Sep. - Dec. 2018
Premera Blue Cross
Vala is a three-month UX design project where I worked in a group of three for our client Premera Blue Cross via UW MHCI+D Ideation Studio. Premera presented us with the challenge that will help them broaden the understanding of the caregiver experience. Within this challenge, we narrowed our scope through a series of formative research to long term domestic caregivers whose loved ones have Multiple Sclerosis (MS). Although we settled on the use case of MS, we want to be sure that any solution we had would have the potential to be generalized for other situations. In the end, we designed a mobile-app based management and education system that assists caregivers in planning, completing, and asking for help with complex medical tasks. I led the UI/UX design and prototype testing and was involved in secondary and primary research, designing the information architecture and user-flows.
Vala is a management and education app that assists caregivers in planning, completing, and asking for help with complex medical tasks.
Keeping Track & Communicating with Doctors
Each week, Vala provides cargiver with a week-long medical task to-do list from their loved one's doctors.
It also gives smart time recommendation for the unscheduled tasks.
Learning with Confidence
Vala provides tutorials tailored to specific complicated medical tasks that aim to alleviate caregiver’s mental workloads as well as increase his/her confidence in performing such tasks.
Get Help from the Community
Vala provides an easy way for caregiver to assign tasks to other people they trust and a system that can keep track of the tasks that are assigned.
During the initial weeks of exploring the caregiving opportunity space, we conducted a lot of secondary research including reading medical literature, watching caregiving experience YouTube videos and reading related posts online platforms such as Reddit.
After the preliminary research, we defined a caregiver as a relative, friend, or neighbor who has a relationship with, and provides a broad range of assistance, for a person with a chronic or disabling condition. We chose Multiple Sclerosis (MS) Caregivers as the main use case to further explore the opportunity.
Multiple Sclerosis is a neurodegenerative disease that affects the entire body. MS patients usually experience chronic pain, cognitive decline, vision and gait issues, etc.
The two major difficulties MS caregivers are experiencing when taking care of their loved one:
Difficult nature of complicated medical tasks caregivers are required to perform.
The impact on quality of a caregiver's life when taking care of someone with an unpredictable disease means care is always needed.
Why Multiple Sclerosis?
In the Pacific Northwest (PNW), the rates of MS are
1 in 500 - twice the national average.
The cost associated with providing care for these individuals is high. It costs around $4.1 million total lifetime medical cost of a person with MS.
MS is not lethal, living only 7 years less than the normal lifespan.
Given Premera's focus on PNW, chronic management over long-term cares is of great importance to their business model.
Why MS Matters to Premera Business?
Multiple Sclerosis Prevalence in the U.S
Research & Synthesis
To better understand the caregiver's experience, our team conducted Cultural Probe by creating an interactive packet of activities with the focus on caregivers’ emotions towards the illness, loved one and related tasks. We distributed this in person and via email for caretakers to complete, and return. Six caregivers participated in the study. We also interviewed 8 caregivers to learn in-depth about their daily caregiving schedules and challenges.
of family caregivers are performing one or more complicated medical tasks.
“ These family caregivers are performing tasks in a home environment that would challenge even seasoned professionals.”
- Susan Reinhard, Senior VP, AARP
Caregivers are performing
complex medical tasks
We define complicated medical tasks as those that require specialized knowledge and would otherwise be performed by a medical professional.
In MS - complicated medical tasks such as localized injections, medication administration, and physical therapy are often completed at home.
Ideation Criteria: Address complicated medical tasks
Caregivers feel intimated by the care they are asked to perform. There is a desire for further training in order to feel like they are doing what's best for their family member.
Ideation Criteria: Educational benefit
of all caretakers weren’t asked what they needed to complete care tasks at home.
of all caregivers are afraid of hurting loved ones due to lack of education.
"The training is more typically written instructions that are handed to you as you’re walking out the door. Literally. You’re then supposed to know how to do this."
- Susan Reinhard, Senior VP, AARP
Caregivers aren’t given enough medical information
of family caregivers ask for help, leaving most caregivers overwhelmed and overworked.
“ Most of the caregivers work alone and we don’t ask help from other people...”
- Alzheimer’s Caregiver, From User Interview
reluctant to ask for support
Despite the fact that caregivers are overworked, they have trouble asking for support. With prolonged diseases like MS, it can be hard for people to continuously ask for help over many years. Even if they do have community support, it can be hard to coordinate their complicated schedules of appointments and medical tasks.
Ideation Criteria: Non-burdensome
Through interviews and competitive analysis, we found that many products on the market focus on only one aspect of caregiving. On a daily basis, caregivers end up having to juggle many products and systems, which can get really tiring. This is a very important insight for us, because we really did not want to create another single function product which would just make the lives of our users more complicated. We want to make things easier for them, not harder.
Ideation Criteria: Non-burdensome
"If it was something that would combine all the functions I need for caregiving, I would be able to afford it rather than paying for many things separately.”
- Family Caregiver, From User Interview
“ I can’t look through a million apps. I’m too exhausted and there are too many monitoring systems out there. Why can't we just have one?"
- Family Caregiver, From User Interview
Caregivers want one comprehensive solution
Project Scoping & Concepting
The focus of our product became clear while we were learning and building our body of research. Long term caregivers had some of the greatest and prolonged difficulties. They needed knowledge about tasks they could do at home and help organizing their busy schedules.
Providing a solution for long term caregivers that would improve their understanding of tasks, the ability to organize their lives, and reach out for help, could drastically reduce caregiver burden.
How Might We -
improve long-term domestic care experience that requires sufficient knowledge to perform complicated medical tasks?
Through a series of brainstorming and sketching activities, we came up with 90 ideas for how to address the long-term care responsibilities of caregivers. We then further specified our focus to helping caregivers support in managing symptoms. This led us to narrow and evaluate our ideas based on their effectiveness at:
We used the 5 criteria extracted from the research, which are what we believe is most important to our target users. We knew that our design solution must address medical tasks by educating users and instill confidence by giving them trustworthy information. Additionally, due to their busy schedules, we placed a strong emphasis on products that were non-burdensome. We filtered our ideas through this set of criteria using a 7 level Likert Scale (from -3: highly unlikely to 3: highly likely) and narrowed down to one idea.
We then used the 6 thinking hats technique in addition to the data from the down selection criteria matrix to narrow down to the three ideas we felt best addressed our problem space.
Top 3 Ideas
This concept involves educating caregivers by breaking down complicated tasks into small, easy to comprehend items. Through a simple swipe-through, the caregiver can learn how to perform the medical tasks, so they feel more confident aiding their loved one.
Doctors directly assign tasks to the caregiver after each clinic visit. The AI system within the task planning app organizes and prioritizes task for the caregiver. Based on past doctor notes, the AI predicts items of high importance.
Remote Dr. Assistance
Digital interactions with healthcare providers to address caretaker concerns and alleviate the time commitment of doctor visits.
Caregiver education is a mobile application which provides smart alerting and medical guidance for complicated medical tasks based on doctor recommended treatment plans.
Prototype & Testing
Our narrowing translated into an intelligent calendar and created the paper prototype to test the concept. This app would use AI to fit the tasks into the caregivers’ calendar, taking some of the burden away from our stressed users. The task items on the calendar would include tutorials and information from the doctor to help the caregiver.
We tested our prototype with 8 participants. They were all caregivers, some with the professional care experience. They were asked to complete the following tasks:
Open the task list for Monday
Resolve a schedule conflict
Complete the blood pressure tutorial and task
Our objectives of these testings are:
Understand how the user attributes value to the scheduling, tracking, and education features
Discover the users’ goals when using different app features
Determine optimal flow based on users mental model
Key Design Problem: Calendar might not be the right solution, but on the way!
We had an idea that resonated with our users and could really help them learn and keep track of tasks. This idea is especially highly beneficial for new caregivers or new tasks. However, a calendar concept might not be the best solution. Main reasons are as followed:
Caregivers don’t really keep their calendar updated, and there are unpredictable technical issues as well. One caregiver from our testing recently lost all the information on her Apple Calendar and she was really leery at this point for using digital calendars.
Caregivers has different calendar platform and medium preference that it would be difficult to convert them to one single platform and have all their daily schedules in one place.
Our focus is on complex medical tasks, integrating adult daily living tasks into our design might take away this focus.
"I use my iPad calendar and on my phone. I'm going back to my hardcopy calendar because I have lost so much information on these electronic programs… I'm really, really frustrated...”
- MS Caregiver, From Prototype Testing
Insights & Decisions
We changed the key design concept to a medical to-do list instead of a detailed caregiver calendar.
We expanded our AI to manage conflict resolution by automatically assigning task to secondary caregivers.
View and management of notes is a vital part of the design. This could be used as a communication method between multiple caregivers.
AI could control the tasks and tutorials so that the user is given the correct information for that specific day and task.
We designed the medical-to-do list and minimize the usage of the personal calendar as well as users' daily task customization. Our experience starts when the caregiver receives the weekly to-do list from their loved one's doctors. This list provides the caregiver an overview of all the medical tasks that need to be done this week as well as smart time recommendation for the unscheduled tasks. The caregiver can check out the tutorials anytime they want to review what they need to perform this week. They can also assign tasks to other people they trust when scheduling conflicts occur. Through this experience, our Vala app aims to make caregivers feel more empowered to manage their responsibilities and can focus on quality time with their loved ones.
View UI Specs
Vala Site Map
1. One Comprehensive Solution
"I like the idea that some of the tasks are being initiated by the doctor. I wouldn’t have to keep reaching out to the doctor." - MS Caregiver
Our testing with the MS caregiver showed that the overall idea of medical tasks being initiated by the doctor is the right direction, because it saves caregiver’s trouble of reaching out to the doctor.
Weekly Dr. Summary User Flow: From the weekly summary from the doctor, users can select a task and confirm the scheduling of tasks based on Vala’s AI suggestion.
2. Caregiver Education for Complex Tasks
"I do like the idea of tutorials, it reassures you… It’s better to have that compared to going through a lot of medical documents." - MS Caregiver
MS caregiver like the idea of tutorials because it gives her confidence in performing specific tasks. Use “give injections” as an example, even though the caregiver went through specific training about it, but because it’s a weekly task and each week the injection has to be done in a different location, therefore, providing tutorials tailored to specific task will alleviate caregiver’s mental workloads as well as increasing his/her confidence in performing specific tasks.
Completing a Task User Flow: From the task to-do list, users can select the task they want to complete, go through the tutorial, write notes to send to the doctor, and mark the task as complete.
3. An Easier Way to Ask for Support
"It would ease my mind knowing that I could leave him to other caregivers … I can see xyz tasks is done by other people, and I will be notified of everything." - MS Caregiver
The MS caregiver in our usability study thinks this feature would ease her mind, especially given the fact that recently, she’s thinking about going back to work and hire a professional caregiver to take care of her husband.
Ask for Help - Primary Caregiver: From edit mode, the caregiver can reassign a task to someone else by emailing them a care request. When they accept, the task will switch assignment to the secondary caregiver.
Ask for Help - Secondary Caregiver: The secondary caregiver receives an email notification with a request for assistance. If they accept, a second email will be generated and users can view an online version of the task details.
Vala's Future Usage
In addition to MS, we found Vala would be useful for both long and short term care, especially for the first time, unprepared caregivers to help them keep their days organized. But from our study, we did learn that eventually, caregivers might grow out of using it once they are familiarized and feel comfortable with performing the complex medical tasks independently. Therefore, from this perspective, we see that Vala will also bring values to short term caregivers who will need to learn and perform a lot of new, constantly changing medical tasks in a short amount of time.
What I Would Do Differently
If given more time, I would reach out to the caregiver community early on in the process to further understand their needs. I would explore more from the doctors' side to see their frustrations and how to connect the caregiver and their loved ones' doctors closer together. We realized that it might not be realistic for doctors to send out notes weekly for each patient. In this case, nurses would send out the weekly notes.
Vala uses an approachable style to come across as lighthearted while simultaneously building trust.
Caregiving is an emotionally taxing responsibility and the burden should always be placed on the system and not the user. Vala must be respectful of the sensitive nature of the situation.
Through planning and education, Vala empowers caregivers to feel competent in their ability to manage care.
The system of type is built using a rounded geometric sans-serif type and a contemporary sans-serif type to convey a relaxing yet reliable feeling.
We chose a muted aquatic color palette for the main features of the platform. This inspiration comes from the fact that whales (Valas in Finnish) are one of the few mammals who care for their elderly.
Caregiving is difficult, and we want to emphasize the fact that everyone needs help and some of the best care is performed when people work together. Vala aims to be one of those helping hands, keeping our users on track and more informed so they perform better care.
We chose to use minimalist cut-out illustrations in order to create detailed images that feel approachable and avoid medical realism. Illustrations are used for tutorials and profile images.