Laura Salisbury. All work
Case study · 04 of 05

A new digital + physical MRI experience for Medtronic device patients.

Client
Medtronic
Role
Research & Design Lead
Year
2017–2019
Disciplines
Research · Service Design · Strategy

Patients with Medtronic-implanted devices faced friction at every MRI appointment — and the burden of explaining safety, settings, and procedure fell on Medtronic's field clinical team.

Over six weeks, our two-person team — in deep partnership with Medtronic's Customer Experience group — set out to redefine the MRI experience end-to-end, reduce service burden, and unlock broader adoption.

Approach

A small team, a focused window, and a full system to understand.

Engagement

I led research as part of a two-person design team, along with deep partnership from the Medtronic Customer Experience Team. Over a six-week period, we conducted on-site qualitative interviews with healthcare professionals, synthesized insights, and co-designed their future MRI experience and workflows to reduce Medtronic service burden and increase adoption.

9
Facilities visited across two U.S. geographies
32
Healthcare professionals interviewed in-situ
6 wks
End-to-end engagement, research through delivery
Outcome

Our team delivered strategic insight into how MRIs for device patients are handled today — pain points, opportunities, best practices, and change management recommendations.

We also delivered two future solutions: workflow changes that could be rolled out immediately, and concepts that included a physical device. These findings were integrated into future Medtronic MRI protocols and rolled out nationwide.

01 / Research

Sitting with the people who actually run the scan.

Method

Through qualitative user research, we sought to gain an in-depth understanding of the MRI process for conditional devices from the perspective of radiologists and MR techs, cardiologists / EPs and their nurses, and Medtronic clinical specialists.

We took an ethnographic approach, interviewing each role individually in their hospital setting. Sessions were 1–2 hours in duration, and included an interview and activities such as card sorting, journey mapping, and co-creating desired solutions to challenges identified in the MR workflow, from the perspective of each role.

Figure 01
On-site ethnographic sessions — journey mapping & card sorting in situ.
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MRI Care Pathway worksheet. Top row maps the typical scenario through MRI referral, device identification, leads identification, patient screening, pre-scan device check and programming, MRI scan, and post-scan check — annotated with pain points like incomplete orders at time of appointment, reliance on cardiologist/EP/Medtronic rep, and waiting/dead time. Bottom row maps an ideal scenario using a chart, patient screener, activator, MRI prescription, video chat, tablet, EHR, programmer, and a device with automatic MRI capability.
Two clinicians in white coats sit at a table, sorting and ranking small printed cards as part of a psychological-needs card sort activity.
A participant works through icon cards laid out across the MRI Care Pathway worksheet, composing an ideal scenario from chart, screener, activator, scheduling, programmer, EHR and other tool icons.
MRI Care Pathway worksheet — typical vs. ideal scenario, annotated with pain points.
What we asked
  1. Walk us through an MRI for a device patient, end to end — who is involved, when, and why.
  2. Where does the workflow break down today, and who absorbs that work?
  3. What does each role need to feel confident handling a conditional device themselves?
  4. If you could redesign the experience tomorrow, what would change first?
Research deliverables
  • Current-state journey map with pain points & opportunities
  • Card-sort ranking of psychological needs by role
  • Cross-role insight set on adoption and service burden
  • Best-practice patterns observed across facilities
02 / Design & Delivery

From insight to a workable plan — short term, long term, and physical.

Approach

After our research and co-design sessions, we translated the findings into insights and strategic recommendations to improve workflow and support adoption of MRI responsibilities for device patients.

These findings were presented to cross-functional stakeholders across Medtronic and were used to drive short- and long-term decisions related to MRI support. Here is a bit of what we learned & delivered.

Workflow recommendations

Immediate changes to roles, hand-offs, and pre-scan steps — designed to be adopted by facility staff without new tooling.

Personas

Five role-based personas covering the MRI workflow — radiologist, MR tech, cardiologist / EP, nurse, and Medtronic clinical specialist.

Change management recommendations

Guidance for Medtronic's Customer Experience team on how to introduce new responsibilities and protocols without breaking trust with facilities.

Physical device concept

A future-state concept pairing workflow change with a purpose-built device — reducing the moments where a Medtronic specialist has to be physically present.

Figure 02
A Model Workflow for Today — end-to-end, role by role.
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A Model Workflow for Today — MRI Referral and Approve & Schedule phases. Steps 1–6: central scheduling receives the referral and books an AM or PM slot; patient picks a time; chart compiler collects history and confirms in the EMR; orders for device scan settings are requested from the EP/cardiologist, with the EP nurse verifying MRI conditionality; chart compiler adds the EP's order to the EMR; the Medtronic Clinical Specialist is scheduled 24 hours in advance.
A Model Workflow for Today — Pre-scan and Scan phases. Steps 7–9: at the MRI suite the Medtronic Clinical Specialist runs a device check, programs the device with the EP orders, and puts it in SureScan mode; MR Tech confirms device readiness and files a report in the EMR while a Monitoring Nurse is called to the suite; during the scan the Monitoring Nurse watches the patient via EKG and Pulse Ox.
Simple Instrument — Post-scan. Steps 10–11: the Monitoring Nurse stays with the patient until the Medtronic Clinical Specialist is present; the Medtronic Clinical Specialist runs another device check, returns the device to pre-scan settings, and files the final interrogation report in the patient's EMR.
Steps 1–6 · MRI Referral & Approve & Schedule — referral routed through central scheduling, chart compiler, EP, and out to the Medtronic Clinical Specialist.
Radiologist persona — Influencer. Radiologists' utmost concern is patient safety; liability concerns arise when there's a lack of communication, so collaboration with Cardiology in early-stage discussions is imperative. Experience: low involvement with scan, low comfort with devices. Mindset, pain points (efficiency pressure, safety with unfamiliar products), and opportunities (forge relationships, device 101 geared to radiology, safety-oriented campaign). Resources ranked from most-valued Time down through Independence/Authority, Support, Confidence, Safeguards, and Immunity from Liability. Click to view full detail
Figure 03 · Persona 1 of 5 The Radiologist — Influencer. Patient safety drives every decision.
Simple Instrument — conceptual drawing of a handheld device with a check-mark display and a small screen reading heart rate 81. Caption notes radiology staff focus on safety; an instrument that increases efficiency and reduces reliance on Medtronic is agreeable. For adoption, it must be simple to use and explicit about what it does and does not do; it should support pre- and post-scan device checks and settings changes with visual confirmations. Click to view full detail
Figure 04 · Concept Simple Instrument — a tool the MR suite would trust, designed for the persona on the left.
Figure 05
Change management — bringing the field team along, role by role.
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Leverage Best Practices for Incremental Change. Headline: 'Learning is easier in stages and comfort is built on increasing levels of familiarity.' Bullets: process improvement today reduces pain across roles; solving today's challenges opens end users to taking on Medtronic's role; incremental change sets the stage for more change. Opportunity areas: how to leverage the OH Health workflow today and build onto it as users transition to new tech and workflows.
Messaging Recommendation slide. Four roles with portrait, name, and tailored messages. Electrophysiologist: solution eliminates tedious checklists and requests for MR orders, keeps device nurses in clinic and Clinical Specialist by your side. Radiologist: solution gives your department more scheduling control, flexibility, efficiency, and throughput. Monitoring Nurse: devices are the way of the future; solution reduces wasted time so you can spend it caring for patients. MR Tech: reliance costs you time; solution gives complete scheduling control and reduces wait time so you can scan more patients.
Recommendation slide with three large circles labeled Promote, Inform, Educate. Promote: change perception, market Medtronic University to roles not yet using it, spread awareness of new product launches, generate excitement. Inform: share a Device 101 with all roles, notify Radiology teams about new tech and workflows before they encounter them, keep MRI roles up to date on conditions and safety changes. Educate: work with educational institutions, get in front of fellows and interns, offer certifications for instrument use and MRI safety, create a traveling training team to elevate device comfort.
Help Them Prepare for the Future slide. Three banners: 'Spread the message' (promote that the future is multi-disciplinary collaboration, quote from Dr. Augustini, OSU); 'Develop and publish protocols focused on burden reduction, and work with hospitals on more tailored protocols' (leverage protocols from high-volume facilities as a standard); 'Go bigger. Work to create industry-wide standards for MRI protocols' (push Medtronic further into industry-leader territory, partner with AvaMed). Opportunity area asks how Medtronic might use what it knows about increasing service burden to motivate others and help them prepare.
Principle · Learning is easier in stages — incremental change today sets the stage for bigger change tomorrow.
03 / Outcome

Findings integrated into Medtronic's MRI protocols, rolled out nationwide.

Impact

Our findings were integrated into Medtronic's MRI protocols and rolled out nationwide — pairing short-term workflow changes the field team could adopt immediately with a longer-term hardware-and-service concept.

The work gave Medtronic's Customer Experience team a clear, role-by-role picture of where service burden was being absorbed today, and a defensible plan for moving more of that work back into the facility.

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