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Project Nightingale

Redesigning the Patient Health Record to improve health literacy

Patient health records (PHRs) are just that: records. While the information within the record is rich and robust, the current design is cumbersome and difficult for patients to use. Passionate about bringing user-centered design to healthcare, a gravitytank team entered the Health Design Challenge, a competition supported by the White House and Designer Fund to redesign the Department of Veterans Affairs’ Blue Button record. The team's entry, Nightingale, won First Place for Best Overall Design.


PHRs are exhaustive lists of health history data that patients and doctors use to inform decisions on prescriptions and past procedures. This information has the potential to empower patients to take control of their health. However, PHRs in their current state are impersonal and full of medical jargon, making it difficult to decipher the information within. To explore ways of reinventing the PHR to serve patients more effectively, the White House and Designer Fund organized the Health Design Challenge.


Designer Fund



Featured Outcomes

Proof of concept interface
visual design
Market summary


The Health Design Challenge had four objectives, as follows:

  • Improve the visual layout and style of the information from the medical record

  • Create a human-centered design that makes it easier for patients to manage their health
  • Enable health professionals to more effectively understand and use patients' health information
  • Help family members and friends care for their loved ones


In order to tackle the challenge, a gravitytank team composed of designers and strategists first sought to understand the pain points around the current PHR. The gravitytank team involved included: Amy Guterman, Stephen Menton, Defne Civelekoglu, Kunal Bhat, Amy Seng, and Justin Rheinfrank.

The team first approached the challenge by conducting research on medical records. They spoke with experts in the field to understand industry trends and with patients who manage multiple chronic conditions. In addition, they reviewed analogous health services and looked critically at the existing Blue Button record to identify opportunities for improvement.

This approach led the team to uncover four key principles to designing an effective patient health record. These principles are:

  • Dynamic - Prioritize the here and now and surface how patient health is improving or worsening
  • Holistic - Show patients how visits, prescriptions, and lab results are related
  • Understandable - Minimize jargon and present information in visual and digestible ways
  • Personalized - Provide the information patients need to take control of their health


The result of the project was Nightingale, a new approach to medical records. Nightingale is a proof of concept to show potential key features that could lead to a more useful patient health record. Unlike other patient health records, Nightingale encapsulates the four key principles— dynamic, holistic, understandable, and personalized—making it easier for patients and caretakers to find and understand health data. Nightingale has been featured in Fast Company Co.Design, TechCrunch, The Verge and PSFK, among other publications.


While Nightingale was not built out as a fully functional solution, the team designed examples of digital user experiences for both a mobile and web application. The Department of Veteran Affairs and the White House used Nightingale and other top submissions as inspiration for developing a new version of the Blue Button record, called bbClear. In the spirit of transparency and contributing to the industry at large, they’ve made the bbClear Framework publicly available here.

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