Change is Good.
The next big step for medicine may not be systems-focused innovation— but simple and patient-focused.
Having possessed a dogmatic interest in biological science since I was about five years old, I find inspiration in white tiles and fluorescent lights, scrubs and lab coats, sterile equipment and strokes of obsession and genius. My heroes? The doctors and nurses I worked with in the ER of a metro hospital, who tirelessly evaluated patients and solved the toughest, highest stakes problems. Scientists like Jonas Salk: who developed a vaccine for polio and ensured its affordability for generations, and Akira Endo: who we have to thank for livesaving statin drugs.
Yet, innovation in healthcare is a tiring subject. The tug-of-war between “technology for technology’s sake” — sometimes driving up prices within systems that think too little about their users — and systems that refuse to push forward — somber about the risks, somber about change, somber about the cost — academically minded and rigid in their traditions.
While not all issues facing medicine can be solved with new apps, surgical robots, or AI diagnostic tools, all do require a large leap forward in one way or another. Change is hard, and in medicine, “dramatic leaps forward” are remembered with the cost of innovation — sometimes patients who were willing to be the first to try, the unsung heroes of the field who will never be named. But many issues can be solved by patient-focused tech, and it has become my primary focus to develop systems with this in mind.
With the increase in the use of tele-health tools by major healthcare providers and hospital systems, the time is perfect for a tool for their patients, too. In order to provide control, and a tool that gives the patient access to and an understanding of their health, I have developed the idea for an app that acts as a risk and progress tracker across mental and physical health domains. Able to sync with users’ favorite fitness & calorie trackers, as well as (eventually) their doctors’ patient portal system, this app would aim to provide digest-able information regarding the implications of test results, fitness progress, and more: providing the user the opportunity to take control of their health. While not a diagnostic tool or an alternative to accessing healthcare, this would be a big step forward towards improved health and preventative care.
Analyzing the Possibilities:
When considering anything new, there’s an element of timing: is the world, or is my society, my audience, ready for this? Often, using a PEST (or, Political, Economic, Socio-cultural, and Technological) analysis is a good place to start.
Political Implications:
Considering that the user would enter their own information or provide permissions for the app to access their healthcare provider’s portal, HIPAA considerations aren’t a barrier to the development of my product. App security would be a priority, necessarily. There are guidelines set forth by the FTC (a list of which can be found here), and it would be necessary and honest to disclaim that this is not a diagnostic tool and should not be used in emergencies or as a replacement to accessing a licensed provider. With this being said, these regulations would protect users, rather than deter the development of such an application.
Economic Implications:
The world, and particularly the Western corner of it, is shifting. With many Americans now working from home, and millions of others out of work, there is the need for a product that is both economically and physically accessible. Creating an app with a “freemium” pricing structure that still enables free users to access key features would be necessary to ensure that anyone can access this application regardless of economic situation.
Socio-cultural Implications:
There is a corresponding socio-cultural shift related to the economic shift described above. Increases in tele-commuting and the use of tele-health tools and patient portals are only a portion of what seems to be the new normal. In the midst of the pandemic, users are finding themselves faced with navigating their own health without access to many in-person, non-emergent services, and many are facing stress due to isolation, worldwide uncertainty and instability. According to Google Trends, there has been a steep increase in interest in personal health since February 2020, inclusive of fitness, preventative care, and mental health. This demonstrates the need for a service that alleviates some uncertainty while providing the user with ways to understand and track their physical and mental health, in one place.
Technological Implications:
There are no broad technological implications of such a service — the tech exists for this product to come to fruition, and users are used to similar services.
Competitive Analysis
While similar services exist, there are none that do exactly what I intend to. There are parts to the whole — general symptom checkers, informative medical sites, fitness trackers, and mental health apps that allow for journaling or simple stress relief exercises— but there are no comprehensive applications that are comparable, leaving a gap the perfect size for this product to fill. The diagram below illustrates where competitors exist along target spectrums, and the gap I intend to fill with my application.
Focusing On The User
The next step for development is understanding how our users feel about this landscape, evaluating their needs and challenges, and conceptualizing how our idea meshes with solutions to user problems. In other words, we must conduct user interviews to check if our idea is as good as we think it is.
My interviewees spanned age groups and their experiences with and interest in their own health varied. When asked what aspects of their health were most meaningful, most of the individuals I interviewed responded with a combination of weight, fitness and eating healthy. There were a few other common answers as well: approximately 80% of users interviewed already use fitness or health tracker apps, and reported that they liked the general usability and features, but overall didn’t have much feedback on the typical tracker apps (such as CalorieKing or my FitnessPal). However, those that used wearables — like Fitbits, Apple Watches, and Samsung Watches — reported being motivated by reminders to get up and move and appreciated the more overall view of their health with features such as heart rate and sleep tracking. This same group that had experience with health and fitness trackers mentioned that there was still an aspect of personalization that was missing. For example, a few users mentioned that they would prefer an app to be able to tailor recommended macronutrient or exercise goals, and one user mentioned that she would like to understand her personal progress better as it related to a chronic illness and total-body health.
When diving deeper into user motivation, users provided some interesting insights. Most users reported finding graphical readouts interesting and beneficial in terms of understanding information, but said that they were more motivated by the animations, vibrations, and praise they received from their wearables after completing a task. This helped me to understand how to maintain engagement and excitement within the context of my product: personalized and positive, engaging reinforcement are the best motivators.
Two of the most insightful questions I asked my users were: “What motivates you to maintain or pay attention to your health?” and, “Are there any aspects of your health that you’d like to understand better, and why?” The answers encompassed both long and short term quality of life unilaterally. This answer held the key to one of my main operating hypotheses: when given the opportunity, people want to take care of themselves. Answers to the second question varied, but indicated that all of the users I spoke to are interested in many facets of their own total health, but lack the understanding of how to go about managing these facets. This was key to my second main hypothesis: if given more well-rounded information about how systems work together, users would be interested in maintaining and improving the whole system, rather than just focusing on one part (i.e., calories, or cardio).
Mind Mapping: Finding the Best Route to a Solution
Now, how do we take all of this information and generate a useful solution?
One tool that I used during the process of developing this app was a mind map. Similar to the brainstorming exercises you may know from high school English classes, a mind map allows you to visualize connections between different ideas, eliminating ones that may not fit and generating more that may be useful.
The overall conclusion that I have come to, based on my user interviewing process and mind mapping is that while many aspects of my app should be scaled down in initial releases, the timing and market atmosphere are conducive to this idea taking hold and benefitting users. My primary focus, with the first iteration of my application, is increasing the users’ understanding of their total health and how to maintain it — and therefore their agency to do so. This would in turn increase the users’ ability to take preventative measures as well improve outcomes from physician intervention when necessary.
So, Where do We Go From Here?
I am going to help users interested in maintaining their own health achieve better progress and a greater understanding of their total health through an app that integrates data from their current wearable or fitness application and generates personalized and social challenges, goals, and information relevant to their overall health and progress. This app aims to provide agency and understanding, with minimal disruption to one’s current wearable or tracker ecosystem. By integrating users’ current apps, it offers the option to switch to my app completely OR continue using their current wearable ecosystem, but have a comprehensive dashboard and social space to view data, get informed and stay motivated.
User Journeys — Further Understanding our User’s Goals
User journeys are a tool often used by UI/UX designers, and are used to understand how to solve our problem for our target customer. The goal is to, as it is put in this article “take an empathy walk” with our target customer or client, and understand what it would be like to use our application from their perspective. Additionally, we want to understand what their goals are and why they might look for our application or website. Understanding this helps us then wireframe, design, and develop our application with the user in mind.
Current Wearable User Journey:
I use a Fitbit and Apple Health, but I wanted to learn more about my health and what all of this information means. Why 10,000 steps? I know I should get up and get moving, but are there other intermittent exercises I could do to meet my goals faster? I found TotalHealth, signed up, answered a few questions about my goals, and was able to sync my data from my other apps. From there, I was able to access personalized and local social challenges in my profile and feed, and see a breakdown of my progress over time in my details, with a summary of what it means for my overall health. This has really helped me stay motivated, and I’ve even started drinking more water now that I understand how important it is!
New to Fitness Tech User Journey:
I was struggling with motivation to exercise, but my friends told me about TotalHealth. Some of them wear Fitbits or Apple watches, but we can all sync our data and compare our mileage and progress — which has kept me accountable to our running challenges! There are also local challenges on the explore page, where we can compete with other runners, and even weightlifters in our area! Since I have them to keep me accountable, I find myself really enjoying getting out and running now.
Understanding the paths my users might take to sign up, and their motivations for even seeking out an app like this helped me to consider how to then begin to design the application.
Wireframing
Below are some images of wireframes for some of the pages and features that would be present on the application. In order to keep it motivating and engaging, visual UI’s and a simple sign-up and integration process would be necessary. Additionally, I seek to create a news feed much like the social media apps we’re all used to in order to encourage socialization, social positive reinforcement, and friendly competition. These are all aspects that should help keep users motivated and loving their experience on my app!
Moving Forward
Inspired by the mavericks of medicine, I have shifted my career focus to developing the skills to find solutions to complex problems in healthcare. I started by considering a simple, non-disruptive solution to a big problem. Throughout my journey and research, I have shaped my idea to better suit the users it will be built for. The next step is to begin development, in stages, on this application, beginning with the key features and building it up to the ideal product that I see as the beginnings of a solution towards patient centered care and greater accessibility.
