10. DROP-IN
Product demo in Red Square at the University of Washington
10.1 OVERVIEW
Premera Blue Cross - a health insurance company in Washington, Oregon, and Alaska that provides coverage to around 2 million people - tasked my team with the following challenge: How might we address the problems of caregivers in aftercare settings?
The company has long been focused on the needs of its patients and providers, but the needs of caregivers had not previously been a focus for the company. (Terminology note: “Caregivers” meaning family members or paid helpers who regularly look after a child or a sick, elderly, or disabled person. “Aftercare” meaning a patient’s care following a hospital stay.)
Project Details
Prompt: Create a design intervention for caregivers in aftercare settingsSponsor: Premera Blue Cross
Duration: 11 weeks
Teammates: Sophia Li, Trevor Larsen
Project roles: UX researcher, UX designer
Project tasks: primary and secondary research, sketching, storyboarding, paper prototyping, wireframing, digital prototyping, usability testing, information architecture, visual design
Final Approach - Demo
10.2 DISCOVERY
During the research phase, it became clear that the experience of caregivers differed greatly depending on the type of illness affecting the patient. In order to narrow the focus and find a disease that could be impacted positively by a tech intervention, I decided to focus specifically on the aftercare of type 2 diabetes patients.Research Questions
- What challenges do unpaid caregivers face? What are their feelings and attitudes?
- How do local and remote caregivers interact? Do they communicate effectively to coordinate care?
- What are the keys to successful treatment of type 2 diabetes?
Research Methods
- Secondary Research:
Reviewed academic journals, and news media sources related to caregiving and aftercare. We also found online forums like caregiver subreddits to be particularly useful for hearing from caregivers in their own words.
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Interviews: Phone interview with a registered nurse for additional context about caregiving and aftercare. In person interview with a person living with type 2 diabetes.
- Cultural Probes: 6 hand-made cultural probes were completed by young Seattle residents living 200+ miles from their families.
Subreddit for caregivers
Completed cultural probesResearch Challenges
One major constraint on this project was the limited time for research, so I had to lean heavily on secondary research throughout the project. I was able to perform two short primary interviews: one with a registered nurse and one with a newly diagnosed type 2 diabetes patient. Key Insights
Coding and affinity mapping the combined research findings about caregiving, aftercare, and type 2 diabetes led to six detailed insights, but I can summarize them at a high level like this: - Family and friends of patients are increasingly getting pulled into unpaid caregiver roles.
- Type 2 diabetes is one of the most prevalent and expensive diseases in Premera’s coverage area.
Problem Setting
Next I set the focus for the ideation phase by defining 3 desired outcomes and writing the following problem statement: How might we help unpaid caregivers establish healthy habits in newly diagnosed type 2 diabetes patients?
Desired Outcomes:
- Connect anyone involved in a patient’s caregiving whether they are local or remote
- Empower unpaid caregivers to help patients develop and maintain healthy habits
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Improve health outcomes for patients and unpaid caregivers
10.3 EXPLORATION
Using the problem statement and desired outcomes as guides, I generated dozens of sketches of design concepts. Ideation Methods
Sketches during ideation
Mind mapping during ideationDownselection
Downselection proved harder than ideation, but I generated the following set of selection criteria to make the process more systematic:
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Flexible
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Beneficial to Caregivers
- Beneficial to Patients
- Enhances communication/coordination
Top 3 Candidates
1. Virtual Caregiver
Pros: Leverages AI to uncover useful patterns in logs of the patient’s diet, exercise, and insulin. Can send alerts to the patient and caregivers.
Cons: No real impact on the health of caregivers.
Pros: Leverages AI to uncover useful patterns in logs of the patient’s diet, exercise, and insulin. Can send alerts to the patient and caregivers.
Cons: No real impact on the health of caregivers.
Concept #1
2. Shared Exercise Streak
Pros: Collaborating on an exercise streak can encourage healthy habits in patients and caregivers. Increased connections between the patient and their exercise partner (local or remote).
Cons: Maybe more of a feature than a product?
Pros: Collaborating on an exercise streak can encourage healthy habits in patients and caregivers. Increased connections between the patient and their exercise partner (local or remote).
Cons: Maybe more of a feature than a product?
Concept #2
3. Geocached Exercise App
Pros: Inspired by a patient’s quote:
“I need a destination. I can’t just walk for the sake of walking.”
Premera incentives exercise with scavenger hunt-like goals randomly placed around the patient’s neighborhood.
Cons: How does this help caregivers?
Pros: Inspired by a patient’s quote:
“I need a destination. I can’t just walk for the sake of walking.”
Premera incentives exercise with scavenger hunt-like goals randomly placed around the patient’s neighborhood.
Cons: How does this help caregivers?
Concept #3
Storyboarding
With the final 3 concepts selected, each member of my team created a storyboard detailing the core idea of each concept. It became clear during this step that the Geocached Exercise app was intriguing, but it didn’t really seem to help caregivers in any direct way.
Instead of random exercise goals sent by the app, I thought out loud to my teammate: “Maybe instead of random goals from Premera the enticement for exercise could be messages from caregivers?”. With the addition of messaging, it all seemed to click into place. This was our concept.
My storyboard for concept #1
Selected Concept
Geocached Messaging App
A mobile-only messaging app where all messages are assigned a location, and the messages can only be viewed when the recipient is in that physical location. With this approach, anyone’s connections with loved ones and friends can serve as motivation to engage in a more active lifestyle.
A mobile-only messaging app where all messages are assigned a location, and the messages can only be viewed when the recipient is in that physical location. With this approach, anyone’s connections with loved ones and friends can serve as motivation to engage in a more active lifestyle.
Selected concept sketch
Pros:
10.4 DESIGN
With a concept selected, the detail design phase of the mobile app progressed relatively smoothly. Two phases of prototyping helped me iron out some usability problems and identify the core flows in the application.
- Inspired by the interview quote: “I need a destination. I can’t just walk for the sake of walking.”
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Regular exercise is essential for successful type 2 diabetes treatment
- Instead of Premera’s goals, friends and family of the patient can send messages of encouragement that can only be viewed at the specified location
- Messaging is two-way, so caregivers also get motivation to be active
- Connect anyone involved in a patient’s caregiving whether they are local or remote? YES!
- Empower unpaid caregivers to help patients develop and maintain healthy habits? YES!
- Improve health outcomes for patients and unpaid caregivers? YES!
10.4 DESIGN
With a concept selected, the detail design phase of the mobile app progressed relatively smoothly. Two phases of prototyping helped me iron out some usability problems and identify the core flows in the application. Paper Prototyping
My paper prototype for what became the track activity flow
Key learnings:
- Follow existing best practices for video message creation and editing (Instagram, Snapchat).
- Add a plus button for new messages to the home screen.
Clickable Prototyping
Key learnings:
- Add an animation when “unlocking” a message to make it feel like more of a special event.
- Call out other nearby messages after a message has been viewed, so users have more guidance about what to do next.
UI Specification
Download the full UI specification here.10.5 SUMMARY
Benefits for Premera
- Designed for a wide audience: Drop-in was designed for Type 2 diabetes patients and their caregivers, but it can be used by any Premera customer looking for motivation to start a new exercise habit
- Two-sided: Messages can be sent from caregivers to patients but also vice versa. This is important since we know relatives of Type 2 diabetes are at higher risk of the disease.
- Reduce health care costs: Any successful intervention to reduce a wicked problem like America’s diabetes or obesity rates would have a huge positive impact on Premera’s bottom line. (Note: In 2017 the USA spent ~$322B on diabetes care which was comparable to the GDP of Denmark ~$324B)
Next Steps
- Add in a feature to place a pin a set time/distance away from the recipient. If existing mapping APIs are insufficient for determining safe locations for automatically-placed pins, perhaps we can use popular locations of previously placed pins instead.
- Explore alternate uses of the product (usage during travel, group messaging).
Personal Takeaways
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Design for one, apply to many: Designing for the needs of one group may prove useful to a larger audience.
- Storyboarding is worth the effort: If you can’t tell a compelling story with your concept, it probably needs to be reworked.
- Design for inconvenience:
The most seamless experience is not always what people need.