Service design case study
QUICK FACTS
Problem: Patients attending Rwandan health clinics face long wait times and reception staff struggle with manual check-in tasks for high patient footfall
My Role: Service design consultant
My approach: Rapid prototyping, guerrilla testing in health clinics, rapid iteration
Deliverables: Figma prototype, usability testing plan, final Figma designs
Users: 16,956 patients across five health centres in the first month
Results: First month: 97.7% health insurance checks, 49% check-ins completed, 81% reduction in check-in times (8 mins to 1.5 mins), 12,476 patient minutes saved, 65,664 staff minutes saved
Context
Babyl is the Africa-based service which Babylon Health founded in 2016, in partnership with the Bill and Melinda Gates foundation, to bring accessible and affordable healthcare to Rwanda.
The service, delivered through the National Health Insurance Scheme, aims to reduce the burden on health clinics across the country by allowing Rwandans to speak to a doctor or nurse over a phone consultation.
Objectives
As one of two service design consultants I helped the Babyl team with the following objectives:
- Streamlining the patient appointment journey in health clinics to reduce wait time and no-shows
- Digitising the health care journey for patients by introducing a self-serve check-in system on a tablet device
My contribution
I helped the team run a design and research sprint where we rapidly prototyped a more efficient check-in experience – including the moment the patient enters a clinic, the identification check, the insurance validation, and the signposting to direct the patient to the correct area of the clinic for their needs.
The existing check-in experience was paper-based and took a reception staff member approximately 6-8 mins per patient to complete, resulting in long wait times at the very start of the patient journey. Our hypothesis was that if we created a digital self-check-in app then patients could validate their health insurance and receive a printed ticket which directed them onwards, therefore reducing and distributing the wait times more evenly across the clinic experience.
We understood that digital literacy was much lower in Rwanda compared to European countries so we aimed to make the experience as quick and simple as possible by removing any unnecessary interactions.
After selecting their preferred language – English or Kinyarwanda – the front-facing camera automatically activates and the patient is asked to hold up their ID to the camera and position it inside the target box. Once the app scans their ID it validates it against the national insurance database and if the patient has insurance a receipt is printed automatically, which is used in the onwards journey (payment and consultation).
We tested our prototype in two Rwandan health centres with translation help from local Babyl staff. We were able to discuss with actual patients waiting in the clinic what they thought of the digital check-in and how it would impact their experience. We learnt that some of the instructions in Kinyarwanda needed improving to be more colloquial and the next steps needed to be more direct, and less fluffy. Patients said that they would use the service again once they had done it the first time, which gave us confidence that our designs were simple enough.
Final thoughts
This project showed me that healthcare anywhere in the world has similar problems, but some places do not have similar resources. It also reinforced to me that design thinking and research works across borders and just talking to the intended users and listen to their opinions will bring you closer to delivering something of value.
The digital check-in app was launched in five health centres in Rwanda and after just one month had been used 16,956 times (97% successfully). 8,208 of those returned valid insurance which equated to 1,094 hours of work saved for reception staff, and 208 hours of patient waiting times.
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