After we identified relevant features based on user needs, we created scenarios based on user personas to demonstrate how these features will benefit and meet the users’ needs specified.
Brianna is a 23-year-old graduate student and has a new job as a Project Manager. She recently moved to Chicago, Illinois.
Brianna noticed she has developed a cough and does not want to go to the doctor right away. She wants to treat her symptoms herself as she is enrolled in her company’s insurance plan and does not have any paid time off yet. In the past, she has “Googled” her symptoms and has gotten a massive list of possible illnesses such as lung cancer, which freaked her out. A friend at work told her about a new MedAssist app, which is one of the company’s benefits.
Over the weekend, Brianna downloads the app onto her phone. After adding her personal information, the MedAssist app pre-populated with Brianna’s health insurance HMO plan, primary care doctor, and medical records. Brianna wants to use the Intelligent Symptom Checker to see what she should do about her cough, which she has had for about a week. Brianna selects the symptom icon from the top of the screen. She is prompted by a series of questions written by a doctor that shows he is affiliated with Cleveland Clinic. MedAssist returns the three most likely options for her issue. She touches a button to see the three options.
Option 3 seems to most closely match what she is feeling. MedAssist also has a built-in thermometer feature that takes your temperature by holding the phone over your forehead or under the armpit. Brianna takes her temperature, which is 99-degrees. MedAssist reports back that if the temperature rises over 100.5, and if the cough persists for more than two weeks, she should contact a doctor.
After two weeks have passed, Brianna still has a cough with phlegm, and now has a sinus issue. MedAssist alerts her to contact a medical provider. When Brianna adds the new symptom of sinus congestion, she sees it populate above her older symptoms of cough and 99-degree fever from two weeks earlier. After another week goes by, Brianna goes into the MedAssist OnDemand Provider Message Center and requests a virtual visit. She sends the MedAssist Symptom Diary, which has the list of the symptoms and their duration. Brianna begins her virtual visit using the MedAssist app that allows her to breathe into the phone, which is connected to the medical provider’s virtual stethoscope. Since her symptoms have not gotten better, the provider recommends an antibiotic for five days. MedAssist knows the nearest pharmacy location and alerts Brianna when the prescription is ready. Brianna begins to take the antibiotic and starts to feel relief after the third day. Brianna is glad to have MedAssist be her guide to managing her symptoms and helping her get well.
Brianna's Journey Map to Wellness
Brianna's journey to treat her cough
Sandeep's Scenario
Sandeep is a 48-year-old engineer in Austin, Texas. Recently, he had his yearly physical and wants to find out his lab results. It is usually difficult for him to check his results. He first has to remember multiple passwords for different hospital logins. One hospital uses MyChart, and the other uses a proprietary system. On those occasions where he could not log in, he would look up the doctor’s phone number. The answering machine system for the practice of eight doctors would say, “Listen to this message in its entirety since options have recently changed.”
Luckily, Sandeep recently downloaded the MedAssist mobile app on his smartphone to help him manage his health. At the top of the screen, he can access his doctors and check health data. From the dropdown list, he selects Lab Results and sees the order from Dr. Rothman with the green indicator that the results are ready. He picks the results and sees a list of all the different tests he had. They all look good except for his cholesterol, which is marked with a high alert indicator. Since Sandeep and his doctor didn’t discuss cholesterol during his appointment, he messages his doctor by selecting, “have a question about your lab results?” which takes him directly to the OnDemand Provider Message Center with the name of his doctor chosen already. Sandeep selects the option to receive a call back from his doctor. Since he just had a visit in-person, he skips the option to request a virtual appointment. Sandeep hopes Dr. Rothman gets back to him quickly, as before using MedAssist, it often took two days to get a response.
That evening, the doctor calls Sandeep back. He mentions he would like to start Sandeep on medicine that should lower his cholesterol and discusses the benefits and side effects. He calls in a prescription for the medication. Sandeep, who is also managing another chronic condition, was happy to hear back from his doctor so quickly. Sandeep wants to learn more about the medicine. Once the doctor added the medication to his health records, MedAssist automatically updated it with a new medication list. Sandeep checks the MedAssist app by clicking the Medications button and selects the medicine to learn about dosing instructions, drug interactions, and side effects. Sandeep is glad to know about these before starting his prescription, so he knows not to take it with citrus in the morning. Sandeep also checks MedAssist for other ways that he can lower his cholesterol, and foods to avoid. Sandeep is happy to have all the information he needs in one place.
Sandeep's Journey Map to Wellness
Sandeep's journey to treat his cholesterol
Discussion
In this project, we aimed to understand the decision-making process of how people resolve health issues and concerns when symptoms of illness arise. We conducted observations with ten participants. Following our observations, we conducted seven interviews. We gained insight into user goals, motivations, activities and pain points. We then conducted a survey and collected data from thirty-three respondents. Survey results supported our previous findings, with some differences noted.
After completing our research and analysis, we identified five stages users go through when responding to a health issue: 1) research symptoms; 2) evaluate information; 3) plan courses of action; 4) treat symptoms; 5) assess treatment. We explored how these themes helped inform implications for design.
(1) Research Symptoms Stage
When using online symptom checkers, participants often skipped over required fields due to time constraints, such as inputting their medications and, for females, if they were pregnant. This implied that our solution must be fast, easy-to-use, and assist the user by populating data based on stored personal health history, saving users’ time when inputting responses to scaffolded questions.
(2) Evaluate Information Stage
Participants voiced major concerns with credibility and trustworthiness of online health information when seeking knowledge about their symptoms and conditions. This implied that our solution must include content authored and overseen by an accredited body of qualified board-certified doctors, teaching hospitals, and research institutions that have no conflicts of financial interest with sponsors.
Participants felt the quality and quantity of search results to make informed decisions about their symptoms was often overwhelming, frightening, and ambiguous due to the need to decipher and sort through complex medical terminology. This implied that our solution must perform the filtering and sorting of results for the user and rank them according to symptom severity and personal health history. Results must be easy-to-understand with common conditions listed first.
(3) Plan Courses of Action Stage
When determining courses of action, participants cited they needed guidance about their symptoms to know the type of care they needed and who should provide it. Some users sought advice from friends, family, and online forums. This implied that our solution must provide recommendations for when to seek guidance from providers, perform self-care, give wait times of local emergency rooms, and have access to moderated peer forums.
Participants cited responsive and timely communication as a primary concern when sharing health information, requesting medication refills, obtaining lab results, and seeking advice from medical providers. This implied that our solution must provide health data sharing that facilitates two-way communication between patients and providers across health networks.
(4) Treat Symptoms Stage
Younger participants cited more frequent self-treatment of their symptoms, and often put off doctor appointments and recommended tests; participants aged 36+ sought regular visits with their doctors seeking follow-up and additional knowledge about their conditions. This implied that our solution must provide reminders and alerts to ensure symptoms get resolved and to highlight frequently self-treated symptoms.
(5) Assess Treatment Stage
Participants cited that how their health issue was triaged can impact the timeliness and quality of care received. Participants reported when doctors give advance notice to ERs, patients access treatment faster and easier. This implied that our design must assist patients in the triage process by alerting ERs that a patient is coming and sending their health data to avoid errors in the intake process.
When visiting local walk-in clinics, participants were sometimes turned away if their particular health issue could not be treated there, resulting in treatment delays and increased health risks. This implied that our design must educate users on which symptoms can be treated at these facilities.
Limitations of Work
Our observations and interviews had small sample sizes consisting of ten participants in the observation phase and seven in the interview phase. Most participants were female consisting of six females in each of the observations and interviews; twenty-two out of thirty-three survey participants were female. Most participants were young and healthy with a majority between the ages of 18-35 living in the greater metro Chicago, Illinois area. Additionally, scenario-based observations were a limited way to explore this problem.
After analyzing survey results, we were unable to test our original hypotheses because we did not have two comparable groups. In the future, we would create a new survey to address demographic gaps such as health insurance plan type and income. We would then explore how age, income and type of insurance coverage are related to self-treatment. Our symptom list was limited, and we could refine it by adding or removing symptoms. We also would consider incorporating additional inquiry methods such as diary studies for participants to track the course of their symptoms. We also would perform a more in-depth research review of consumer and professional symptom checkers and self-triage tools, as we only focused on those found on free websites.