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Image by Oleg Laptev

Virtual Community

Healum • Digital Healthcare • Behaviour Change

INTRODUCTION

One of the main challenges for Healum was to make people want to use the app. This is the common challenge that many digital healthcare startups face: self-management of long-term conditions such as diabetes requires patients to learn the ins and outs of the condition, monitor symptoms and activities on a daily basis, not to say make positive lifestyle changes in a pretty short period of time. The app provided users with the tools to make a positive change but it was not motivating people enough for it to be used on a daily basis.

      At that time, Healum started this project with the aim to increase user engagement with the app. The goal of the first phase, presented on this page, was to do discovery work and then visualize some of the concept ideas that came out of the research.

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MY ROLE

Product Designer

User Research, Visual design

July 2021 - Nov 2021

1. Background

Healum is a digital healthcare startup based in London. The suite of Healum products consists of...

  • a patient management system that ‘enables healthcare professionals to improve outcomes for people with multiple long-term conditions and deliver care more efficiently.

  • a mobile application that helps patients stay connected with their care team, set health-related goals, and monitor health metrics to make the best possible choices in their daily lives.

I joined Healum as a sole product designer a year ago. After a few months when the team started working on this particular project I was leading the discovery process conducted by another designer. I was responsible for leading the ideation process as the final output of this phase.

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        “Healum’s mission is to enable people with long term conditions to live longer, healthier and happier lives by supporting them to make positive daily choices.”

MY ACHIEVEMENTS

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I've grown a lot during this project, some key achievements of which I have listed in this deck...

 
 

2. Process

In general, Healum follows Double Diamond Theory with a strong emphasis on Behaviour Change - COM-B model principles are used to facilitate decision-making at every stage of the design process. For example, during discovery one of the important part is to identify behaviour ‘barriers’ towards the desired behaviour.

For this project, I incorporated the key phases of Discovery, Definition, and Early Ideation.

MY ACHIEVEMENTS

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        “Healum’s mission is to enable people with long term conditions to live longer, healthier and happier lives by supporting them to make positive daily choices.”

3. Discovery

To start with I reviewed users' and clients' feedback that the team received after the release of the app and uncovered a few concepts worth exploring further.

 

These concepts are:

  • A global community for patients to connect and exchange knowledge

  • Inviting family members of patients to allow them to support and motivate these patients

  • Gamifying the experience of the app to reward users for their achievement

Quite a few users expressed their interest in “a safe place for people like me”. That is why I decided to start the discovery work with the community idea.

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        We used the term “community” to define the place where people can connect (without defined functional requirements just yet)

3.1 Doing Secondary Research
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       Before proceeding to primary research I decided that it was necessary for the other designer to understand the context and get an idea of the factors affecting people's engagement in health-related communities. See image on the right

3.2 Defining Discovery Objectives

To proceed with primary research, I decided to conduct individual interviews with type 2 diabetic patients, aged between 18 and 60. The objectives of the discovery were...

  • To validate whether there is an actual need amongst users to have social interaction virtually with people on a similar journey.

  • To find out whether existing forums are missing anything which users need / want from a virtual community

  • To find out what unique value (if any) Healum's virtual community could provide compared with to an alternatives (i.e. support forums such as Diabetes UK)?

  • To find out how Healum users would feel about the community being open to any individual with similar health circumstances.

  • To find out what capabilities, opportunities and motivations would influence users’ decisions to engage in a virtual community.

3.2 Defining Discovery Objectives

6 participants were interviewed to address the discovery objectives. A summary of the key needs is presented below...

  • A need to have a safe place where they can connect without worrying about being judged. A closed community to share knoledge and motivate each other

  • A need to get a sensiere advice from people who can understand them better than anyone, people with similar problems. Participants claimed that doctors sometimes seem to be indifferent to their problems, do not have enough time to discuss certain issues. Also different doctors suggest different strategies which makes it even harder to make weighted health decisions.

  • A need to meet people with similar interests and problems. One participant mentioned that she’d want to have a buddy from Indian community to share Indian recipes with her.

  • A need to get motivated by people with similar health issues. This is interesting as the research also shows that people do come to communities for inspiration when they are doing ok, and to observe failure at the bad times.

  • Participants who have been diagnosed a few years ago and who made some progress expressed their desire to help others. A really good example is Vance. Watch a video of his unbelieveable body tranformation.

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4. Understanding user needs

Using the insights from the discovery, I decided to express user needs in a Jobs To Be Done format...

  • I want to feel comfortable sharing my personal sensitive experience without being afraid of receiving abusive comments from other members.

  • I want to get advice from people who went through a similar journey to understand what I can do about it. Different doctors say different things - I don’t know who to believe and it feels like they don’t really care that much.

  • I want to meet people who have the same health problems as I do to be truly understood for once.

  • I want to get inspired by people who succeeded in managing their diabetes

  • I want to coach others to show them that having a long-term condition is not the end of the world, and they can do it if I managed to.

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       People want to engage with others, but at the moment they do not have a safe place where they can do it. They also do not have the opportunity to connect with people with similar interests, ethnicities to satisfy their individual needs, etc.

4.1 Updating personas
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       Using these jobs to be done I have created 5 personas representing different user groups affected by diabetes and obesity.

  • Beth

  • James

  • Tanya

  • Vance

  • Jackie

 
 
4.2 Behaviour Change Lens

As the jobs to be done were defined it was important to look at them through the lens of the COM-B model. The aim was to capture behavioral domains that were relevant for these Jobs.

DOMAINS

JOBS TO BE DONE

  • Emotions affect users motivation to continue working towards a healthy goal. Positive emotions and feeling of security 

I want to feel comfortable sharing my personal sensitive experience without being afraid of receiving abusive comments from other members

  • Knowledge. Users should know how to achieve healthy goals.

  • Social influence. Users observe what other people with similar goals are doing and how they achieve goals.

  • Environmental context. Having the ability to meet people with similar health goals. Have the necessary tools around to achieve healthy goals

I want to get advice from people who went through a similar journey to understand what I can do about it. Different doctors say different things - I don’t know whom to believe and it feels like they don’t really care that much.

  • Environmental context. Having the ability to meet people with similar health goals. Have the necessary tools around to achieve healthy goals

I want to get advice from people who went through a similar journey to understand what I can do about it. Different doctors say different things...

  • Social influence. ​People with experience who went through the same journey can influence others

I want to get inspired by people who succeeded in managing their diabetes.

  • Social influence. Users want to act as role models to get some recognition

I want to coach others to show them that having a long-term condition is not the end of the world, and they can do it if I managed to.

      This helped me then match the domains to well-performing intervention techniques that can be used in the design. See below...

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5. Ideating Design Solutions

Before ideation, I categorized ways of how people interact with each other online. Below is the screenshot which emphasizes the pros and cons of each method.

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METHODS OF COMMUNICATION

  • Verbal

  • Image/Video based

  • Reaction based

  • Observation

5.1 Closed circles

Purpose: to create a virtual place for people with the same health objectives/backgrounds to be able to connect, review the progress of each other, support each other and engage in common activities. Social learning & facilitation, recognition, competition

In a closed circle, members will be able to view...

  • Engagement highlights of its members (automatically posted)

  • User progress and activities (posted by users)

  • Prompts (automatically posted)

  • Messages and activities posted by doctors (posted by doctors)

In a closed circle, members will be able to react...

  • By selecting a reaction in a form of emoji.

Behavior science lens: Providing a commonplace for people to observe each other's progress encourages social comparison and provides people with the means of understanding the benchmark for certain behavior. This in turn should motivate people to achieve higher results. 

Reactions are forms of body language and facial expressions transformed into an online language. A positive reaction to a certain behavior is positive reinforcement for it. Not only do they provide us with a social reward but also a variety of these positive reactions (e.g.love or thumbs up emoji) can convey a certain mood and emotions from other people. In addition, emojis are widely used and are well-known by the majority of smartphone users suggesting a steep learning curve.

BCTs USED

  • 2.1 Monitoring of behaviour by others without evidence of feedback

  • 2.5 Monitoring outcome of behaviour by others without evidence of feedback

  • 3.3. Social support (emotional)

  • 6.1 Modelling or demonstrating the behaviour

  • 6.2 Social comparison

  • 6.3 Information about others’ approval

  • 10.4. Social reward

  • 13.1. Identification of self as a role model

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This solution is for... Users post their achievements and results to get some recognition from the circle. This can be a particularly powerful feature for those users who have already made some progress like Vance or Jackie and are ready to coach other people.

 

Or for people like Tanya who would benefit from social support coming from people with the same health objectives.

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5.2 Community challenges

Purpose: to motivate people and reinforce their engagement with the health objectives they set for themselves. Sharing a challenge with partners is meant to help people...

  • Feel that they are not alone in this journey

  • Commit to the challenge as others are involved

  • Motivate to achieve better results

  • Raise their confidence and self-efficacy

In a closed circle, members will be able to...

  • Initiate challenges

  • Share challenges with other members of their circle

  • Join existing challenges shared by other users, doctors, or the app

  • Monitor general progress of other users

At the end of the challenge, users will be presented with a leaderboard with the top 3 performers.

BEHAVIOUR SCIENCE LENS

  • 6.2 Social comparison

  • 10.4. Social reward

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Providing a common place for people to observe each others progress encourages social comparison and provides people with the means of understanding the benchmark for a certain behaviour. This in turn should motivate people to achieve higher results.

This solution is for... Social pressure and comparison (6.2) motivate people to perform the behavior. Some people like Vance, James, and Beth want to meet someone to be accountable to, as this will help them stay committed.

 

Beth is the person motivated by reward ,and she'd also get a motivation boost by getting on top of the leaderboard list (10.4)

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5.2 Patients' Stories

Purpose: to lead by example and introduce people's stories to show the progress of other people and how they reached it, what tools they were using. If a user monitored certain metrics or completed health goals in the app, his story will display this information and will provide people with the opportunity to start doing the same. Stories are based on the profiles of people from a closed circle.

Members will be able to...

  1. Track their meals/exercises using photos and then post them to stories

  2. View engagement highlights and members' progress from the community feed (2.5, 2.1)

  3. See how many people viewed and reacted to a story (10.4)

BEHAVIOUR SCIENCE LENS

  • 6.2 Social comparison

  • 3.3. Social reward

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This solution is for... A story is all about individual progress wrapped in a short and engaging presentation. It is meant to really emphasize individual progress and give people some recognition (10.4). Those members who achieve positive outcomes will be able to share what they did with others - lead by example (6.1). This feature will be particularly useful for Vance and Jackie.

 

Newly diagnosed or prediabetic patients like Beth and James will get the support they need to start building healthy habits and giving up on the bad ones (3.1, 3.2, 3.3).

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6. Challenges & Questions

By the end of this ideation I have a pile of questions to answer before we could even start testing some of these. Some of them are...

  • Is there a way of using individual and group chat functionality that is currently present in the app to form closed circles? At the moment chat only allows having an individual chat with a doctor as a group chat facilitated by a doctor. The current version of the chat has a few downsides...

    • Verbal communication that requires facilitation

    • Users can’t have a private chat with one another

    • Doctors don’t have much time to chat with their patients online

  • Shall we redesign the chat to fit the closed circles idea or what this new version would look like? Would people find it sensible to have chats and closed circles in one place etc?

  • Who would form a closed circle? Would that be Us? Doctors? or Patients?

  • Healum works with multiple clients - private and public companies that provide weight-management and diabeties-management programs. Should a closed circle mix people from multiple clients or should the access be restricted to a client?

  • Should the target for a challenge be the same for everyone e.g. drink 7 glasses of water today or should it be an accumulative target where everyone can contribute towards it i.e. drink 50 glasses a day (5 glasses per person max)

  • Is it safe to allow people to post images in their stories? How are these stories going to be managed? Is there a need for a facilitator?

And many many more...

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I am working on the next phases of this project, so stay tuned for the updates!