design management

04

07

09

MSK Patient Finances

Illustrating Information

Design Research Methods

15

About Me

Iterative Design

11

2005 2006 2007 2008 2009 2010 2011

Education

Skills

Employment

University of Chicago Lab Schools

University of Wisconsin-MadisonParsons The New School For Design

Oilily USA Bortz Group

Al Johnson Art Inc.

Memorial Sloan-Kettering

Visual Merchandising

Marketing

Artist’s Assistant | InstallationsInnovation Lab Design Research

Design+Management

area indicates skill development and implementation

Newspaper Editor-in-ChiefWritingEditingLayout

Pagemaker

Window display planning / executionPromotional Material

Adobe suite

ResearchExecuted Marketing plans

Excel

Design StudiesFinance

GRAPHICDESIGN

DESIGN RESEARCH

INFORMATION DESIGN

PROJECT MANAGEMENT

CRITICALANALYSIS

about me

Design PrinciplesKnowledge and application a wide variety of principles and processes to enhance the design and development process in a wide variety of contexts. A clear foucs is placed on user experience design methodol-ogies: task flows, personas, scenarios, mental models, usability testing etc.

Through my education and professional experiences I have had the op-portunity not simply to understand theories and principles of strategic thinking and management of design and business but to them in real-world scenarios.

Process Understanding of the lifecycle of an idea from need finding and problem definition through brainstorming, prototyping and positioning.

Research and AnalysisExtensive experience of both academic research as well as ethonographic research

Project ManagementConsultation and creative direction of web strategies, markup structure, budgets etc with a proven track record of design management - incuding

remote teams.

2005 2006 2007 2008 2009 2010 2011

Education

Skills

Employment

University of Chicago Lab Schools

University of Wisconsin-MadisonParsons The New School For Design

Oilily USA Bortz Group

Al Johnson Art Inc.

Memorial Sloan-Kettering

Visual Merchandising

Marketing

Artist’s Assistant | InstallationsInnovation Lab Design Research

Design+Management

area indicates skill development and implementation

Newspaper Editor-in-ChiefWritingEditingLayout

Pagemaker

Window display planning / executionPromotional Material

Adobe suite

ResearchExecuted Marketing plans

Excel

Design StudiesFinance

GRAPHICDESIGN

DESIGN RESEARCH

INFORMATION DESIGN

PROJECT MANAGEMENT

CRITICALANALYSIS

5Process Understanding of the lifecycle of an idea from need finding and problem definition through brainstorming, prototyping and positioning.

Research and AnalysisExtensive experience of both academic research as well as ethonographic research

Project ManagementConsultation and creative direction of web strategies, markup structure, budgets etc with a proven track record of design management - incuding

remote teams.

Traditional print & logo designHand-crafted vector design for more traditional forms of marketing collateral such as: logo design, style guides, brochures, posters, business cards etc.

7

Noise Pollution

Given the central role of research in all of the disciplines studied in the Design + Management curriculum at Parsons, our understanding and ability to employ relavent research methods is essential.

This research report was a semester-long project designed to showcase our ability to appropriately use, apply and analyze different methods of research to address an area of research based on the identification of a question concerning New York City residents.

Process• Areaofresearchandproblemidentification• Researchstrategyandplaning• Expertinterviewsandresearchreportanalysis• Designandexecutionofourownmethods,tailoredspecificallytotargetuserandresearchquestion

Exercise 8Contextual Inquiry, Part I

Procedure/Structure

1. Introduction and Warm-up

• set up equipment, explain to user they will be wearing headphones

• explain the purpose of experiment in broad detail

• emphasize role as observer and learner

• remind the participant to narrate what he or she is doing and no to go for deep explanations

2. Instructions What to say: "Keep your eyes closed. I am going to play you a series of sounds. Each sound you hear tell me your instant reaction. Say the first word that comes to mind...." -(the key is not to tell them exactly what reaction you are trying to get from them)

3. Main observation period Play each sound below one at a time, allow user to vocalize reaction, write down what is said. Playlist

a. Car hornb. Car sirenc. Constructiond. Train stop (until 27th second)e. Muffled TV (until 50th second)

4. Follow-up interview Ask them in-depth questions to clarify their reactions, understand their emotions.

• Why did you say this when you heard this?

• What is it that makes you feel this way?

• Give specific examples.

5. Wrap-up Asking the participant about the contextual inquiry experience from his or her perspective.

• Was there anything about it that made him or her anxious?

• Is there anything the participant would like to do differently?

• Are there things that we, as the apprentice, could do differently?

REsupply supplies you with quality plastic products to help you become more sustainable. REsupply will be

available at several local neighborhood venues.

Once your REsupply product has come to the end of its lifecycle, it can be returned to

any participating retailer, where your deposit will be returned to you. That deposit can then be used for the purchase of your

next REsupply container!

REsupply products are designed with the user in mind. They are made with number 5 plastic, which is commercially recyclable, microwave proof, diswasher proof

REsupply

REsupply’s goal is to REculture of the way people think about the reuse of food containers. REsupply is a system that seeks to change

habits, influence sustainability, redesign infrastructure and promote ef-fective recycling practices.

before RE after RE

REsupplydesigncycle

culture

use REsupply

venue

REsupply helps you easily form new, sustainable habits.

ProblemIdentification

Observation ProblemDefinition

Research Brainstorming Conception ConceptDevelopment

DesignPrototype

UserTesting

DesignEvaluation

Refinement

Research/Brainstorming

9

RE fill

culturestoreuse REsupply accessories line

RE fill

culturestoreuse

Did you RE today?

RE fill

culturestoreuseRE fill

culturestoreuseRE fill

culturestoreuse

Don’t forget your REsupply containers!

REsupply softbag

REsupply hardbag REsupply utensils box

REsupply door sticker REsupply t-shirt

16 OZ

REsupply cup heat insulator

ReSupply

This container reuse service design was developed beginning with opportunity identification. After discussion, analysis and research an emphasis was put on rapid prototyping, evaluation and refinement of ideas to enhance the design develpment process.

Problems identified with food containers (both disposable and reusable) were discussed and researched at length. Our areas of interest for develpment included practicality, durability, hygene, user-friendliness and sustainability.

Process• ResearchanddesignprocessesutilizedinthisprojectareillustratedintheREthinkandREsearchdiagrams

LegalIssues

MarketResearch

ScientificInquiry

Current Trends/

Tendencies

GovernmentalBusiness Incentives

Hygiene/Health

RegulationsUser

Groups

Demographics CostAnalysis

GeographicMarketDefinition

IndustryCompetitive

MarketAnalysis

CompetitorAnalysis

Facts

Material

Health/Hygiene

Lifestyle

SocialMedia

Platforms

Trendsin general

Designfor the

product line

Branding/corporate identity

Theirapplicationto ourmarketing strategy

Scientific Inquiry Market Research

Legal IssuesCurrent Trends/Tendencies

RE fill

culturestoreuse REsupply product line

PICK UP and

PURCHASE

Although available, use of RE containers is not required in order to eat or get food from these establishments. Disposable containers will still be available as the product is phased in, however users will incur a small fee.

When ordering food, customers will have the choice between using a disposable container, a newly purchased RE container, or a previously owned RE container the owner has sanitized him or herself.

PCF Phase 0Project // Mapping

Service MappingApproved, In-Network, PPO, POS, Out-Patient

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PATIENT INTERACTION

INTERNAL INTERACTION

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VISIBILITY

copies of medical records

Contacts MSK and faxes records

POA / PAS startsconversation

• MSKCC.org• Cadence• Outlook

insurance card

Asks insurance agency and MSK questions about insurance and/or looks online.

POA/PAS transfer call to PFS or insur-ance

PFS updates record in cadence w/ insurance information

PFS tells patient they are in-network or out-network

new visit appointment

Slide Scans

decides to schedule and requests slide scans to be sent to MSK from referring MD prior to appointment

POA / PAS calls and requests slide scans

CadenceCIS

registers by phone to give demographic information and to get MRN #

PFS calls to obtain demo-graphic and insurance information and creates MRN #

SMSCadencePatient Portal

Patient Portal registrationPFS Phone CallMRN#

arrives for PFS office to sign documents

PFS gives documents to sign and copies ID to complete registration

consent formAOBGOA

goes for first MD appoint-ment and completes all new visit paperwork

SA verifies ID and checks in for appoint-ment

SA II enters patient information form

EMR

decides to stay for treatment

MD discusses plan for treatment

POA refers to PFS for ques-tions on cost of treatment

asks cost of treatment

goes home

MD / SA completes charge ticket and submits bill to PBD

PBD recieves charge ticket and enters into IDX and send claim to insurance company.

POA maintains copies of charge ticket for 6 months

Ancillary Systems- lab, pharmacy, radiologyIDX GE- physician billing system

calls to check and request pre-certification done for specific services

PFS pre-certifies radiology/ procedures

POA / SA communi-cates CPT code to PFS

begins treat-ment

goes home

CIC scans clinical notes and medical records

MD sends clinical note to referring MD

Insurance pays PBD clinic

MSK bills-1) guide to billing2) explanation of outpatient bill3) FAP

EOBSMSK billsEOBS

receives MSK bills and insurance EOBs, access patient portal to see or pay current balance

patient charges electronically uploaded on patient portal for viewing

PA / PBD sends bill to patient

Patient PortalIDX GESMS, Siemens

EMREclypsis

does not understand balance because EOB does not match bill, and/or cannot a�ord pay, and/or ignores bill

patient calls PA / PFS or goes to PFS o�ce with questions on bill and/or calls patient representative if thinks unfairly charged.

PBD or PA reviews charges and then calls back

If requested SA/POA refers to PFS w/ questions about bill

POA/SA advises to contact insurance and/or PBD/PA

after inquiry at bill PBD / PA reviews bill - may contact MD o�ce for clarification

pays co-payment balance

PBD records payment

Compliance audits periodoically

PBD / PA writes o� charges

Office ? checks EMR reconcilation report to ensure MD documents all out-patient visits and follows up on missing notes

MD documents missing notes or requests reversal of charges

HISIDX GE

insurance bill

Referral Assistants or POA waits for faxes and creates record in cadence

Records are reviewed by PAS/RN/MD

MSKCC.orgInsurer Web-siteCadenceDOH website

POA/PAS calls after records are reviewed, schedules MD appointment, enters exter-nal MD infor-mation, requests interpreter if needed, and submits pathology/radiology materi-als prior to appointment.

POA/PASregisters for patient portal

education materialsappointment reminder medical notes

POA/SA schedules future appointments

Cadence CIS

SA scans any medical reports done outside of MSK

intero�ce mail- PBD

PCF Phase 0Project // Mapping

Service MappingHMO, Out-of-Network, PPO/POS, MCI

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PATIENT INTERACTION

INTERNAL INTERACTION

CONT

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MSKCC.org or ASKPAInsurance WebsiteCadence

Cadence Outlook

Outlook Cadence

insurance cardMSK Website

PFS updates record with insurance information

PFS says they are out of network and depending on POS/HMO, they need to obtain authorization for compre-hensive consult

PCAP counsels and educates on insurance

PFS/PCAP con�rms authorization for PAS for OON authorization for manage care

tries to get authorization for insurance and then calls MSK with insurance information and/or faxes authorization to PCAP/PAS/PFS

decides to schedule

POA / PAS enter appoint-ment and call on phone.

POA/PAS schedules MD appointment, enters external MD information, and requests interpreter if needed

SA collects green sheet to place with patient packet for MD to see

PFS/PAS/PCAP documents conversation and counsel-ing and emails MD o�ce to communicate status

insurance company can fax authoriza-tion to PCAP/PAS/ PFS

Cadence

phone call

complete pre-registration by phone giving demographic and insurance information

POA / PASregisters patient for patient portal

PFS places MCI with date

SMSPatient Portal

gives authori-zation at PFS when they arrive for appointment

green card

completes registration with PFS by signing documents, then goes for �rst MD appointment

Patient Portal

SA checks in for appoint-ment and veri�es ID

SA II enters PIF

Cadence EMR

decides to stay for treatment

MD discusses plan for treatment

decides to speak with PFS Post Consult

MD / SA completes and submits outpatient charge-ticket orMD takes bill back to o�ce and MD / POA completes and submits bill

POA / PFS facilitates request of pre-certi�cation as needed

If MCI hold lifted, PFS emails MD o�ce

MCCM

begins treatment

CIC scans clinical notes and medical records

MD sends clinical note to referring MD

Insurance pays PBD clinic

patient recieves MSK bills and insurance EDBs

patient gets monthly PBD and PA bills

patient access MSKCC �nancial portal to pay or see current balance

patient charges uploaded on patient portal for viewing

PA / PBD sends bill to patient

Patient PortalSMSPBD System

patient portal

pays balance, contacts patient representative or POA/PBD with questions about charges

PBD / PA refers case to case management

Bluemark (charity care system)

applies for charity care / settlement payment and deemed eligible for FAP or pays making their balance zero

Financial assistance in process to determine eligibility for charity care

PBD / PA writes o� charges

HIS

PBD / PA communicates adjusted charges as appropriate

ineligible for FAP and recieves collection letter

SMSMCI BlockCadence

SAII shows clinician green sheet

POA/SA fax disposition to PFS

copy of disposition

PFS discusses cost and options in post consult

tries to get authorization fortreatment

PFS sends MCI email

Case manage-ment intervenes, if needed, and requests letter of medical necessity from MD o�ce, PCAP

Outlook

HOLD lifted by PFS

Gets authori-zation or pays based on disposition, requests letter of medical necessity from MD o�ce

copies of medical records

Contacts MSK and faxes records

POA / PAS startsconversation

• MSKCC.org• Cadence• Outlook

Referral Assistants or POA waits for faxes and creates record in cadence

Records are reviewed by PAS/RN/MD

Asks insurance agency and MSK questions about insurance and/or looks online.

POA/PAS transfer call to PFS or insurance, if not in network, charges need authorization or pay cost referred to PCAP

PFS calls to obtain demographic and insurance information and creates MRN #

PFS gives documents to sign and copies ID to complete registration and issues green card/sheet

POA refers to PFS for questions on cost of treatment

Ancillary Systems- lab, pharmacy, radiologyIDX GE- physician billing system

PBD recieves charge ticket and enters and send claim to insurance company, assigns codes for bill for 3rd party claim, sends copies of charge ticket to POA

POA maintains copies of charge ticket for 6 months

SA/POA Corrected charge ticket resubmitted to PBD

calls to check and request pre-certi�cation done for speci�c services

does not understand balance because EOB does not match bill, and/or cannot a�ord pay, and/or ignores bill

MSK bills-1) guide to billing2) explanation of outpatient bill3) FAP

EOBS

PBD or PA reviews and discusses with patient charges and then calls back

If requested SA/POA refers to PFS to discuss Financial Assistance

POA/SA advises to contact insurance and/or PBD/PA

after inquiry at bill PBD / PA reviews bill - may contact MD o�ce for clari�cation

Compliance audits physical bills and dictated notes two times a year

O�ce ? checks EMR reconcila-tion report to ensure MD documents all out-patient visits and follows up on missing notes

MD documents missing notes or requests reversal of charges

PCF Phase 0Project // Mapping

Service MappingSchedu;e Admissions “In Network,” Surgery

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PATIENT INTERACTION

INTERNAL INTERACTION

CONT

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VISIBILITY

copies of medical records

�rst contacta) call

b) websitec) walk in

medical reports faxed

to MSK

patient access online

resources

patient speaks to

POA / PAS

start conversation

MSKCC.org

Insurer webpage

MSKCC.org

Insurer webpage

outlook and cadence

insurance card ID number

MSK website for new patients

insurance Questa) refer to PFS

b) Insurance agentc) access resources

POA/PAS answers ?s or transfer call to

PFS or insurance

look for insurance

information

PFS record of insurance

informationcreating a record in cadence

referal assistances waiting for faxes/ logs

them in

PFS tells patient they

are in-network or

out-network

patient calls back 1-has info about

insurer

get referral from PCP

patient decides to schedule

POA / PAS enter into

Cadence call patient on

phone

POA / PAS schedules MD appointment

POA / PAS enters

external referring MD

POArequests

interpreter through LAP

Cadence

PFS pre-registration phone call to patient# MRN

pre-registration by phone MRN #

SA / POA / PASregisters

patient for patient portal(where they can review

charges)

create MRN pre-

registration

enter into PA (SMS) system

Patient Portal

Patient Portal registration

Patient arrives for PFS

appointment

Patient arrives to PFS to register

sign consent AOBGOAetc.

registered including

signing docs

patient account

created in Patient Portal

SA verify patient ID

go for �rst appointment

(MD)

Patient arrives to clinic

appointment for inital visit

Patient completes MD

information form for

referral info

Patient is checked in for appointment

SA II enters PIF into Cadence

Cadence EMR

patient decides to

stay for treatment

MD discusses plan for

treatment with patient

patient asks cost of

treatment - referred to PFS

MD / SA completes /

submit outpatient

charge-ticket or

MD takes bill back to o�ce

MD / POA completes / submits bill

PBD recieves charge and enters and send claim

CIC coding for 3rd party

claim

copies of charge tickets

sent from clinic to POA’s in

o�ce

POA’s maintains copies of

charge ticket for 6 months

Corrected charge ticket resubmitted

Incomplete charge ticket

rejected by PBD or charge ticket

sent back to o�ce / clinic

Insurance recieves claim and processes

Ancillary systems:

Lab, pharmacy,

radiology, pt

IDX GE

patient calls to check pre-certi�cation done for speci�c services

patient requests pre-certi�cation:

SA / POA / PFS facilitates as

needed

case manage-ment contacts MD o�ce for

letter of medical

necessity

PFS pre-certi�es

services

POA / SA communi-cates CPT

code to PFS

PFS contacts insurance

veri�es POS / PPO when

pre-certifying SX, RT, high

cost drug

Case manage-ment appeals

system

MCCM (case manage-ment system)

CIC scans clinical notes /

medical records

MD sends note to

referring MD

admit lands on PFS

reservation log

POA/SA enters case in

OpTime

veri�cation of bene�ts

patient goes to pre-surgical

testing

PFS contact CM Of

Insurance and initiates

Pre-Certi�cation

Insurance Carriers Issues Authorization

OR Scheduling System OpTime

PA System

day before admission, pt receives call on time and

location

arrives to designated

area

patients o�ered private rooms/teleph

one

PSC unit asst veri�es pt ID,

procedure, and directs patient

to area

MD documents op

note or inpt note

MD/o�ce generates

charge ticket/submits

to PBD (maintains

copy)

CM initiates concurrent

reviews every other day with

insurance

Appeal Process during inpt stay

(concurrent) CM/Attending

Physician

case info tracked in OpTime

pharmacy charges

captured by patient

accounts

enter pay or contacts

clinical into MCCM for insurance

companies

CM arranges D/C plan

Home care covered or not

coveredCM discusses with patient

CM sets up discharge planning

during concurrent

review

CIC scans inpt chart

charges sent to insurance/

patient

CIC coders generate inpt

hospital charges

EMR, billinb systems

PBD / PA communicates

adjusted charges as

appropriate

discharged

patient receives

discharge plan

POA/SA communi-cates to pt.

surgery date/ admit date

Admitting calls patient with time of admission

patient assigned bed

authorization obtained including

number of approved days

Case Management/

PFS System

smart card message

entered into SMS/MCCM re: approved # of

days

receives treatment or has surgery

patient receives care/

treatment procedure

CM discusses coverage with

patient

Esig

medicaid record forms

database

clindoc, ESig, OpTime,

Pharmacy system

USPS

patient portal

sirius system

D/C planning in MCCM

patient given meds and discharge

order

patient receives EOB/LTTR shows

balance not covered from

insurance

insurance company

pays/denies charges

appeal inpatient denials in

house with CM or

outsource NCD

PBD/PA works with insurance

to collect charges

CM/PA system

patient calls Pa or PS

inquiry unit

EOB uncov-ered balance bills

patient pays balance or copay

deductible or cannot- (is referred to

PA/PBD)

patient calls POA/SA/PFS/Pati

ent Rep / walk-ins with

question about bill

CM/NCO contacts pt for

consent appeal

“0” balance

“0” balance

“0” balance

Insurance recieves claim and processes

Ancillary systems:

Lab, pharmacy,

radiology, pt

IDX GE

Case manage-ment appeals

system

MCCM (case manage-ment system)

Initial map iterations

11

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INTERACTION

INTERNAL INTERACTION

VISIBILITY

registration

Day of �rst consult Treatment

PCF blueprint

PFS pre-certi�es radiology/ procedures

POA / SA communicates

CPT code to PFS

PA/PBD sends bill to patient

Cadence CIS

Insurance company pays

MSK

For MCI patients please see additional diagram

Patient information

uploaded for viewing on

patient portal

consult

Medical recordsMCI memo Physicians Bill

Hospital billEOB

EOB

DIsposition form

Patient goes to consult physician for �rst appointment

Clincal SA gets patient’s medical records and MCI memo. Begins

consult

Dr. meets with patient. Discusses further treatment courses of action

POA/SA schedules future appointments for tests or treatment

Clinical SA gives doctor MCI

memo

Doctor gets patients �le and

receives MCI memo

Clincal SA faxes disposition form

completed by physician to PFS

PFS receives disposition form.

Prepares for post-consult appointment

POA refers to PFS for

questions on cost of

treatment

MD / SA completes

charge ticket and submits bill

to PBD

SA scans any medical reports done outside of

MSK

pre-registration

PFS contacts patient. Obtains

personal and insurance

information

Communicates patient’s �nancial responsibility and

what is needed for initial visit

including $550 payment

Identi�es whether paitent

falls into MCI category based

on insurance info

Enters information into

cadence

PFS contacts patient. Obtains insurance information

Patient’s SSN, personal information and insurance provider

if yes

Arrives 30 minutes before

consult and checks in at registration

Patient’s physical ID, insurance information

Goes to waiting area and is seen by next available

�nancial interviewer

Financial interviewer

reviews forms and contracts,

obtainpatient signatures

Informs patient they must return

after appt. for post consult

Meets with �nancial

interviewer.

Patient decides to continue

treatment at MSK

Schedules appointment for

further treatment

Patient goes home

Veri�es pre-certi�cation

for speci�c services with

insurance

Receives Hospital bill, Physicians bill

and insurance EOB

Patient begins treatment with

MSK

Pays co-payment if applicable

AOBGOAgreen identi�cation card, MCI Memo for physician

Registration checks in patient, obtains I.D. and insurance info

Understand Involve Identify Show Implement

ObservationInterviewsShadowingIdentify Touchpoints

Data AnalysisDesign Activities• mindmapping• storyboarding• storytelling• creative play

Target Areas of InterestIdentify InsightsPersonasPrototyping

MappingVisualizationBlueprintEvaluation

ImplementationDelivery

Stages of Service Design-Opportunities for Engaging the User

Memorial Sloan-Kettering

As an intern in the Strategic Plannning and Innovation Lab at Sloan-Kettering I was involved in a number of different projects but my primary focus was dealing with patient-centered-finances. The hospital wanted to improve the billing process both in the hospital and for patients. The systhem is incredibly complex, so I focused on visualizng complexity through a service blueprint.

Process• interviewingpatientsandmanagingfocusgroups• shadowingemployeesforobservationalresearch• collectionandanalysisofdatafrombrainstorms

I’m 45 and at Memorial Sloan-Kettering to visit my mom. I come into the gift shop with my wife Heather. I know all I want is coffee and a news-paper so I head straight there and pay imme-diately at the main counter. My wife Heather drifts over to the cards and decides to pick up a balloon and some flowers. She asked for ad-vice but I really didn’t have an opinion.

My name is Daniel and I’m 11. I came from Oregon to MSK with my family to get treatment for my leukemia. I get bored sometimes so my pediatric nurse takes me over to the gift store. I don’t really buy anything, I like to look at some of the toys. It’s hard though because I can’t go everywhere I want with my wheelchair. My par-ents are here getting food in the cafeteria.

I’m 51 and have been working at MSK for years as an administrator. I come to the gift shop a lot during my breaks. I like to try out the lo-tions for fun. I expect them to keep my favorite brand of panty hose in stock in case I need them. Sometimes I’ll grab a latte, and today my son made me promise to pick him up some silly bands.

Alan Gordon

Daniel Ashcroft

Liz Duncan

13

Visual Autobiography

This diagram was created during my second semester at Parsons when I was beginning to learn about infographics. I became completely enamored with the idea, and this piece just sort of emerged from my interest and doodling. Noupe.com named one of my journal diagrams in their article “Stunning Infographics and Data Visualization. http://www.noupe.com/inspiration/stunning-infographics-and-data-visualization.html