Communicating Critical Lab Results
Designing a secure, acknowledgment-driven notification system to ensure urgent lab results reach the right doctor at the right time.
UX Research
Information Architecture
Data Visualization
Technical Writing
Content Strategy
Team
Me
Tanushri Kakad
Yanfei Wang
Jiang Yuxuan
Yuetong Zhao
Project Partners
Dr. Maeve Doyle
Dr. Grace Chan
Project Guide
Dr. Kevin Doherty
Timeline
2024 (May - Aug)
The full story
Project Overview
Context
In clinical microbiology, some lab results indicate immediate, life-threatening conditions. These results must be communicated to doctors quickly, securely, and without ambiguity. However, many hospitals still rely on pagers and manual phone calls, systems that are slow, interruptive, and unreliable.
This project was carried out during my Master’s in Human Computer Interaction and focused on solving a real problem within clinical microbiology in Ireland.
The challenge
Urgent lab results were often delayed, missed, or acknowledged too late because:
Calls go unanswered or require multiple callbacks
Pagers provide no context or confirmation
There is no clear audit trail to confirm delivery and action
These gaps can directly impact patient safety.
Why It Matters
Delays of even a few minutes can change treatment outcomes in conditions like sepsis. Designing for speed alone is not enough. Reliability, acknowledgment, and accountability are equally critical.
The Opportunity
This project focused on designing a secure alerting system that:
Replaces blind calls with prioritized notifications
Requires acknowledgment from doctors
Supports escalation when alerts go unanswered
Fits within existing hospital workflows and security constraints
By shifting the focus from calls to acknowledged notifications, the project explores how design can support safer, clearer, and more dependable communication of urgent lab results.
Research & Insights
Research Process
📚
Extensive Literature Review
💬
Interview Project Partner
📊
Quantitative Survey Analysis
Key Findings from Literature Review 📚
⏱️
Urgency Alone Is Not Enough
Timely delivery of critical lab results is essential, but without confirmation of receipt, speed alone does not guarantee clinical action.
☎️
Traditional Methods Are Fragile
Phone calls and pagers introduce delays, interruptions, and uncertainty due to missed calls, and manual escalation.
🔔
Secure Alerts Improve Reliability
Secure notifications reduce communication time and improve acknowledgment compared to call-based methods.
✅
Acknowledgment Matters
Systems that confirm receipt and automatically escalate unanswered alerts achieve faster and more reliable responses.
🔐
Security Shape Design
Healthcare alerting systems must be built around GDPR compliance, controlled access, and minimal exposure of patient data
🔗
Integration Drives Adoption
Alerting tools are more effective when they fit seamlessly into existing hospital workflows and systems.
But…..
Are Notification Alerts really better than Calls?
To answer Call vs Notification Alerts, we studied two real-world implementations:
Cortext
A secure messaging system designed for sharing protected health information across devices, with built-in delivery, read confirmation, and audit logs.
Hospital Clinical Information System (HCIS)
A hospital-wide system integrating SMS alerts, persistent on-screen notifications, and automated escalation, with clear success and failure tracking.
Key Insights
Notification times dropped from 16.6 → 5.9 minutes (Cortext) and 30 → 11 minutes (HCIS) compared to manual methods.
Unsuccessful or delayed notifications were drastically reduced through acknowledgment and auto-escalation mechanisms.
Communication records were automatically logged, creating clear audit trails for delivery, receipt, and action.
Manual phone calls and resident escalations were nearly eliminated, reducing workload and interruptions.
Staff reported higher confidence and satisfaction due to clearer, more predictable communication.
Key learnings
Secure messaging can outperform calls when acknowledgment and traceability are built into the system.
Notification systems reduce uncertainty by making delivery and confirmation visible.
Mixed-methods Approach
To understand the challenges of communicating critical lab results, we adopted a mixed-methods approach, combining qualitative interviews with Dr. Grace Chan and a quantitative survey. We focused on identifying pain points, evaluating current systems, understanding technology and usability needs, addressing security concerns, and uncovering desired features for an improved solution.
Insights from Partner Interview 💬
⚠️ Current Challenges
Inefficient communication:
Doctors rely on pagers and phone calls, often needing multiple attempts to reach the right person.
Limited context:
Pagers provide no patient information or urgency, causing delays and confusion.
Manual and error-prone processes:
Callbacks are time-consuming, lack tracking, and increase risk of missed results.
Cross-hospital delays:
Reaching doctors in satellite hospitals requires intermediaries, slowing response.
Data security concerns:
Personal phones cannot be used widely due to sensitive patient information.
✅ Desired Improvements and Opportunities
Secure mobile-first app:
Two-factor authentication, work-specific device use, GDPR-compliant.
Result prioritization and tracking:
Color-coded urgency (red, yellow, green), acknowledgment system, audit trail.
Integration & accessibility:
Link to hospital systems, secure PDF viewing, adaptable across hospitals & GP practices.
Efficiency & usability:
Faster delivery of critical results, clear follow-up options, intuitive interface for busy clinicians.
Quantitative Survey Analysis 📊
Survey Overview
Participants: Doctors, microbiologists, and lab staff
Responses: 9
Method: Online survey (20 questions divided into 6 sections of Demographic Information, Current System Overview, Challenges and Pain Points, Security Concerns, Technology and Usability and Desired Features)
Insights At-a-Glance
88.9%
Experience delays in urgent result communication
77.8%
Rely on phone calls for critical alerts
55.6%
Are concerned about data breaches
44.4%
Prefer app-based notifications for urgent results
Key Insights
User Pain Points
Lab results are delayed.
Alerts lack context and urgency.
No confirmation of receipt.
Risk of human error and missed alerts.
Hard to reach the responsible team.
User Needs
Acknowledgement of receipt
Read confirmation
Fast, reliable result delivery.
Clear, prioritized alerts.
Secure, GDPR-compliant communication.
Drafting Design Opportunities from Problems
Enable Fast, Reliable Communication
Implement automated, real-time notifications to give professionals control and reduce delays.
Prioritize Alerts Clearly
Introduce color-coded priority tagging to help clinicians focus on the most critical results first.
Ensure Secure and Trustworthy Handling
Strengthen authentication and encryption to build confidence in the system’s security.
Provide Receipt Acknowledgment and Tracking
Add acknowledgement and tracking features to ensure accountability and team alignment.
Design for Usability and Seamless Integration
Create an intuitive, easy-to-use interface that fits naturally into clinicians’ daily workflow.
Defining the Primary Users
Jonathan Hayes · Laboratory Assistant
Goals
Communicate critical results quickly and accurately
Improve patient safety
Improve lab efficiency
Pain Points
Hard to reach the right clinician
Manual, time-consuming alert process
Poor workflow integration
Patient data security concerns
Needs
Fast, reliable alert delivery
Simple, integrated workflow
Acknowledgement and read receipts
Strong data security
Dr. Emily Carter · Clinical Microbiologist
Goals
Acknowledge critical alerts promptly
Provide accurate treatment plans
Coordinate effectively with lab teams
Pain Points
Delayed alerts
Limited access to patient context
High alert volume
Patient data security concerns
Needs
Reliable, timely notifications
Quick access to results and patient info
Easy-to-use interface
Secure communication
Design
User Flows
Laboratory Assistant
Doctors
Note
The userflows focuses on the "happy path" for communicating and acknowledging the critical lab results. Due to time constraints, we discovered the edge cases but excluded them from the flows.
Some edge cases identified:
Alert not acknowledged within expected timeframe
Escalation to backup clinician or team
Incorrect recipient or reassignment of responsibility
Defining Urgency Levels for Critical Results
Before moving into UI design, we defined how critical lab results are classified based on risk severity and response urgency, guided by the Health Service Executive (HSE) handbook.
Urgency Categories
Category A - Immediate Danger 🔴
Response time: Within 2 hours
Meaning: Life-threatening or immediate risk
Category B - Significant 🟡
Response time: Within 24 hours (same working day preferred)
Meaning: Serious findings requiring prompt attention
Category C - Important 🟠
Response time: Next working day
Meaning: Impacts patient management, but not immediately critical
Design Consideration
The HSE handbook defines urgency timelines but does not specify color usage. While Category B appears visually less urgent than Category C, these colors were retained to align with the source guidance. However, from a UX perspective, swapping Category B and C colors could better reflect perceived urgency for doctors.
Example from the HSE Handbook
Visual Design & Final Solution
Based on the defined user flows, information architecture, and urgency logic, we moved into high-fidelity screen design. I led the flows, content structure, and information architecture, while Tanushree focused on visual and UI execution. Throughout the trimester, we iterated on these screens by incorporating continuous partner and tutor feedback before the final presentation.
Screen 1: Secure Sign-Up (Restricted Access)
Purpose: Prevent unauthorised access while keeping onboarding simple for lab staff.
Key decisions:
Sign-up restricted to HSE email IDs only
Email verification required before password setup
Ensures only verified, authorised lab technicians can access the system
Screen 2: Login & Account Recovery
Purpose: Enable fast, secure access without compromising data protection.
Key decisions:
Login limited to HSE credentials
Password recovery mirrors sign-up verification flow
Screen 3: Lab Technician Dashboard
Purpose: Give lab staff a clear overview of all alerts and their current status.
Key decisions:
Prominent “Create Urgency Alert” CTA to reduce time-to-action
Five alert status (Sent, Reviewed, No Response, Contact Done, and Contact Pending)
Filters for priority (A/B/C) and ongoing vs completed alerts
Table layout optimized for scanning critical information quickly
Note:
Personally, I would reduce the alert status to just three (Sent, Acknowledged, and No Response) to reduce cognitive load.
Screen 4: Create Urgency Alert
Purpose: Enable fast, accurate creation of critical alerts with minimal friction.
Key decisions:
Structured inputs for patient, sample, urgency, and GP details
Clear urgency categorization (A, B, C) aligned with clinical guidelines
Simple Cancel / Send actions to avoid accidental submissions
Screen 5: Doctor Dashboard (Receiving Alerts)
Purpose: Help doctors prioritise and act on critical alerts immediately.
Key decisions:
Alerts displayed as cards for faster visual scanning
Tabs for Ongoing, Unresolved, and Completed alerts
Search and filters to manage high alert volumes efficiently
Screen 6: Alert Detail View
Purpose: Present all critical information needed for quick clinical decision-making.
Key decisions:
Color-coded urgency label for instant prioritization
Clear separation of patient, sample, and lab details
Read-only PDF access to maintain data integrity
“Mark as Reviewed” CTA to close the communication loop
Partner Feedback
Before the final presentation, we reviewed our designs with our partners to validate assumptions and usability decisions.
Key Feedback Highlights
Simplify data entry:
Limit patient inputs to Patient ID, Name, and DOB to reduce cognitive load.
Clear urgency colors:
Use consistent color coding for Categories A, B, and C across web and mobile.
Smarter form behaviour:
Use dependent dropdowns for Sample Type → Test Name and allow multiple tests per alert.
Reduce system complexity:
Consolidate alert statuses from five to Sent, Reviewed, No Response.
Improve traceability:
Add audit logs (sent, viewed, PDF opened, acknowledged) to support accountability.
Doctor-centric mobile views:
Show only essential fields (Patient ID, Name, Test Name) with tabs for All, New, Missed alerts.
Note
Due to academic time constraints, this feedback could not be incorporated into the final designs.
However, partner feedback, especially around reducing the alert statuses, validated my suggestion.
Reflections & Learnings
Understanding the Healthcare Context
This project made me understand how healthcare systems differ across different places. Early on, I had to unlearn assumptions shaped by my experience in India, such as patient access to reports and home-based diagnostics. Learning that, in Ireland, doctors perform phlebotomies and that lab reports remain confidential between the lab and GP reshaped how I approached privacy, access control, and system boundaries in the design.
Collaboration & Ownership
Though the project started as collaboration, the responsibility gradually fell on Tanushree and me. I took ownership of defining flows, content structure, information architecture, and research synthesis, while also ensuring alignment and quality across the project. Although this was challenging, it strengthened my ability to lead, make decisions under pressure, and maintain quality despite constraints.
Navigating Constraints
A key challenge was limited access to our initial clinical partner due to scheduling constraints. To avoid stalling the project, we proactively informed our academic tutors and successfully onboarded a secondary clinical expert. At the same time, we also reached out to professionals via LinkedIn to validate assumptions and gather domain insights.