Better GI Mobile App

Improved Usability of Healthcare Intervention

25 to 45 million people in the United States suffer from Irritable Bowel Syndrome (IBS), an incurable but manageable chronic condition.

I collaborated with the team at the University of Washington (UW) Alacrity Center on their mission to manage IBS and mental health by transforming a research-backed, paper-based self-management experience into a more user-friendly, digital solution.

25 to 45 million people in the United States suffer from Irritable Bowel Syndrome (IBS), an incurable but manageable chronic condition.

I collaborated with the team at the University of Washington (UW) Alacrity Center on their mission to manage IBS and mental health by transforming a research-backed, paper-based self-management experience into a more user-friendly, digital solution.

Data-Driven Approach

Data-Driven Approach

Data-Driven Approach

OOUX Methodology

OOUX Methodology

OOUX Methodology

Continuous Improvement

Continuous Improvement

Continuous Improvement

background

The University of Washington (UW) developed a research-backed Clinical Self-Management Intervention (CSMI) to help individuals with both IBS and anxiety and/or depression. While the program demonstrated positive outcomes across three clinical trials, its paper-based format proved ineffective for user engagement.

The University of Washington (UW) developed a research-backed Clinical Self-Management Intervention (CSMI) to help individuals with both IBS and anxiety and/or depression. While the program demonstrated positive outcomes across three clinical trials, its paper-based format proved ineffective for user engagement.

Opportunity

Recognizing the need for a more accessible and user-friendly approach, the Alacrity Center at UW led the transformation and reimagining of CSMI as a digital solution that enhanced usability and patient retention while maintaining its proven effectiveness.

Recognizing the need for a more accessible and user-friendly approach, the Alacrity Center at UW led the transformation and reimagining of CSMI as a digital solution that enhanced usability and patient retention while maintaining its proven effectiveness.

the solution

One App. Complete Support.

Patients can now leave the paper behind and access a full, digital self-management toolkit - anytime, anywhere.

This holistic approach integrated lessons, activities and tracking across essential areas like: diet, relaxation, mindfulness and lifestyle.

Helpful Guidance For All.

Patients received personalized lesson content to support them with IBS regardless if they were newly diagnosed or had been struggling for a while. 

The app prioritized high-value content for all, with expandable secondary materials available for those seeking deeper support.‍

Stay On Track With Ease.

Eliminate the guesswork in navigating the intervention.

The app provides a clear, personalized path for each patient, offering helpful tips and motivation to keep them on track throughout their journey.

so, how did we get there?
so, how did we get there?

discovery

As this was a new problem space for me, diving into the discovery phase was crucial to building a strong understanding. I focused on reviewing existing data, exploring the complexities of the problem, and gathering valuable insights through client conversations to inform my approach to finding a solution.

Gathering & Analyzing

The client had already conducted a post-clinical trial user research study, revealing key insights into participant experiences with the existing intervention:

  • a low usability score of 52.5

  • common pain points around motivation and time commitment

Building on the user research findings, I performed an in-depth analysis of the existing paper-based intervention. Next, I collaborated with the team to conduct an comparative analyses of other behavioral therapy and learning management systems, identifying best practices and key opportunities for improvement. Simultaneously, I gathered critical product requirements through direct-stakeholder conversations, ensuring that our solution was aligned with both user needs and business goals.‍


Key insights

After analyzing the results from all points of discovery, our team synthesized key insights, confirming that mobile app delivery is the most effective approach for self-management therapy solutions. We found that the existing intervention's text heavy design increased mental load, diminished motivation, and created cumbersome, time-consuming task flows. Users expressed a strong need for a solution that seamlessly fits into their busy lifestyles. Additionally, we identified the most impactful elements of the intervention, providing clear direction for optimizing the experience.

onward to design exploration...
onward to design exploration...

initial design phase

Using the discovery insights as a guide, during the initial design phase, I focused on defining structure, reducing mental load and simplifying task flows.

Defining structure

One of the key discovery insights was that end users would prefer to engage with this healthcare intervention as a mobile app instead of a dense, paper booklet.

But, how do you even begin converting a 150-page paper document into a simple, streamlined mobile app?

Wrangling large amounts of information is a challenge I love. For sense-making problems, my go-to approach is the OOUX (object-oriented UX) methodology that maps system objects and how they interact. The OOUX Object Map is powerful tool for understanding the current state of the system, while also identifying how, where and when the system can improve over time.

I built the Object Map to identify the fundamental components and high-level interactivity of the system using ORCA:

  • Objects - What things make up the system?

  • Relationships - How will users navigate between the objects?

  • CTAs - What actions can a user take on each object?

  • Attributes - What content and metadata are included within each object in the system?

This Object Map evolved throughout the project and was instrumental in helping our team align on the basic information ecosystem of the app. It also facilitated important team conversations about the overall business strategy, information architecture, and design approach.

Reducing Mental Load

The original paper intervention, while informational, was very dense with text, making it difficult to digest. This would be very problematic in mobile format, so it was important to distill the content down to its simplest form. I worked directly with stakeholders on ways to distill the content, while keeping the fundamentals of the intervention.

The top goals were:

  • define the information architecture within each Module

  • reduce text while keeping the essence of the intervention

  • create a more engaging experience that would retain users’ attention.

To achieve these goals, I transformed the more traditional writing structure of the paper workbook into a simple, supportive narrative that resonates with patients of IBS.

During the process, I referred to the information structure defined in the Object Map. The intervention content was organized into Module objects, with Lessons and Activities being nested objects within the Modules. Our team worked directly with the medical stakeholders to categorize the content into 15 Modules (8 core, 7 optional), using findings from the clinical research and the user research studies to prioritize content.

After categorizing the content into Modules, Lessons and Activities, I began chunking and further distilling the information. Then I moved the content into screen wireframes where I could experiment with the sequencing of the information.

I collaborated with the creative team throughout the design of a medium-fidelity prototype, determining how the users will move through each section, keeping in mind the key discovery insights that users want their daily interaction with the intervention to be simple, fast and impactful.

Simplifying Task Flows

We learned from the user research that the existing program is too task heavy, requiring patients to spend time flipping through paper, bookmarking pages and making copies of forms. I looked for ways to simplify flows and reduce user time spent wayfinding.

The Sleep Tracking task flow is one example. The intervention recommends that the optimal time to log sleep details is first thing after waking in the morning, but the original intervention is too time-consuming.

The original flow was too lengthy and left lots of room for frustration and abandonment. Patients must track their sleep when they first awake, but it often required finding the right page, making a new copy of the form and manually reviewing the data across forms to identify trends.

In the redesigned flow, patients receive a notification on their mobile device when waking up. They tap on the notification taking them directly to that day's digital form. They complete the form and can either close the app or quickly view the real-time sleep report.

The result - no more finding forms, no more copies, no more searching for trends!

now...what do user's think?
now...what do user's think?

user testing

Study Details

Our UX team conducted a usability test that examined the overall usability and engagement of the app, while also assessing patient sentiment toward mobile delivery of the intervention. The study involved:

  • 8 participants, with varying experience with IBS

  • 10-day study testing the mobile app prototype

  • participants completed the onboarding, first 3 Modules of the program, and recorded daily tracking of symptoms

  • 3 post-lesson surveys were administered

  • an exit interview was conducted for each participant

The Good News

The usability score of the intervention increased significantly with the transformation from paper to digital mobile delivery.

3 Things to Improve

This study revealed many areas where we could continue to improve the experience. I focused on the following findings that most impacted the areas of structure, content and flow.

01 Continue Refining Information

Participants expressed varying need for the amount of information, tone of copy, and type of content. Participants tended to fall into 2 groups:

02 Improve Discoverability

When asked to return to a previous exercise, only 1/2 of the participants located the easiest path - through the Practice Tab on the menu. The other half of participants took a very long path, clicking through the corresponding Module to find the exercise. Users will need to practice exercises daily as part of the program, so it is important that the fastest path is clear.

03 Enhance Engagement

Because of the subject matter and length of this program, stakeholders worry about the risk of abandonment. When asked, participants noted a variety of ways they would feel motivated to complete the program:

  • sense of accomplishment

  • feeling of support

  • reminders

  • encouragement

  • seeing positive progress

next up...design improvement
next up...design improvement

design improvement

The findings from user testing guided the process of design improvement.

01 Refining Information Structures

To account for the varying information needs of users discovered during testing, I created two categories of information:

  1. Primary information - essential for all users’ understanding of the intervention program

  2. Secondary Information - helpful, but supplemental. Not necessary for success with the intervention program.

02 Improving Discoverability

One surprise during user testing was that many participants took the long path to the activities, rather than the shortest route through the primary navigation. I explored ways to not only improve discoverability, but also define recognizable patterns to reduce user guessing.

One example is the in the redesign of the Home Task List. During usability testing, participants tended to quickly reference the task list, but then struggled to navigate quickly to the relevant content.

To solve this, I redesigned the task list to be interactive and dynamic. The task list now guides each user through their individual intervention journey, reducing mental load and time spent wayfinding.

Improvements include:

  • Direct links. Relevant tasks are clear and easily accessible.

  • Task status. Users see quickly if a task is new, continuing or completed.

  • Expandable list. The top 3 relevant tasks are shown by default with the ability to expand and see more.

03 Enhancing Engagement

To motivate users to continue the program, I focused the research findings that addresses the user needs for:

  • a sense of accomplishment

  • encouragement and support

  • a feeling of progress

The result was the design of a success state module that appears when a user completes a day's tasks. The module combines positive messaging with real-time progress metrics to give users a sense of accomplishment and support. Users can control the display of these metrics in Settings.

what's next?
what's next?
next steps

Status

After the last round of design:

  • This mobile app is currently under development

  • After development, it is expected that the efficacy of this digital intervention model will be tested in a clinical trial.

Proposed Metrics

As I wrapped my portion of the project, I recommended that the following metrics be gathered and analyzed in order to continue to improve the user experience of this mobile app over time:

  • % program completion vs. abandonment

  • Task completion by Module

  • Level of engagement with each Module

  • Continued user sentiment analysis

In addition, I proposed a plan for gathering metrics after launch. In the designs, I indicated where and when we could gather behavior and usage metrics seamlessly during the experience in the least intrusive way.

One example, is a modal that appears after completion of a required Activity series. In addition to allowing users to personalize their ongoing intervention after the official intervention ends, it also gives the client important feedback. This data will convey which Activities are most impactful to users. Over time, the data can be used to prioritize content and improve engagement.