, stakeholders, competitive landscape) – workshop – customer journey / business case


  • researched competitive landscape trend of provocative and cohesive customer service throughout multiple industries including hospitality, retail and technology to provide inspiration for higher vision for the client
  • created current state customer journey map to highlight break points of the customer experience (used at a workshop)
  • created the initial plan and set the foundation for the future state customer journey that highlights opportunities


  • comprehending complex organization that supports customer experience and visually highlighting break points and opportunities


  • Client developing programs / projects that came out from the service design deliverables

KIA. Customer Experience from Sales to Service

May ~ June, 2014 (2 month)
Research summary
Guideline for concepts
Customer journey map

Discovery of opportunity areas and guidelines for customer experience roadmap for KIA in the U.S and E.U markets. Kia wanted to develop compelling and consistent customer experience from sales to service globally. Fjord New York has been selected to research and develop preliminary concepts so that Accenture Korea could implement them in customer experience management.

    Service Design Lead
    Business Design Lead
> Interaction Designer
    Accenture Korea

New York, LA, Seoul

Customer Journey of Current State & Opportunity Areas

2014 KIA-Customer-Journey-V4-FINAL-small

^ Customer journey map from sales to service that highlights disconnected interactions between divisions in the current state. As a core team member of this project, I created this document based on our research findings and concepts. It took many whiteboard sketches and stickies to figure out the right story. Here’s the process.

Process of Creating the Journey Map


^ The team visited dealers and stakeholders in the U.S and U.K (I visited 4 dealers in the U.S), and interviewed 8 consumers who recently purchased a vehicle.  From the interviews, we identified car buyer/owner’s pain points as well as Kia’s organizational challenges.


^ 7 themes were extracted out of the research findings


^ Many whiteboard sketches were drawn to find the right way to visualize our themes in the context of customer experience.

2014 KIA Customer Journey V1-01

^ The first version of the journey map is created.


^ We presented our research findings, themes and the journey map in a client workshop to align on our vision and generate future concepts. (2 days workshop at Irvine, CA)


^ After we came back to NY studio, we developed the concepts that were generated in the workshop further into more compelling stories and laid out where our concepts are applicable in the customer experience.

Research Summary and Concepts


^ Sample pages of the final delivery that explains our process, principles and concepts

(I have been part of every step in the project from visiting dealers to developing concepts to support this final document)

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


  • as a main/solo interaction designer, supported the team leaders in every step of the project
  • created current state customer journey map that illustrates disconnections and highlights opportunity areas


  • comprehending complex organization that supports customer experience and visually highlighting break points and opportunities


  • Concepts were further developed by Frum (Korean service design agency)
  • Client developing global programs / projects from the concepts
  • Client and Accenture Korea team who collaborated in the project were impressed by the work that we did and the way we work as well.

Play with Playmobil. Service Design Prototyping Tool


December 2013 ~ March 2014 (3 month)


One of the best way to build a successful digital interface is through prototyping (AKA failing fast). Same principle can be applied to service design, but we have limited tools to prototype systems where we have to consider people and surroundings. To bring service design methodology in our everyday design practice, Lena Hammes and I proposed to purchase a series of Playmobil. The small size replication of our world can be used in all stage of service design process from visualizing complex systems to envisioning design solutions.

Our proposal was accepted and I ran two series of design sessions to show what they are, and how we use them.


This was not a client project, but an initiative that came out of my curiosity. Finding a way to work better as a team is also a big part of what I do at Fjord.


2014 Playmobil proposal

^ Summary of our proposal

They are here!

2014 Playmobil

^ This is a shot from the day it arrived (January, 2014). After the arrival, I ran a couple of design workshops to promote our new hires into the studio.

Design Workshop Part 1


^ On Feb 14, 2014, I invited everyone in the New York studio to brief what we’ve got and why we got them as well as to give them hands-on experiences. We divided into 3 groups and within 30 min of time, they produced really fun stories told with Playmobils.

Design Workshop Part 2

2014 Playmobile example

^ Soon after the first workshop, designers started using Playmobil in their work. A team did a great concept deck to show a workflow of an app that they were designing, which was a great way to visualize the usage of the app without showing too much details. Another team bought more Playmobil sets to use in the business development deck to visualize their perception on the subject matter. On March 21, we had ‘Play with Playmobil’ workshop part 2 to showcase these examples.

Aetna. Designing New Business for Workforce Availability 

April ~ November, 2013 (8 month)
Service blueprint
Stakeholder map
Visual design
New business development around workforce management within Aetna from concept to product. At Aetna, internal new business development team has embarked on a journey to develop a new business in regards to managing absence in organizations. Fjord was selected to define the details of the new business, develop core concepts and design the MVP which involves multiple types of users. (employee, supervisor, and Aetna service representatives)
    Service Design Lead
    Business Design Lead
> Interaction Designer
    Visual Design Lead
    Project Manager

New York, Hartford


2013 AWA stakeholder map

2013 AWA process map

^ After talking to multiple stakeholders, day-in-life research and a 3 day workshop with Aetna and the potential clients for the new business, the team have learned the complexity of how currently workforce availability has been managed in large corporations.

Framework & Strategy

2013 AWA service principles

2013 Aetna framework

^ Design framework and principles



^ From the framework, we’ve envisioned 3 concepts

Detail Design


^ Final visual design samples for 3 types of users; employee, supervisor and the service admin


^ The Fjord team identified 3 major user types of the service and designed an online service with 3 faces; for employees, for front-end supervisors and for service representatives. The images are the sample pages from the wireframe documents. Wireframes were used to communicate with visual designers, clients, and developers who were building the MVP for initial release.



  • Research (stakeholder interviews – field interviews – stakeholder map – service blueprint) – concepting – detail design – development


  • as a core team member of the design team, support all aspects of service design in this complex multi-actor play from the beginning to end
  • support facilitating 3 days workshops (lead breakout sessions) to define actors, their relationships and the workforce management processes
  • played an integral role in stakeholder interviews, field interviews, concept and direction development.
  • designed detailed interaction for multiple users of the system


  • complex system – hard to comprehend by anyone. compiling many voices of constituents and stakeholders, tight timeline for detailed design for multi users


  • ceased while MVP under development