Presentation
From Symptoms to Solutions: Rapid Patient-Partnered Co-Design to Improve Diagnostic Communication
DescriptionPatient-provider communication breakdowns during symptom description contribute to diagnostic delays, inefficiency, and preventable harm. Patients often struggle to articulate symptoms in ways that align with clinical decision-making frameworks (e.g., OLDCARTS) while providers face time constraints that limit their ability to elicit complete symptom histories though spontaneous disclosure. Existing symptom communication tools are often designed without meaningful patient input, rely on assumptions about health literacy, or prioritize clinical completeness over usability. We applied FlashBuild, a rapid co-design methodology to develop the Voicing Health communication tool through authentic patient partnership.
The FlashBuild process consisted of three weekly two-hour virtual sessions with six patients (representing experiences across emergency medicine, cancer diagnosis, chronic pain conditions, military healthcare, and specialist consultations) and three researchers with expertise in human factors, public health, and medicine. The methodology followed a discovery-definition-prototyping arc. Session one began with brainstorming exercises where participants shared challenging experiences describing symptoms, followed by empathy mapping to capture patient thoughts, feelings, observations, and actions during clinical encounters. This revealed that symptom communication challenges extend far beyond word choice—patients invest significant emotional labor in crafting their symptom presentation. As one participant explained: “Where I feel like I have to…be nice to everybody. I feel this pressure. I have to be nice. Because then they'll take good care of me...And you know, that's exhausting."
Session two involved comparative analysis of existing symptom tools and collaborative discussion to define core content areas. Participants reviewed tools ranging from comprehensive cancer symptom trackers to simple pain scales, identifying key limitations: overwhelming complexity, failure to account for chronic conditions with established baselines, and lack of patient-centered prioritization. A patient with chronic pain articulated the fundamental problem with standard pain scales: "For those of us who are chronic pain patients, it's broken...I typically use with my doctors is this is my baseline and then my baseline plus one is I can do it, but it's uncomfortable. Baseline plus two is I can't really do it, but if I had to, I could do it. Baseline plus three is I cannot do it." The group emphasized five essential components: symptom description with quality descriptors, visual mannequin for location marking, modified pain scale accounting for baseline functioning, patient-centered questions about concerns and goals, and metaphor/word banks to bridge communication gaps.
Session three focused on rapid prototyping through "Crazy Eights" exercises where participants sketched eight design ideas in eight minutes. This generated diverse concepts including: baseline-plus pain scales for chronic conditions, symptom metaphor wheels (like feelings wheels used in therapy), body system organization using plain language, and patient-centered sections asking "what do you think is going on?" One participant emphasized the repetition problem: "There's a diminishing point every single time I tell that story and those symptoms again...I will go in and I will bare my soul and say this is what's wrong with me. And there's a diminishing point every single time I tell that story." The collaborative refinement process emphasized accessibility and flexibility for different patient populations.
The resulting Voicing Health tool incorporates structured prompts adapted from clinical history-taking (onset, quality, alleviating/aggravating factors); visual mannequin for symptom location and radiation patterns; symptom metaphor library organized by body systems using patient-generated language; modified pain scale emphasizing functional impact rather than numerical ratings; and patient-centered questions that surface priorities, concerns, and goals. Design principles emerged organically: plain language over medical terminology, high contrast layouts, options for private completion, and modular structure allowing patients to complete relevant sections.
Evaluation data demonstrated FlashBuild's effectiveness in co-design. Participants rated the experience as highly valuable, with strong agreement that their contributions were meaningfully incorporated into the final design. As one participant reflected: "This has been really rewarding... because I got a chance to hear and see different perspectives to a common problem...very rewarding to have a voice that was actually listened to." The structured co-design activities enabled participants to move beyond advisory roles to actively create design components, contributing specific ideas like baseline-plus pain scales and symptom metaphor libraries that were integrated into the final tool.
Our FlashBuild approach demonstrates that structured co-design can yield highly usable and equity-conscious tools without lengthy design cycles. FlashBuild illustrates how patient expertise can be rapidly incorporated while maintaining methodological rigor and producing implementable solutions. The Voicing Health tool exemplifies patient-centered design by balancing clinical information needs with patient communication preferences.
The FlashBuild process consisted of three weekly two-hour virtual sessions with six patients (representing experiences across emergency medicine, cancer diagnosis, chronic pain conditions, military healthcare, and specialist consultations) and three researchers with expertise in human factors, public health, and medicine. The methodology followed a discovery-definition-prototyping arc. Session one began with brainstorming exercises where participants shared challenging experiences describing symptoms, followed by empathy mapping to capture patient thoughts, feelings, observations, and actions during clinical encounters. This revealed that symptom communication challenges extend far beyond word choice—patients invest significant emotional labor in crafting their symptom presentation. As one participant explained: “Where I feel like I have to…be nice to everybody. I feel this pressure. I have to be nice. Because then they'll take good care of me...And you know, that's exhausting."
Session two involved comparative analysis of existing symptom tools and collaborative discussion to define core content areas. Participants reviewed tools ranging from comprehensive cancer symptom trackers to simple pain scales, identifying key limitations: overwhelming complexity, failure to account for chronic conditions with established baselines, and lack of patient-centered prioritization. A patient with chronic pain articulated the fundamental problem with standard pain scales: "For those of us who are chronic pain patients, it's broken...I typically use with my doctors is this is my baseline and then my baseline plus one is I can do it, but it's uncomfortable. Baseline plus two is I can't really do it, but if I had to, I could do it. Baseline plus three is I cannot do it." The group emphasized five essential components: symptom description with quality descriptors, visual mannequin for location marking, modified pain scale accounting for baseline functioning, patient-centered questions about concerns and goals, and metaphor/word banks to bridge communication gaps.
Session three focused on rapid prototyping through "Crazy Eights" exercises where participants sketched eight design ideas in eight minutes. This generated diverse concepts including: baseline-plus pain scales for chronic conditions, symptom metaphor wheels (like feelings wheels used in therapy), body system organization using plain language, and patient-centered sections asking "what do you think is going on?" One participant emphasized the repetition problem: "There's a diminishing point every single time I tell that story and those symptoms again...I will go in and I will bare my soul and say this is what's wrong with me. And there's a diminishing point every single time I tell that story." The collaborative refinement process emphasized accessibility and flexibility for different patient populations.
The resulting Voicing Health tool incorporates structured prompts adapted from clinical history-taking (onset, quality, alleviating/aggravating factors); visual mannequin for symptom location and radiation patterns; symptom metaphor library organized by body systems using patient-generated language; modified pain scale emphasizing functional impact rather than numerical ratings; and patient-centered questions that surface priorities, concerns, and goals. Design principles emerged organically: plain language over medical terminology, high contrast layouts, options for private completion, and modular structure allowing patients to complete relevant sections.
Evaluation data demonstrated FlashBuild's effectiveness in co-design. Participants rated the experience as highly valuable, with strong agreement that their contributions were meaningfully incorporated into the final design. As one participant reflected: "This has been really rewarding... because I got a chance to hear and see different perspectives to a common problem...very rewarding to have a voice that was actually listened to." The structured co-design activities enabled participants to move beyond advisory roles to actively create design components, contributing specific ideas like baseline-plus pain scales and symptom metaphor libraries that were integrated into the final tool.
Our FlashBuild approach demonstrates that structured co-design can yield highly usable and equity-conscious tools without lengthy design cycles. FlashBuild illustrates how patient expertise can be rapidly incorporated while maintaining methodological rigor and producing implementable solutions. The Voicing Health tool exemplifies patient-centered design by balancing clinical information needs with patient communication preferences.
Event Type
Oral Presentations
TimeMonday, March 2311:15am - 11:37am EDT
LocationMurray Hill East
Patient Safety Research and Initiatives