About the Project

The Problem of Readmissions

Readmissions cause both emotional and financial stress for patients and caregivers. Many of these readmissions can be prevented if patients better understood how to care for themselves following their hospital discharge.

Readmissions & Discharge Planning

UPMC Enterprises charged our team with coming up with a solution to help reduce readmissions by exploring the discharge planning process.

We were asked to create a tool that addressed factors outside the hospital that are critical to patient outcomes, like a patient’s support system, transportation, access to follow-up care and more. Our task was to support clearer communication and planning around these “soft factors” during care transitions, ultimately reducing a patient’s risk for readmission.

Patient‑Provider Collaboration

We chose to focus on a collaboration tool to improve communication between patients and providers during discharge planning, so that
  1. Providers can better understand patients’ lives outside the hospital.
  2. Patients can more fully clarify, understand, and even shape and co-create their plans.
  3. Chronic disease patients’ adherence to care instructions will improve, due to a sense of ownership and empowerment, leading to better health outcomes and reduced readmission rates.

Our Vision

Discharge plans are based on medical conditions
What is meaningful to each patient is incorporated into their plan
Patients are overwhelmed once they get home
Patients are encouraged to plan ahead while they’re at the hospital
Patients are asked the same questions over and over again; and questionnaires are tedious
Providing information is fun and engaging for patients
Patients are given instructions and don’t know that they can ask for alternatives
Patients co-create their discharge plan with providers so they have a greater sense of ownership
Patients have trouble following abstract instructions like “follow a low-sodium diet”
Patients get actionable suggestions that meet them where they are at, helping them make baby steps

Next Steps

Final Deliverables

  • a 3-minute concept video
  • a high-fidelity, interactive prototype
  • a web-based, functional prototype
  • a 40-page research report
  • a 40-page design report
  • 2 × 40-minute presentations

Piloting at the Hospital

Within our scope and timeframe, we weren’t able to pilot our solution at the hospital. Before implementing our solution, we strongly recommend that UPMC conduct a pilot within the app’s intended environment of use. The pilot should include a sample of patients using OnTrack, and a control group. The effectiveness of OnTrack should be evaluated along the following metrics:


Does OnTrack reduce miscommunication, helping patients, caregivers, and hospital staff coordinate better?


Will OnTrack account for all of the staff’s logistical challenges, or should some revisions be made?


Do hospital staff continue to use the inpatient component of OnTrack through the entire length of the pilot? Do patients continue to use the outpatient component of OnTrack for the entire 30- days after discharge?


Are patients using the inpatient and outpatient components of OnTrack more likely to adhere to their care instructions than the control group?

Reduced Readmissions

Are patients using OnTrack less likely to be readmitted within 30 days than the control group?

This application is engaging because it shows interest in me as an individual. These are things about me the hospital should know, and they don’t ask those questions now.” —Mary, Heart Failure Patient
This is fun! It’s like playing solitaire or bingo!” —Dora, Diabetes Patient
I think this would be awesome. Especially for someone who is new to medicine, just had a heart attack or something. It would help caregivers, nursing home staff, or a patient who lives alone to have the most important instructions sectioned out and easy to read like this.” —Caregiver

Team Quetzal

Anna Malone

Team Lead

Anna has a background in English, Philosophy and UX Design. Within the field of user-centered design, she aspires to empower people and improve their daily lives.

Diya Deb

UX Lead

Diya has a background in Industrial Design and UX Design. She views user-centered service design systems as a means of introducing positive social change.

Jay Liu

Tech Lead

Jay does UX design, prototyping, and web development. He endeavors to serve and empower people through the effective design of technology.

Mike Szegedy

Design Lead

Mike has over 10 years of industry experience in interaction design and UX research. He enjoys difficult problems and exploring new design spaces.

Tina Jose

Research Lead

With a background in Design and Psychology, Tina has worked in the digital space for over 10 years. She enjoys finding elegant solutions for complex problems, and sees herself as an advocate for the user.