Patients First
Creating a support system for pre-surgical patients, in order to relieve stress.
This iOS app helps connect pre-surgical patients with individuals who are currently undergoing, or have undergone similar procedures. This gives patients a better idea of what to expect, helping them manage pre-surgical stress and improve their post-surgery outcomes.
Overview
Project Type: Academic
Timeline: 3 weeks
Roles: UX Researcher, UX Designer
Tools: Figma, InVision
Project Brief
Conduct research that builds an understanding of patient experiences for an initiative aimed at improving healthcare. The initiative aims to place people and patients at the center of healthcare by more deeply understanding patient needs and experiences, while improving patient outcomes. Based on your research insights, explore a potential digital solution.
aPPROACHING THE CHALLENGE
To tackle this challenge, I followed a design-thinking framework. This user-centered approach is non-linear and allows for innovation through multiple rounds of feedback and iteration.
Empathize
Secondary Research
Primary Research
Define
Persona
Ideate
Task Flows
Prototype
Low-fi Wireframes
Mid-fi Prototype
Test
Iterations
Empathize
pROBLEM sPACE
Mental Health and Post-Surgical Outcomes
The perioperative period can be a stressful time for patients. A growing body of research suggests that preoperative educational efforts, related to improving nutrition, exercise and well-being, can boost not only patients’ personal experiences, but their physical recovery as well (Weiner, 2019). Understanding pre-operative patient needs is crucial to ensure that patients receive the support they need.
sECONDARY Research
Emotional distress negatively impacts outcomes
Psychological factors, such as anxiety, depression, and catastrophizing can contribute to negative post-operative outcomes, including increased pain. Post surgical pain delays recovery and discharge (Khan et al., 2011).
Stress management training pre-operation was found to reduce depression and fatigue during the post-surgical period in breast cancer surgery patients (Garssen et al., 2013).
The right support is integral
The ERAS (Enhanced Recovery After Surgery) society provides tailored guidelines to optimize patient health before surgery.
Following these guidelines improves clinical outcomes and patient satisfaction, proving that it’s worth investing in pre-operative patient support.
Pre-admission counseling and education can reduce anxiety and improve post-surgery outcomes.
The way perioperative care is usually done is, I tell a patient in 34 days, I’m going to take out two-thirds of their liver. Then all the patient can do is wait, which can be so challenging psychologically. Now we are giving patients something they can do. We empower them to have some ownership over their outcomes. That really changes the mental model they bring into the operating room.
- Michael Englesbe, MD University of Michigan Medicine
Design Challenge
How might we reduce stress in perioperative patients in order to improve their post-operative outcomes?
Research & Strategy
Research Objectives
- Understand how patients are currently supported by their healthcare team during the perioperative period
- Understand how patients feel emotionally before and after an operation
- Identify what makes patients feel supported during the perioperative period
- Identify the resources patients turn to for support during the perioperative period
Hypothesis
I believe that patients feel stressed during the perioperative period and don’t have access to resources that could help them manage this stress.
I will know I’m right when I see the following feedback from the market: Post-operative patients report high stress levels before and after surgery.
Assumptions
- I believe my users have a need to reduce their stress levels during the perioperative period.
- I believe that users don’t practice stress management techniques during the perioperative period because they lack the resources.
- These needs can be solved by stress management treatment plans.
- My initial users will be adult patients with scheduled operations.
- The #1 value a user wants to get from this product is reduced stress and improved post-surgical outcomes.
- The user can also get the added benefits of education and access to healthcare services.
- My biggest risk is not seeing meaningful change in either a) clinical outcomes, or b) patient experience.We will solve this by ensuring the solution uses evidence-based techniques.
Primary research
Talking to Patients
In order to better understand the perioperative patient experience, I conducted 5 interviews with adult Canadians who had undergone at least 1 surgery in the past 5 years.
After completing the interviews, I compiled a list of pain points, motivations and behaviours expressed by my interviewees. From this list, I identified the following themes and insights:
Healthcare Team Support
Patients’ experiences are more positive when they feel listened to and are treated with respect. Trust in healthcare teams eases worry.
Health is a Priority
Patients view regular visits to their primary doctor as integral to staying healthy, alongside regular exercise and a healthy diet. Living a long life and healthy life is a strong motivator.
Independent Research
Patients conduct independent research before reaching out to their primary doctor. In some cases, independent research occurs because there is a lack of support from healthcare teams.
Lack of Psychological Support
Perioperative support focused on physical health and doesn’t address other patient needs.
Peer Support
Connecting with friends, family, or peers who went through a similar operation was important for reducing stress and providing emotional support.
Key Insight: Peer Support
I assumed that patients were experiencing significant levels of stress during the perioperative period and didn’t have the resources to manage their stress.
However, my primary research suggests while users do experience stress, they’re able to manage it. In particular, speaking with friends and family who have undergone similar procedures makes patients feel supported and helps to reduce stress and worry.
Define
Persona
Who are we designing for?
I took the information I gathered during the interview stage and synthesized it to create a persona. This allowed me to keep my users’ perspective at the forefront of my design process.
Revised design challenge
Challenging my Assumptions
After creating my persona, I revisited my design challenge and initial "How Might We." Before conducting primary research, I assumed that patients were experiencing significant levels of stress during the perioperative period and didn’t have the resources to manage their stress.
I found that while patients do experience stress, they’re able to manage it. In particular, speaking with friends and family who have undergone similar procedures makes patients feel supported and helps to reduce stress and worry. Patients want an easier way to connect with peers who have undergone similar procedures.
Revised Design Challenge
How might we connect preoperative patients to peers who have undergone similar procedures in order to provide additional support?
Ideate
user stories & task flows
What are the functional needs of my user?
With my revised HMW in mind, I began authoring user stories to identify the main tasks that my users might want to perform.
Core Epic: Chat with a Peer
I selected “Chat with a Peer” as the core epic because my users told me that this was the most effective way to manage pre-operative stress. Users found comfort in hearing about their procedure from a patient point of view. In some cases, users may have a hard time finding peers who have undergone a similar procedure, so designing a solution that addresses this challenge could have a large impact.
Find a Peer Task Flow
Epic: Chat with a Peer
Persona: Pre-operative Patient
Main Task: Message a Peer
Subtasks: Complete Questionnaire, Review Search Results
User Stories:
As a pre-operative patient:
- I want to find a new post-operative peer to chat with one-on-one, so that I can I can understand their experience and feel more prepared
- I want to be matched with multiple potential peers, so that I can choose the best fit
- I want to direct message my new peer so that I can ask specific questions
Prototype
Sketches and wireframes
Exploratory Sketches
After creating my task flow, I was ready to start sketching out low-fidelity solutions. I created a UI inspiration board using InVision and drew inspiration from a variety of sources, including other medical apps such as OpenCare.
Homepage
Questionnaire
match results
messages
Solution Sketches to Wireframes
I selected the most compelling exploratory sketches, based on their adherence to my users' existing mental models, and translated them to wireframes. I started with lo-fi wireframes, and after adding copy, completed my mid-fidelity prototype which was ready for user testing.
Test
usability testing
Improving Designs through Testing
In order to ensure that my designs were intuitive for users, I conducted 1 round of usability testing, with 5 users. This gave me the opportunity to obtain practical, real-time feedback, which I incorporated into my designs.
Users were given the following scenario:
You’re a pre-operative patient and your scheduled surgery is coming up. You’re feeling a little nervous and you want to better understand all aspects of your upcoming surgery in order to feel more prepared. You can assume that you’ve already signed up for the app and provided information about the type of surgery you’ll be receiving, your location and other relevant details.
Top 10 usability issues
- 1) “Start Over” tapped accidentally
To fix: reduce size and add modal for user to confirm selection - 2) Match History unavailable
To fix: add page to lower navigation bar where users can access past searches for peers - 3) Users scanning questions
To fix: Increase question font size - 4) Users are unsure during questionnaire
To fix: Include “Help” icons + modals during questionnaire - 5) Reduce clicks during questionnaire
To fix: Change “Next” button to read “Doesn’t Matter” where applicable
- 6) Users can’t navigate within questionnaire
To fix: Make the progress bar interactive - 7) Users want more information about peers
To fix: Access Peer Profiles on “My Matches” - 8) Users were surprised by the flow after messaging Lynda
To fix: Change destination of “Back” after message in flow - 9) Users want to see all the possible answers during the questionnaire
To fix: Eliminate scrolling on Question 1 - 10) Users want to refine “My Matches”
To fix: Add “filter” and “sort by” options
Major Change 1: Start Over Button
Problem: When users tapped “Start Over” (either accidentally or out of curiosity) their previous search was immediately lost, which lead to frustration.
Solution: a) I applied a primary button style to “Resume” and a secondary button style to “Start Over” in order to prevent accidental taps.
version 1
version 2
b) I added a confirmation modal, which is displayed when users tap "start over" to prevent errors.
version 1
version 2
Major Change 2: Questionnaire
Problem: Users were scanning questions and didn’t always understand what was being asked. Additionally, they felt like there were unnecessary taps and that the process could be more efficient.
Solution: In order to draw users’ attention to the question, I increased the font size. I also included a “Help” button, so that when users don’t understand the question they can read additional details to help them answer. Finally, if users don’t have a preference, the main button will display “Doesn’t Matter.” If the user does make a selection, the button text reads “Next.”
version 1
version 2
Next Steps
future thinking
Additional User Testing
One round of user testing highlighted the most pressing usability issues, however it’s important to test my revisions to ensure they’re appropriate solutions. I would like to conduct additional rounds of user testing with pre-operative patients to understand if their needs are being met.
Post-operative Persona
I’ve focused on the experience of a pre-operative patient, but in order to connect with peers I need to consider the experience of post-operative patients as well. Their experience with this app would look different, and therefore require additional primary research, persona development, and ideation.
