People with Type 1 Diabetes know their care better than anyone because they live with it and manage it daily. Some HCPs' training in T1D is not up to date. Some do not perform patient-centered care. PWT1D receives low-quality care or are not satisfied with the care they received.
As a solution, we designed T1D Care Directive, a lightweight tool that promotes shared decision-making. A more elaborate version is on the way.
Role
Product Designer, UX Researcher
Duration
June 2021, 20 weeks
Team
Jodie Li, Jhea Espares, Denise Tang
Given our understanding of the problem spaces through our prior need-finding research, we narrowed the focus onto the need to bridge the gap between people with type 1 diabetes and healthcare providers. We focused on answering:
“How might we design a new tool for two distinct types of users (people with type 1 diabetes and health care workers) such that quality of care can be improved through shared-decision making?”
While there are care plans and advance care planning and advance directives available to people, to our knowledge, there is not a “living directive designed for people living with diabetes. Therefore, we propose a “T1D care directive” that could be useful to aid people with type 1 diabetes.
We conducted several rounds of user interviews on Zoom over three months asking questions about their experience with healthcare providers, from nurses to endocrinologists, to challenge our assumptions and refine our design direction. We chose to use an affinity map, a similar design artifact as mindmaps, to visually analyze our findings into patterns and themes.
In total, we conducted 10 user interviews: 6 PWD, 3 HCP, and 1 PWD who is an HCP themself. We asked questions including, but not limited to, the relationship between PWD and HCP, conflicts PWD had experienced, struggles of being an aging PWD, and a possible medical resume/directive.
1. PWT1D who are motivated to plan for the future experienced landmark events that get them out of denial of death.
2. Trust and understanding between PWD and HCP stem from having meaningful conversations.
With these insights, we learned that being overly prepared and involved in their health management and progress greatly improves the quality of care patients receive from their HCPs. Trust, here, is built on both ends. How might we bring empowerment into the hands of T1D so that they have the means to build this trust?
Personas are abstractions of our target users based on our research. Our target users are PWDs and HCPs. By creating these abstractions, we aimed to understand the varying and similar contexts and needs of our two target user groups.
We wanted to lay out the general issues both sides have regarding their interactions, whether it be troubled perception or a lack of resources. Some of the main findings we wanted to reflect into these personas are the desire for PWD to be given transparency over diabetic management by HCPs, and the importance of time for busy HCPs.
We decided to design a tool that will help T1D improve their healthcare experience. After several rounds of brainstorming, we decided to move forward with a “Type 1 Diabetes Directive”.
This storyboard shows how it is used:
This experience map shows the scenarios and process related to creating and using the directive:
Our team developed a wireframe and lo-fi of the diabetes health directive. Using our information from our user insights and learnings, we each put together a wireframe, and merged parts of each one into a single page that we could show for another round of interviews.
We wanted this to be specifically short, considering that some PWD assumed that a long directive would deter HCP from reading it. Also, brief information about their management shows some credibility of being in charge and control of their diabetes. At the bottom, we included statements of PWD needs and the people they depend on if their needs cannot be met. We considered it would be important for negotiation by bringing in a medical professional like an endocrinologist.
We interviewed a total 6 healthcare providers, including doctors from UC San Diego Health and Stanford Health, and conducted usability tests through story board and A/B testing. The result shows that a short directive is valuable in certain settings where HCPs might not have sufficient knowledge on type 1 diabetes.
Some concepts we tried to validate are:
Based on the usability testing, we were able to identify important insights in regards to the directive.
1. People with Type 1 diabetes believed that a shorter version of the form would lead to a higher chance of success in terms of garnering attention from Healthcare providers.
2. Healthcare providers prefer shorter documents but will need verification of the information listed either from patients themselves or hospital tests/records.
3. The effectiveness of the document depends on both the doctor, the staff, and the hospital. In the presence of a diabetes team and sufficient resources, the effectiveness of the document could decrease. However, the concept of the document is valuable when HCPs are not knowledgeable about type 1.
4. While the form cannot guarantee that all wishes of the patient are fulfilled by the healthcare providers, it is effective in increasing the credibility of the patient.
Currently, our team is continuing the development of the product as well as seeking partnerships with other research groups and hospitals. Our next steps aim to solidify the implementation plan for our care directive and begin the process of creating a long-term functional platform for people with type 1 diabetes to utilize.
We aim to conduct beta tests with the care directive in a real-life hospital setting to determine the effectiveness of the document and the possibilities for improvement.
Though we are confident in our design of the care directive, we recognized that the artifact itself is only one part of the experience. The process from learning about the care directive, to creating one's own, to updating the document are all steps that must be explored in our next steps. Ultimately, we aim to develop a functioning tool and system.
There are a lot of logistics of designing for health care that needs to be considered, which brings a lot of difficulties. This was a big learning experience for me, where I had to look at the bigger picture with politically and what is implemented in such a vast existing system.
Also, given limited resources, we could not ship and test a beta version of our website prototype. Even with the handoff to developers, there was a lack of being able to bring this to fruition past a Figma design.