MAYO CLINIC DECISION AIDS
Team: 2 | Duration: 7 weeks | Read time: 10 min.
"How can conversation be facilitated between a patient and a doctor to ensure that the patient gets treatment that is best suited for his or her own benefit?"
Patients and doctors have varied sets of expertise when it comes to making consequential clinical decisions. The patient knows his or her own body well and the doctor has more in-depth knowledge about medication and treatments for certain conditions. Conversation drives the relationship between a patient and a doctor, gives the patient that sense of comfort and allows the doctor to understand what the patient needs. One such use case where conversation is key, is with patients undergoing depression. They need to be well informed about how medication can not only help them cope with depression but how it affects their sleep, weight, libido, budget and other factors. This system has been created in collaboration with the Mayo Clinic.
Design ideation and brainstorming, sketching, user research, creating initial mockups, iterative design, visual design, interactive prototyping and communicating ideas.
Studying the current system
The Mayo Clinic's Center for Innovation has created paper cards called 'Decision cards' that doctors use to identify how different medicines can affect the patient's lifestyle and daily routine. Each of the cards represents a particular factor (sleep, weight change, sexual issues, cost, stopping approach) and crosslists how different medicines affect that factor. The effect is calculated on a scale - positive, negative or neutral. The patient and doctor use these cards to decide what factors matter most to the patient and then narrow down medicines that will best suit the patient's needs.
Issues with the physical cards
Although the physical cards are successfully introducing conversation between physicians and patients, the physical nature of the cards poses many problems to the overall system.
| Memory load & tedious shuffling
Since the cards need to be physically shuffled to compare various factors, a memory load occurs for both the patient and the doctor in remembering what they want to look at.
| Issues with flexibility & scalability
Since the cards are in a physical form, it is not easy to update the information presented on them. If a medicine is suddenly banned, a whole new set of cards needs to be designed and printed to accommodate that change.
The availability of space on a physical card can be very limiting and there is little to no scope of adding new features or increasing the amount of information.
| Printing cost
The cards need to be printed and distributed in color to doctors all over. This is an added expense to the clinic's budget and does not prove to be the most economical solution to the problem.
Understanding the domain and users
Before bringing out our markers and sketchpads, we did extensive research about patients undergoing depression, how the decision aids help or hinder their ability to make decisions and how conversation can be facilitated using these aids. Our research included viewing videos of the cards being used (shared with us by the Mayo Clinic), reading articles and carrying out a comparative analysis of other decision aids out there.
After understanding the domain, my team mate and I carried out multiple brainstorming sessions.
We went through three rounds of iterative design to come up with these ideas
Iterative testing and feedback
During this process, we regularly presented our ideas to the Mayo clinic stakeholders since access to actual patients was difficult due to confidentiality of their personal information. Feedback included was:
The colors are too soft, it is hard to decipher what holds authority, the heat map may not be the best solution for viewing effects on a scale.
The scrolling may cause patients to miss out on information if they do not see all the information on one page, think about what is important instead of finding/choosing the ‘optimal medication.’
The "View medication profiles" interaction may be unnecessary because it may not flow well with the overall interaction, make the selection and deselection of items more apparent.
Sorting cards according to ascending and descending values is a very useful feature, keep an icon to remember which card has already been selected or compare more than one card at a time, try to show multiple cards on screen.
The feedback helped us understand that the interface needs a clear sense of hierarchy and is still not successful in inducing conversation.
User testing and final design
Highlights of testing:
The interaction of the cards sliding in is very intuitive and easy on the eyes
The design seems more medicine-centric than issue-centric
The drug names do not look like they belong in the same section as the cards
The system successfully induces conversation
FINAL FEEDBACK AND TAKEAWAYS
"The prototype can be submitted to Mayo Clinic as a final product."
Iterative prototyping gets harder as you get to the end of the process.
Never get too attached to ideas, be open to taking risks.