Steps and tools to reach a well-researched early prototype of a patient-centred mobile health app
At Salumedia I’ve had the opportunity to enter in the world of digital health and, among many things, understand and participate in the development of mobile health applications.
In this blog-post I’m going to share a bit of what I’ve learned, by summarizing the design process to reach a first prototype.
A QUICK INTRO TO USER-CENTRED DESIGN
User-centred design (UCD) is a multi-stage, problem-solving process that investigates the needs, desires and limitations of users to increase the success rate of the usability in computerized systems
UCD is considered a prerequisite for useful health technology that meets the requirements and preferences of the patients. It’s an iterative process, which has many variations and can be adapted depending on your needs.
Different stages of the UCD process.
Check this paper for a practical example of its implementation for the development of a mobile health app: https://www.ncbi.nlm.nih.gov/pubmed/25099556.
HOW TO CREATE A FIRST LOW-FIDELITY PROTOTYPE…
User & context research
Review the online resources (websites, blogposts, etc.) and the literature.
Check https://libguides.uwf.edu/c.php?g=215199&p=1420520 to understand how to conduct a valid and effective search.
Consult with healthcare professionals through individual interviews and discuss your findings.
Gather information from the users’ perspective.
Run, for example, focus groups and/or individual interviews and/or surveys (take a look at https://www.nngroup.com/articles/focus-groups/ and https://www.nngroup.com/articles/interviewing-users/ ).
Create 3 to 4 personas based on information gathered - the purpose of personas is to create reliable and realistic representations of your target users, to have their needs into consideration throughout the design. For details on how to create personas check this paper: http://media.autentisktledarskap.com/2014/10/LeRouge-et-al-2011-User-profiles-and-personas-in-the-design-and-develo....pdf.
Example of a patient persona. Taken from https://ieeexplore.ieee.org/document/8104295/.
Define your global use case and the main content requirements.
Do this in a group session with your team and take into account all the information gathered from previous steps (check https://www.ncbi.nlm.nih.gov/pubmed/25099556 for more details).
Example of a global use case for a self-management app for prostate cancer survivors, taken from https://ieeexplore.ieee.org/document/8104295/.
Review state of the practice for existing technologies.
This step will help identify if there is a gap in solutions for the purposes you’ve defined. This will also feed the actual ideation session, giving a sense of what is already available and possible features to include.
For the market review give a look at the methodologies used in these papers: https://dl.acm.org/citation.cfm?id=2990030 and https://www.amjmed.com/article/S0002-9343(15)00537-9/pdf. For the literature review, you can follow a systematic approach like the one in https://libguides.uwf.edu/c.php?g=215199&p=1420520.
Do brainstorming sessions using, for example, the affinity wall method.
Check https://www.lucidchart.com/blog/affinity-diagrams-your-key-to-more-creative-problem-solving for further details.
The sessions should take into account the personas, the global use case and the requirements created in previous steps.
IMG Source - [https://www.entrepreneur.com/article/276405] and
[“Affinity Diagramming 2.” d_jan. Creative Commons.]
Create a requirement list based on results from the brainstorming session.
Create a paper sketching.
Include the necessary buttons and instructions for screen interaction. At this stage, there is no need to give priority to content or visuals. (check https://uxplanet.org/the-art-of-ux-sketching-and-paper-prototyping-5dae5a1efc7d or https://www.uxpin.com/studio/blog/paper-prototyping-the-practical-beginners-guide/ )
Then simulate interactions between buttons and screens using for e.g. Proto.io.
Have domain and technical reviews of the prototypes with healthcare professionals and technical experts.
The technical review can start with a heuristic evaluation (check https://www.interaction-design.org/literature/article/heuristic-evaluation-how-to-conduct-a-heuristic-evaluation for details). Take into consideration digital literacy and
Do usability tests.
An example is the task scenario test in which you give participants a task and you observe them (check https://www.nngroup.com/articles/task-scenarios-usability-testing/). You can use the think-aloud method (check https://www.nngroup.com/articles/thinking-aloud-the-1-usability-tool/ ) and/or you can record a video of their interaction with the app.
Depending on your resources you will need to decide if you’ll bet in improving the outcomes of this early stage prototype or decide to develop a functional prototype and continue with more advanced design iterations.
There are many resources on how to implement UCD and you will most likely find a set of methods that will fit your resources and needs.
The design team should be multi-disciplinary and ideally include experts in: healthcare, human-computer interaction and computer science.
When the end-users are patients, their involvement needs to be carefully planned to avoid overload.
You can find an example of a first iteration of such design process in our work on ‘The Design of a Mobile App for Promotion of Physical Activity and Self-Management in Prostate Cancer Survivors: Personas, Feature Ideation and Low-Fidelity Prototyping’, which can be accessed here: https://ieeexplore.ieee.org/document/8104295/