enriching the human experience
flourish
PROJECT
Flourish: Patient Community App
CLIENT
ROLE
DURATION
TEAM
Catalia Health
UX Designer & Researcher
5 months
Renee Reid, Alex Rosales,
Grace Guo, Alexa Steinhauser
THE OVERVIEW
Catalia Health is a digital healthcare management company based in San Francisco. Their core product is Mabu, an interactive robot. Mabu is distributed to hospitals and given to patients as part of their treatment plan for certain types of chronic illnesses. Using an AI algorithm, Mabu helps guide patients to regulate their medications and well-being through conversational UI and various interactions. The recorded health data is then transmitted to their healthcare provider and acts as a way of overseeing the management of their overall health.
THE CHALLENGE
Primary studies performed by Catalia Health indicated that chronically ill patients had a tendency to develop depression. After diagnoses, patients revealed that they had feelings of confusion and helplessness regarding their condition, with little opportunity to connect with others undertaking similar challenges with their new prognosis. They sought companionship and felt isolated.
THE OPPORTUNITY
We were tasked with the challenge of creating an online community for patients with chronic heart failure— a safe space for patients to engage with one another, feel more informed about their conditions, and be more motivated to adhere to their treatment plans. This heightened sense of social belonging could ultimately lead to better personal healthcare management and a higher sense of well-being.
THE OUTCOME
We completed a booklet documenting our UX process from start to finish, along with a high-fidelity prototype, tested with chronically ill patients, outlining our solution and demonstrating two to three user flows of our key community features. Browse the publication and overview video below:
now, let's get into the details...
PROJECT TIMELINE
THE DESIGN PROCESS
We followed the Double-Diamond Process Model to organize and execute our solution. This process, developed by the Design Council, uses divergent thinking to explore an issue broadly, and convergent thinking to develop a focused conclusion. To discover and define the problem, we conducted primary research by creating an informed survey of questions and interviewing patients. We then developed our ideas through a series of sitemaps, sketches and wireframes. After multiple iterations and a round of user-testing, we delivered a high-fidelity prototype as our solution to Catalia Health.
THE GOALS
CONSIDERATIONS FOR USERS' PRIVACY
We realized that this project would be research-heavy due to various reasons. Catalia Health had never facilitated patient-to-patient engagement, whose research at the time of study focused more on patients and their engagement with Mabu and healthcare providers. Recruiting for patients required more effort than other users due to the specificity of their conditions and privacy laws within the healthcare industry. We chose to narrow our scope down to patients with congestive heart failure because this was an important patient group already being researched on by Catalia Health.
Interacting with patients through interviews required more care towards their physical/emotional states and privacy due to the sensitivity of personally identifiable information for HIPAA compliance. Our team was required to complete a HIPAA-compliance training course before beginning research in order to adhere to these standards and protections. In addition to the certification, we received participant agreement forms from each patient studied during our project. We took great lengths to keep patient data private and secure by:
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Using secure platforms to host patient information and communications
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Using codes to de-identify patient information (e.g. patient numbers vs. names)
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Deleting patient data and information at the end of the study
DISCOVER
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Data & Literature review
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Competitive Analysis
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Patient Interviews
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Surveys & Card Sorts
SECONDARY RESEARCH
To get a better understanding of the problem space, Catalia Health provided the team with data about patients with chronic illness. This helped the team understand some of the physical and emotional challenges this group faces when dealing with their conditions. We also conducted some additional secondary research to contextualize key areas that would help guide how we approach the generative primary research with patients:
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48% of chronically ill patients were scored as depressed by the Beck Depression Inventory scores (Gottlie)
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Heart failure self-care requires following advice of providers to:
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Take medications,
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Eat a low-sodium diet, exercise, and
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Actively monitor themselves for signs and symptoms
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Our secondary research involved learning how a patient community could help patients deal with chronic illness. Some key findings we discovered were:
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Patients derive personal meanings out of other illness trajectories through the act of comparing and contrasting experiences
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Websites such as patientslikeme.com or curetogether.com were effective in “psychological experience in living with their conditions and perceived control over their conditions”, yet due to the problem detailed in the point above, there are limitations in these services
PRIMARY RESEARCH
We sought to complete exploratory research with actual patients to gain a better understanding of the target users. We limited our scope to patients with congestive heart failure (CHF) since they are a target demographic for Catalia Health. In recruiting this specific group of patients, we leveraged existing connections from Catalia Health. One of their patients was also the founder and administrator for a Facebook group for patients with CHF. She let us post within this group to recruit additional participants.
Outside of these connections, we also reached out to chronic illness, heart disease, and heart failure communities on Reddit. Since this platform allows users to retain anonymity, we thought it would be a good alternative to find patients not connected within our closer networks. Lastly, we reached out to those within our personal networks. We were able to recruit 42 participants for interviews and a survey/card sort exercise. Participants were between the ages of 30-65 and lived across the United States.
% of recuited participants by network
RESEARCH METHODS
We completed remote interviews with 13 chronic heart failure patients and administered a card sort and survey to all 42 participants. From our more intimate interviews, we hoped to gain insight on daily life of a chronically ill patient and understand how patients currently engage in online communities.
Most of these interviews were conducted using Zoom or through a phone call, recorded with patients' consent. Phone-call participants tended to be on the older end of our research group and less likely to engage with online communities, while participants who opted into video chat tended to be younger and more engaged with online communities.
Our card sort and survey were aimed at discovering desired attributes and features of an online patient community. We also wanted to study the demographics of patients who use online platforms so that our design could be informed by the diversity and interests of their population. For the first part of the activity, participants were asked to complete a survey that gauged demographic information, behaviors and attitudes surrounding online/offline communities, and devices used to access said communities. They were then asked to sort 17 cards, containing aspects of a patient community derived from our patient interviews, into categories by level of importance (very important, important, somewhat important, and less important).
17 cards were given to participants to sort into categories by level of importance
OUR FINDINGS
According to the card sort, we discovered that the most important community aspects are the ability to discuss a specific diagnosis, educational resources, a safe space to share ideas and experiences, a community that can be checked any time, and low-sodium diet information. Meanwhile, intimacy, religious support, and an unmoderated community ranked as the lowest level of importance.
We uncovered 5 major themes that informed us of patient attitudes and behaviors from our interviews:
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Patients use community for a sense of belonging and giving back
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Patients felt that a community where users were identified (vs. anonymous) made them feel more supported.
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Older participants preferred face-to-face interactions
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All patients use their mobile phones; not all participants had a computer
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Common pain points among patients were transportation and maintaining a good diet
Three main attributes informed by our research for a patient community
DEFINE
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Research Conclusions
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Personas & Archetypes
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Affinity Diagramming & Crazy 8s
RESEARCH CONCLUSIONS
Drawing from our discoveries in the research phase, there seems to be an equal importance placed on both online and offline interactions to help strengthen the idea of community among potential users. We found that consistent participation from members, along with personalized and dynamic content, keeps users engaged and interested in becoming part of a larger collective.
Many of those interviewed also placed value on in-person interactions, admitting that face-to-face conversation provides the most support within their daily lives. They also displayed a need for connections to resources, like grocery shopping and transportation. Although facilitating these types of meet-ups would be the pinnacle of group resources, Catalia Health had to limit our project scope to a predominately online patient community due to technological limitations.
Ultimately, we agreed that designing an app would be the most accessible for patients because a majority of them had access to a smartphone over a computer.
Research findings reveal which types of interactions are important within a community for app development exploration
PERSONAS & ARCHETYPES
Catalia Health provided us with their existing patient personas to assist with defining user journeys within a created online community. We learned that the content within a community could change drastically based on how long a patient has been diagnosed with CHF. For this purpose, we personified the use of the "beginner" and "intermediate" patient, concluding that they would gain the most benefit out of community engagement and resources.
We found three types of community user archetypes in our primary research: two archetypes (contributor and lurker) whose characteristics were independent of their progress in their patient journey and one archetype (mentor) whose behavior was tied to the length of time they had been a patient.
Existing Personas
Archetypes
AFFINITY DIAGRAMMING & CRAZY EIGHTS
We used the interview, survey, and card sort results to diagram various aspects of community, along with specific features to include in our product development. This included things such as an account profile, resources and discussion forums to onboarding a new patient looking to join.
After brainstorming an array of community aspects and journeys, we reviewed the affinity map as a group and began iterating various features as wireframes through a process called crazy eights. In eight minutes, each member of the team creates eight variations of a specific wireframe or aspect. When time is up, everyone shares their designs and their thought processes behind design decisions. The best parts of each variation are combined to develop one concise wireframe and user journey. Voila, our key community features have come into fruition.
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Breaking out features into sections labeled “community,” “education,” and “resources”
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Utilizing personalization to cater dynamic content relevant to the user
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Branching out the “community” feature into different topics for easier navigation
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Incorporating Mabu as a mascot for Catalia Health-generated prompts
Affinity diagramming and the crazy eights exercise helped us create a main user story to base our features off of
DEVELOP
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Site Mapping
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User Journeys
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Wireframing
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Prorotyping
DESIGN SPRINT
Our in-person design sprint took place over a few days in San Francisco with our client liaison, Catalia Health designer Stacey Seronick. This process is generally known for utilizing design thinking principles to ideate and iterate upon a product or prototype. In this experience, we brought together our working knowledge of the problem space and generated a more focused solution by narrowing down key features of the app. Once we had an intentional design direction, the rest of the exercises (affinity diagramming, site mapping, and user journeys based on personas) flowed with ease.
Sitemap and information architecture of main app features
Diagramming features of the main navigation bar
We created a hierarchy of navigation menu items, which in turn revealed both the “explore” and “community” pages as highlights of the community app. “Explore” would act as the homepage for users upon opening the app. After being onboarded (in which data points collected on the user would map them into one of the patient types on their patient journey), content on this exploration page would be catered to the user.
Community feature user flow and wireframes
Explore feature user flow and wireframes
BRANDING & DESIGN
Our client shared with us their branding specs, such as specific fonts and colors used for both Catalia Health and Mabu. Since they did not have a formal design system, we used our best judgement in order to establish the look and feel of the app.
We focused on making the interface appear lightweight and clean by choosing a minimal color palette and modern san-serif font, careful treatment of white space, and subtle shadowing. We hoped that this would make the app more intuitive and delightful to use.
The app name, Flourish, is a verb that means "to grow in a healthy way from being in a favorable environment." Meanwhile, the logo is meant to symbolize both a flower in full bloom and the intersection of similarities as one. This correlates with the app because we hope that our users can meet like-minded people, grow together, and flourish within their community.
PROTOTYPING
We created low-fidelity wireframes through Sketch, then utilized Figma to create high-fidelity mockups of the design. Using the user flows previously defined, we built out the navigation bar and each screen as it pertained to those flows. A working prototype was developed, thus allowing us to use it for user testing.
Prototyping visual from Figma
DELIVER
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User Testing
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Concept Iteration
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High-Fidelity Prototyping
USER TESTING
Upon completion of the first prototype, we conducted user tests to validate our design work. Feedback was needed on usability, information architecture, user interactions, visual design, and the mental model for personalization. Five participants volunteered to test the prototype remotely. The goals were to understand how patients engaged with the prototype’s “explore” and “community” feature, as well as understand patient expectations for the types of content they would expect to see while on their health journey. Our key user testing findings included the following:
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Every participant is willing to use the stories section to share their personal story
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Stories and posts should have titles to give readers a general idea of what their post is about
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Stories should also have an option to add pictures, making patients feel more connected through personalization
FINAL DELIVERABLE
Our team was able to provide an interactive high-fidelity prototype, tested with chronically ill patients, which outlines the solution and demonstrates at least two to three user flows of the key community features. Access the prototype here.
Final screens of high-fidelity prototype, including the community and stories features
Final screens of high-fidelity prototype, including the explore feature and comment posting flow
NEXT STEPS
Throughout this capstone project, we have learned about how various patients across different parts of their journeys wish to engage with a group of people they can call a community. We have designed two main user flows and have built the framework for other features to follow suit.
We recommend building out those features that facilitate in-person meetups and resource location, because several participants in our research phase acknowledged interest in face-to-face interactions and things like grocery delivery or carpooling. Developing this feature would also give Catalia Health a competitive advantage over other community platforms, because this does not currently exist in a majority of online patient communities and would improve their quality of life.
While Catalia Health currently has a great solution for increasing better patient outcomes with Mabu, we believe the community app will further improve this engagement while enabling richer interactions between actual patients. Another benefit to building an online community is that it is more accessible than requiring users to have a Mabu device, which means it has the potential to reach a much larger patient demographic.
fini.