Introduction
In 2016 my 1-year old son underwent a bone marrow transplant in an attempt to cure him of a rare autoimmune disease (chronic granulomatous disease). Part of his recovery required my wife and I (the caregivers) to conduct home infusion therapy on him. This means we were injecting IV medications into him and pulling blood samples daily.... by ourselves.... from home.... without the help of medical professionals or the resources available in a medical facility. If that sounds intimidating, it is.
Did we get it right? No. In fact, we made a critical error within the first week causing a ripple effect leading to a change in the medications of his care plan. In the end, the transplant worked and he is now a normal little boy. Performing home infusion therapy was an extremely daunting part of that journey.
I was the sole UX designer, UX researcher, user interface designer, and project lead for this venture.
Did we get it right? No. In fact, we made a critical error within the first week causing a ripple effect leading to a change in the medications of his care plan. In the end, the transplant worked and he is now a normal little boy. Performing home infusion therapy was an extremely daunting part of that journey.
I was the sole UX designer, UX researcher, user interface designer, and project lead for this venture.
The Problem Statement
Home infusion therapy is the optimal therapy for patients requiring many infusions. It is mutually beneficial for patients, insurance providers, and health care providers together. The pain points and barriers to home infusion therapy are the patients themselves. People with little to no medical experience are being asked to perform a procedure that must be done flawless each and every time. Performing home infusion therapy incorrectly can result in severe complications, the critical of these is death.
What is Home Infusion Therapy
For people who require chronic IV infusions, home infusion therapy offers patients a less intrusive medical experience by reducing clinic visits and hospital stays. They are able to perform their many IV infusions and blood draw samples from the comforts of home. Home infusion therapy has proven to be a mutually beneficial cost-efficient solution for patients, medical facilities, and insurance providers together. Patients and insurance providers avoid clinic visit costs, while medical facilities are able to free up backfilled beds while still providing the patient the service of home infusion therapy.
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In order to perform home infusion therapy patients must first be surgically implanted with a central vascular access device (CVAD). This allows needle-less connection to the bloodstream. Implanting a CVAD leaves a lumen protruding through the skin which is able to screw onto the tubing of the infusion medication making for a quick and easy link.
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There are 3 main types of CVADs; a peripherally inserted central catheter (PICC Line), a central venous catheter (Central Line), and a portacath (Port).
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The Problem
While home infusion therapy has many benefits, it also comes with the possibility of severe complications, including death, if done improperly. The onus to perform these infusions correctly each and every time creates a high-stress situation for many users, especially those just beginning.
On the opposite end of the spectrum, people well-versed in home infusion therapy, notching a myriad of infusions, tend to gravitate toward autopilot, glossing over crucial steps in the procedure.
These factors cause a situation ripe for human error.
On the opposite end of the spectrum, people well-versed in home infusion therapy, notching a myriad of infusions, tend to gravitate toward autopilot, glossing over crucial steps in the procedure.
These factors cause a situation ripe for human error.
Before starting home infusion therapy you go through training taught by a professional on how to do it correctly. Once you feel comfortable in the process, you can start doing your infusion on your own from home.
Patients are then given printed step-by-step instructions and information on who to contact for questions or should something go wrong. A troublesome issue is that the resources given are too generic and not conducive to each patients specific circumstances.
Patients are then given printed step-by-step instructions and information on who to contact for questions or should something go wrong. A troublesome issue is that the resources given are too generic and not conducive to each patients specific circumstances.
Discovery Phase
HIPAA regulations made it challenging to find and gain access to people who were using home infusion therapy. This meant I had to get resourceful in finding recruits for interviews and surveys. Turning to social media, I struck gold with Facebook support groups. In joining and following these pages I gleaned tremendous insights about the daily struggles for people conducting home infusion therapy. Posts from these groups were a huge asset throughout this project, especially in development of personas.
Screener Survey
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With the help of social media I was able to garner 31 responses to the screener survey with 22 (71%) participants having performed infusion therapy at some point in their lives. I gleaned many insights from the survey that helped zoom my focus onto areas that needed to be explored more in depth. A main takeaway was that most people did not think that the training provided was satisfactory. Another important insight was that of those who experienced complications, the majority of them thought they were preventable.
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Interviews
Next, it was time to hear from those who have been in the trenches in some one-on-one interviews. I also was curious to hear what the experience was like for healthcare professionals so I made it a point to round up a few nurses and pharmacists to mix into my interviews. I found that in many instances couples worked as a team to help reduce stress during infusions. I also learned that injecting medication through an IV can be just as stressful for a skilled nurse as it is for a layman just starting out.
PROPERLY DISINFECTING THE ACCESS POINT TO THE BLOODSTREAM IS IMPERATIVE!!!
PROPERLY DISINFECTING THE ACCESS POINT TO THE BLOODSTREAM IS IMPERATIVE!!!
Affinity Diagrams
I discovered copious amounts of data from my research, interviews, and surveys. Affinity mapping was a tool that helped me organize these findings into clusters and make sense of what I was learning.
Empathy Mapping
My research was giving me a firm grip on what people were feeling, thinking, saying and doing while performing home infusion therapy. The next step was compiling all those insights into empathy maps to give me a consolidated visualization of the needs of my users. I was starting to grasp clear points of pain and formulate goals to assist users in overcoming these obstacles.
Personas
To represent the users accurately I came to the conclusion that I needed 3 personas. Each persona would have a varying trinity of traits and circumstances representing the key users of the home infusion therapy demographic.
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PERSONA 1:
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PERSONA 2:
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PERSONA 3:
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Designing A Solution
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Keeping a sterile environment is crucial. To ensure hands stay sterile while working with lumens, voice navigation is of utmost importance. I had to create a tool that could customize each patients infusion plan to their own specific situation. I had to ensure that no step would be missed.
I concluded that an application containing a detailed overview of their entire infusion plan was needed. One that would incorporate voice navigation to keep hands sterile and focused on maintaining their infusion lines. Users needed customized videos mimicking the steps unique to them for performing their infusions. Each video would be customized to their unique situation including instruction which lumens each medication was to be infused into. |
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Minimum Viable Product (MVP)
The most important function of this app is walking the user through their infusions and blood draws. Setting up your own customized infusion plan to match the specific details unique to your situation is also a very crucial feature for this app.
These 2 features were fundamental to this app and had to be thought out if an MVP were to be created.
This app would then keep a history of all your infusions / blood draws and send you alerts when it was time for your next infusion or blood draw. Saving a record of infusions is helpful because in some situations users could be infusing sedatives, pain medication or other things that can leave you feeling disoriented.
Other features like ordering medications, tracking shipments, live chatting with your care team, and others can be worked out in future versions.
These 2 features were fundamental to this app and had to be thought out if an MVP were to be created.
This app would then keep a history of all your infusions / blood draws and send you alerts when it was time for your next infusion or blood draw. Saving a record of infusions is helpful because in some situations users could be infusing sedatives, pain medication or other things that can leave you feeling disoriented.
Other features like ordering medications, tracking shipments, live chatting with your care team, and others can be worked out in future versions.
Sitemap
Once all the information was organized, I got busy figuring out where it would fit within the app.
User Flows
Next, I needed to map out user flows for what I deemed the 2 most important features of the app. This was setting up your own customizable infusion schedule and walking a user through an infusion. Depending on variables chosen from customizing your infusion schedule, each infusion walkthrough would be slightly different.
Ideating Initial Drafts
With a clear path set in front of me I put pen to paper and started sketching out the first drafts of the app. The minimal viable product
Wireframes
After drawing out rough versions of the screens, and testing a rudimentary prototype with people created in inVision, I was able to catch and fix some substantial user design flaws in the medication scheduling process. After a little more research studying various apps that implement a lot of complicated scheduling I was able to come up with a less complicated and user friendly way to schedule medications. Now I was ready to start getting digital with my designs. For this I used Sketch to create my wireframes.
Style Guide
It was a bit of trial and error coming up with the style guide. The original color palette I had chosen failed when I ran it through accessibility testing to evaluate for color blindness and contrast standards. It was back to the coloring board.
Since this app is designed to act as an infusion nurse in your pocket, I wanted the main colors to have a visual association with nurses scrubs. I chose the primary color to be #1BA39C (Java Teal) and the secondary color to be #1E90FF (Dodger Blue) to achieve that effect.
Errors during infusions can be catastrophic so for errors in the app I chose #B50000 (Deep Red). This whole app has a connotation with blood and I thought this color would tie in with that perfectly.
It was of the utmost importance for me that people not miss the CTAs. They really needed to something that popped. Not locating a CTA while doing something as dangerous as injecting chemotherapy into your bloodstream was not an option. Over the teal and blue, #FF4500 (orange/red) jumped off of the screen.
As for typography I was looking for a font that was easy to read, but was unique and endearing. Something that would stand out from the crowd with a bit of a digital flare. Barlow was the perfect option.
Since this app is designed to act as an infusion nurse in your pocket, I wanted the main colors to have a visual association with nurses scrubs. I chose the primary color to be #1BA39C (Java Teal) and the secondary color to be #1E90FF (Dodger Blue) to achieve that effect.
Errors during infusions can be catastrophic so for errors in the app I chose #B50000 (Deep Red). This whole app has a connotation with blood and I thought this color would tie in with that perfectly.
It was of the utmost importance for me that people not miss the CTAs. They really needed to something that popped. Not locating a CTA while doing something as dangerous as injecting chemotherapy into your bloodstream was not an option. Over the teal and blue, #FF4500 (orange/red) jumped off of the screen.
As for typography I was looking for a font that was easy to read, but was unique and endearing. Something that would stand out from the crowd with a bit of a digital flare. Barlow was the perfect option.
Hi Fidelity Screens
After working out some design flaws by testing my initial sketch drawing screens with people, I felt I was at the point where I could start designing high definition screens that wouldn't be too impacted by further design tweaks. I used Sketch to make the screens.
