The Unique Insights of Home Visits

At Design Science, our research most often focuses on the environments of medical professionals—ORs, cath labs, clinics. Yet some of the most rewarding research I have conducted here has involved visiting patients’ homes. Accompanied by a videographer, I’ve traveled past cornfields and baseball diamonds to meet families that are coping with serious conditions and investigate how they are wielding the medical tools and technologies they need to lead fuller and more independent lives.

A home visit presents a unique opportunity to discover how a patient or caregiver manages medications, supplies, and everyday device use. Home visits, however, are not only about medicine. In a home visit you learn if a participant has a dog, a rabbit, or no pet at all.  You may glimpse sports gear, vacation photos, a child’s cartoons on TV. You see who a person lives with and gain a sense of relationships between mothers and sons and husbands and wives.

You begin to view a participant no longer just as a "patient," no longer just as a "user," but as a whole person with a rich emotional and social life.

Why is this important? Because a patient’s world is always broader than a diagnosis or a device. If we focus on the device alone, we miss how it is actually used in everyday life, how it fits in with—or grates against—the activities people regularly pursue, their interests, obligations, and concerns. If we really want to grasp unmet needs, it is not enough to consider the user and the technology alone; we need to understand things such as support systems, hobbies, the impact of a treatment on work or school, and the financial and emotional strain that managing a particular condition can put on a family trying to live as normal a life as they can.

The home visit is a staple of ethnography, a research method with roots in the discipline of anthropology and its central insight: To learn about people you need to leave your comfort zone, enter their world, and, most importantly, participate and observe. To step across the threshold of someone’s home is to participate, even in just a small way, in what he or she does. Design Science has long been committed to ethnography, but we are also increasingly describing our approach as contextual inquiry. We understand that innovation requires entering the real contexts where products are used and observing the real activities people perform with them.

It is not easy to let a researcher and videographer into your home, especially to observe something as personal as one’s health and treatment. I have been impressed with the generosity of our participants, their efforts to make us feel at home, and their willingness to share their experiences and stories.

This post was edited by Matthew Cavanagh.

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