MAYO CLINIC - SHARED DECISION MAKING

Duration: 7 weeks | Team: 2

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. Thus, the question is, "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?" This system has been created in collaboration with the Mayo Clinic.


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.

How the physical cards facilitate conversation


PROBLEM SPACE
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:

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.

Issues with flexibility and 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.

Real-estate: 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.

Memory load and tedious shuffling: Since the cards need to 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.

After considering the four primary problems mentioned above, we decided to design a digital version of the cards since it would help eliminate almost all of them.


MY ROLE
Design ideation and brainstorming, sketching, user research, creating initial mockups, iterative design, visual design, interactive prototyping and communicating ideas.


THE PROCESS

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.

Initial brainstorming

After understanding the domain, my team mate and I carried out multiple brainstorming sessions.




Iteration 1

After coming up with multiple possibilities, we decided to narrow our attention down to three ideas:


Idea 1


Idea 2

Idea 3


Feedback and Iteration 2

We presented our ideas to the Mayo clinic and received feedback such as:
Idea 1: 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.
Idea 2 and 3: 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 feedback helped us understand that the interface needs a clear sense of hierarchy and is still not successful in inducing conversation.


Iteration 2: Idea 1


Iteration 2: Idea 2

Feedback and Iteration 3

We presented our ideas to the Mayo clinic again and received the following feedback:
Idea 1: 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.
Idea 2: 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.

Iteration 3




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 design (using tools such as PowerPoint, Axure and Marvel App):

After going through two more iterations of making minor visual and interaction design changes, we created our final design.









Use case of the final product

In order to pitch the final product in a compelling manner, we created two use cases of the app being used.


Storyboard A:

Patient and doctor explore issue cards together, and doctor highlights two treatment options based on explored issues, without a concrete option in mind initially. One medication option is left highlighted and one is crossed out, after previously being considered, due to a prohibitive factor (i. e. cost is too high for the patient).


Storyboard B:

Patient comes to the visit with a specific medication option in mind, and the issues are explored based on patient interest and with a focus on the medication. After viewing potential unwanted effects of this medication, the doctor suggests an alternate option based on issues important to the patient. Patient finds the alternate option to satisfy their expectations and needs. Explore the storyboards in detail here.


Interact with the prototype here


Check out the process book


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.


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