Bariatric Surgery Decision Aid is a patient-centric application that informs patients about various bariatric surgery procedures and aids them in making an informed decision.
I and my team were participants of infoLab, a School of Information initiative. We worked as designers and consultants for an Ann Arbor based healthcare technology company called ArborMetrix. "Outcomes Calculator" is a website which belongs to Michigan Bariatric Surgery Collaborative (M.B.S.C.), and is maintained by ArborMetrix.
The outcomes calculator requires physician guidance and misses an opportunity to educate patients and help them select a “best fit” surgical choice.
Outcomes Calculator is used to inform patients about various bariatric procedures and the risks related to each procedure taking into account their illnesses and demographics. This website is used by the physicians during an appointment with the patient.
Some major issues concerned with the previous website were :
1. Not patient friendly
2. Unorganized content
3. Confusing interactions
4. Required a physician presence
In order to make the website more patient-friendly, we interviewed our stakeholders to determine the goals. We had to understand the objectives behind the previous Outcomes Calculator in order to make it more user-centered. After talking to the stakeholders and understanding the previous platform we decided to address the problem from usability as well as a business point of view. We understood that the outcomes calculator was the main sales application of the ArborMetrix. Hence, we had to take that into consideration.
1. Making the Outcomes calculator more patient centric will allow the user to access the website in the absence of the physician
2. Application needed to be clean and easy to use.
3. Educate patients about various bariatric procedures.
We mapped out the various interactions the physician/patient needed to make in order to get the results. The whole website has 4 main interactions-
1. Procedures: which takes into account the surgeries a patient is interested in.
2. Demographics: which takes into account the weight, age, and other factors.
3. Comorbidities: which takes into account the illnesses the patient is suffering from.
4. Other risk factors: which takes into account influential factors like smoking and mobility aid.
1. Decision aids are well received by patients and significantly increase patient knowledge.
2. Physicians reported decision aids facilitated communication with patients.
3. Informational tools need to describe the standard treatments, risks and benefits of each treatment, and lifestyle implications.
4. Pictorial information is an important component in a decision-making tool.
We referred to blog, articles and videos of people who had undergone Bariatric surgery in order to get insights on pre and post surgery issues. These are some of the insights we got -
“I was also deeply ashamed of it [my body].”
- Women's Health Magazine
“Even though I was a little scared, I saw the surgery as a rebirth of sorts, the solution to all my mental and physical pain.”
- Women's Health Magazine
“Some did not like the way they looked. It was not enough weight loss, or they were not aware — although it had been part of their presurgery education sessions — that they would end up with big flaps of loose skin that could be gotten rid of only with extensive and expensive plastic surgery.”
- The New York Times
We studied various health applications and decision aids in order to understand the requirements of the Outcomes Calculator.
Based on the research insights and the literature review we conducted,we built up a persona called "Martha". Martha is an amalgamation of real world goals and issues of people who want to undergo a bariatric procedure.
We brainstormed components and ways we could implement the learnings from our research. We tried to figure out ways in which we could improve the user flow of the website.
1. We decided to add a few steps to the existing user flow of the Outcomes Calculator. After our literature review, we understood the need of implementing a "Decision Aid" as opposed to a calculator. This decision was influenced by the goal of educating the patients instead of helping them pick a bariatric procedure. Decision aid would educate the users about procedures in a holistic way by taking into consideration pre and post surgery requirements as well.
2. The second major decision we made was to introduce a "General comparison" and "Personalised comparison". The General comparison would provide users results, by taking into consideration similar demographics. The Personalised comparison would provide users results based on the selected health issues and other risk factors with consideration of demographics.
3. We decided to add a Summary page at the end of the decision aid. The motive behind adding a Summary page was to help the users get all the information in one page which he would either print and take it with him during a physician visit or email it to his physician.
To test our user flow we created a low fidelity prototype using Figma. Lo-Fi prototype allowed us understand interactions and visualize the whole process flow without expending too many resources.
By conducting guerrilla usability tests we wanted to gain insights on process flow, interaction clarity and user efficiency. We could not conduct any usability tests with the actual potential bariatric patients, hence we resorted to conducting them with users of various demographics. In order to get the user into correct mind set we followed an interview script and encouraged user to think like "Martha"(Persona) would. We mainly tested the prototype with the students from School of Information. In total we conducted 4 usability tests which helped us understand key issues with our process. We received great feedbacks from the participants.
“I did not see the tab switches between General comparison and Personalised Comparison”
- Participant 1
“I feel like there will be a lot of text.”
- Participant 2
“How do I go back from General comparison / Personalized comparison to the initial Comparison page?”
- Participant 4
This project mainly helped me understand how things work in health informatics sector. This project taught me the usage of literature reviews when contextual inquiry with the users was not possible. It helped me understand ways to acquire information through guerrilla usability testing on random users when the actual users were not available.
We have received a positive feedback about design solution from the adminitrative, medical as well as sales team at ArborMetrix. Right now, ArborMetrix plans to use the High Fidelity prototype during the Sales meetings of the company, in order to generate customers for the upcoming product. This project will be further developed by the ArborMetrix's development team.