Nurse App (2016)
Patient Centered Healthcare
Case study: Nurse App
Designing a monitoring and emergency notification feature with emotional design considerations.
As the healthcare debate heats up in America, the race has begun for a solution to skyrocketing costs and well rounded care. At Nurse app, we applied design thinking practices to this hot button issue, because… let’s face it, the problems with healthcare can’t be resolved by policies.
The challenge was to apply design thinking to create additional features that improve the patient experience, while reducing overall healthcare costs.
In a team of 3 designers, I lead the group in navigating the discovery, research, and testing phases. After a 3 week design sprint, we presented our findings and solutions, in which I had a significant role as the main presenter.
iOS Ecosystem: iPhone & Apple Watch
At the inception of the project we wanted a holistic understanding of our problem space before narrowing our scope.
In order to see the big picture, we first researched the state of electronic-health records (EHR) and the overall impact of technology in the medical field. Due to information sensitivities, we discovered that this space was woefully fractured and there was yet to be a consensus on the best way to give patient's control over their medical records.
But how were the patient's interacting with their medical records and what was their relationship with their healthcare? We conducted a survey and grouped potential users around their healthcare habits. Natural groups formed around age segments with the 45-65 age group being the most willing to use online health portals to access health records.
However, their willingness was not an indication of action. More than 50% of this same group was living with one or more chronic disease, ranging from diabetes to COPD. After interviewing individuals fitting the profile, we found:
- Patients could not locate their health records easily
- Healthy habits are extremely subjective
- Does not always listen to doctor recommendations
As part of the discovery process we wanted to know how other companies were approaching this problem space. What were their value propositions, what were their key features, and how were they leveraging existing technologies? We looked at a myriad of online symptom checkers, health trackers, health portals, and emergency alert systems.
Companies portray their best selves in their own marketing materials, but we wanted to know what people really thought. To gain some quick insight iTunes reviews were our best friend. We went sorted and catalogued the most common pain points so that we can avoid these pit falls from the start.
Guiding principles and Insights
- Health records aren't easily accessible
- High expectation on hospital to know about the patient's health
- We are dealing with very sensitive data
- Compensative approach to health was more prevalent than a preventative approach
- A health portal alone could not be a standalone service, because of infrequent use
- In an emergency, it's important to feel that someone is there for you, but when it's not an emergency independence is supreme
Based on these insights we wanted to create something users would find useful and potentially keep them healthier, longer. We knew that we wanted to work with some type of monitoring and reminder system to keep users engaged. In our research we found the 45-65 age group also were high adopters of smart watches and other tracking devices.
Since a person's health is a sensitive subject, we wanted to make sure we were inclusive of emotional design. Don Norman states there are 3 levels to emotional design; behavioral, reflective and visceral. In order for us to design a truly patient centered product we would need to address all 3 levels.
We started to play with some ideas that mixed health monitoring, reminders, and in case of emergency alerts. Given our research participant's disposition of preexisting conditions and we found that we could make the biggest impact by monitoring fluctuations in heart rate using Apple Watch's heart monitoring ability.
Because we wanted a monitoring product, we wanted the design that was always on, but not intrusive. The goal was to create something that is friendly and assistive without annoying the user and making them feel comfortable and secure. We did this by:
- One time input of disease, emergency contact information and medication schedule during on-boarding
- Apple Watch monitors and measures average heart rate and sudden changes
- Drastic changes to the heart rate, prompts a draining heart with haptic pulse, requiring interaction. During this screen an alarm would sound off, gradually getting louder as the heart timer winds down.
- Touch to dismiss or call for help
- Do nothing, allows heart to drain, automatically calls for help. The alarm rings, until turned off, to notify bystanders help is needed.
- If help is needed, an automated message will be sent to predesignated emergency contacts with GPS location & heart activity. The emergency contact would contact their loved one, then call 911 if appropriate.
- Another interaction is needed to call 911 to prevent false positive calls, displayed on all devices the app is installed. This is outward facing and is available even without unlocking the phone, so bystanders can assist the patient in an emergency setting.
In order to prototype quickly, I found that Marvel App to be the best tool for this case because of the Apple Watch compatibility. We prototyped and tested both the on boarding and emergency monitoring flows.
The key to a good test is to make sure the user is in a similar context to a real situation. Unfortunately, given the nature of our use case, we had to manufacture a stressful situation for our participants. This scenario consisted of bootcamp style counting & a blow horn in a random sequence.
We also watched educational videos to understand the motor ability of the moments leading up to cardiac arrest, stroke, and other traumatic events. By watching these videos, we introduced force touch/3D touch interactions to address accidental dismissals.