Counsyl — Fixing the Pipeline

tags: user research, workflow analysis, service design, ethnography

Our goal

To increase the number of patients who got genetic screening done. Despite both physicians and patients saying they wanted to do so, the reality was far less than expected. We wanted to figure out why, and what could be done to help patients who wanted screening get access.

My part

I was brought on to understand whether a tool the company was developing could help bridge the gap between interest and action. Following my analysis of its efficacy, I worked in the field and in clinics to create a comprehensive understanding of the primary barriers for patients to get genetic screening. This research informed subsequent product development decisions and strategy.

The story

Genetic screening is a very new technology, so many patients and physicians don’t understand its clinical value. In order to help educate patients about their genetic screening options and to aid physicians in capturing consent from their patients, we piloted a new iPad-based tool in clinics with pregnant women. My role in this project was multi-pronged: firstly, to help design the tool; secondly, to evaluate whether our tool was effective; and lastly, to determine how to best scale our most effective technologies.

Our solution

To accomplish these objectives, I used numerous design and research methods. When designing our piloted tool, I ran usability studies with women who were pregnant or were trying to become pregnant on mocks I drafted. To conduct root-cause analysis on what was inhibiting physicians from screening patients, I traveled in the field to numerous clinics across the US in order to interview medical staff and to document clinical workflows. With this research, I translated the findings into strategic recommendations for product decisions.

My process


  • How do we scale this tool?
  • Is this tool successful? Why or why not?
  • Understand clinic factors that lead patients to fall through the cracks of quality care

Ethnographic Research:

  • Conducted field research with hospital clients
  • Interviewed mid-level providers and physicians
  • Conducted usability testing with patients and providers
  • Documented clinic workflow processes


  • Produced workflow diagrams to communicate user needs and business opportunities
  • Offered model for expanding research and tool scalability
  • Analyzed qual and quant data to understand users’ motivations


  • Refocused on more promising market segment and business opportunities
  • Improved tool during weekly scrums
  • Grew volume of screens ordered by diagnosing and treating root-cause bottleneck