UX Project: APT
Project duration
8 months
CareerFoundry,
UX Immersion design project
My role
UX Research
UX Design
UI Design
Copywriting
Tools
PROJECT OVERVIEW
Problem Space
People rehabilitating an injury need to perform certain exercises to feel better and heal. Traditionally, a care plan involved driving to a clinic, learning exercises with a clinician, taking home poorly copied printouts of their home exercise regimen, and performing them on their own accord during the week. The whole cycle repeats every week until the recovery goal is reached or the patient discontinues the process.
The Data
it doesn’t look good.
Data indicates that after one month, 50-70% of physical therapy patients are 100% compliant with their exercise program. After three months, only 35% are compliant and after eight months, only 25% are compliant.
Users list these barriers to complying with their physical therapy program:
Forgets to do the exercises.
Does not remember how to do the exercise correctly.
Still feels pain, does not feel the exercises are helping and gives up.
Time commitment and scheduling difficulties.
Feels they do not need the physiotherapy intervention (e.g., "I feel better, I don't need it anymore.")
Proposed solution
Create an app that motivates and rewards users to complete their prescribed physical therapy program. Key features include:
Easy-to-access, easy-to-follow exercise program that tracks pain level
Online appointment scheduling
Feedback loops including including instant messaging the clinician and the clinic scheduler
Instantly updated weekly statistics that stores the user’s program history and reward status
RESEARCH
Competitive Analysis
I conducted a competitor analysis to get an idea of what users might expect from my app, which of my competitors are doing a good/poor job at solving user problems, and find opportunities to meet an unfulfilled user need. I conducted heuristic analysis of several apps. I narrowed my focus two apps: PhysiApp and Medbridge GO.
Reasons:
Both apps are used by healthcare professionals who provide physiotherapy.
Features of these apps help the healthcare provider remove barriers that patients face when undergoing a physical therapy program.
Key Findings
Target Audience
Working in tandem with a clinician (e.g., physical therapist, occupational therapist, athletic trainer), a physical therapy patient will have a successful rehabilitation experience with the help of the app. How-to videos, written descriptions, daily reminders, patient feedback portals, and fast PT response will make the exercise program easier for the patient to complete with the program with 90%+ compliance.
The mindset of our target user is someone who is suffering a physical injury that requires physical therapy, but isn’t totally committed to doing the work every day due to fear or uncertainty.
Competition
MedBridge has the most robust library of video exercises in the market (6500+) and offers patient education videos.
Risk/Opportunity
The primary risk is that our app will take a while to get to the robust library of content that exists on the MedBridge app.
There is a chance that we can stand apart by providing a better patient and provider feedback loop that makes our product more friendly and customer-focused.
Conclusions
It’s possible our app could be considered a better option for clinician because it will have LESS video options, which streamlines their search.
It will provide more direct contact with patients, building the patient's confidence and satisfaction in the prescribed program and clinical service.
User Interviews
Once I learned more about competitors in the market, I set out to empathize with and understand user needs. I conducted four user interviews in person over Zoom. My goals were to:
Discover what the barriers are that prevent a person from executing the physical therapy as prescribed, and
Discover what motivates a person to do their physical therapy program.
I collated the data from the user interviews and grouped the behaviors, attitudes, needs, goals and frustrations into affinity maps. This qualitative data was grouped into categories that highlighted common themes.
Key Findings
Users do the exercises only if they are in pain and want the pain to go away. Once pain becomes manageable, they stop doing the exercise program.
Users need to be provided a list of exercises and a visual reference on how to do them.
Users like having a video that shows how to do the exercise, which can be viewed on demand.
Users like the app at first, but stop using it because after a while because it does not add value to the experience. There needs to be an added incentive to use the app.
Users need feedback from the therapist to feel motivated —having access to their progress notes could provide motivation
Users want to know how to care for the injury, so care advice on the app would be an added benefit.
Users need a phone notifications to remind them to do their exercises and of their upcoming appointments.
Users want the convenience of booking their appointment online, with available slots visible and selectable.
Users felt if they were held accountable, they would have completed their exercises more often.
Users want goals and expectations defined as well as how each exercise helps them reach their goal.
Problem Statement
Users need to have barriers – such as forgetting to do the exercises and uncertainty on how to do the exercise correctly – removed and be provided an easy feedback mechanism to help them complete their prescribed physical therapy program to keep their recovery timeline on track, resulting in better clinical outcomes.
We know this to be true when after one month, the user has at least 75% of the prescribed days and exercises marked as completed on the app and the feedback on their pain level shows a steady downward trend.
User Personas
I created user personas, a quick shorthand for the customers’ context, motivations, needs, and approaches to using the product. I narrowed down the customers to three, so I could focus on what matters most to the users. These distinct personas are memorable, actionable, and distinct from one another — they sum up the main needs of the different audience segments so that I can recall and empathize with them easily.
Michael. The Workaholic.
He hates to disrupt his work routine and needs immediate proof that the rehabilitation program benefits him. He spends all his work hours on the computer so being able to access his exercise program on the computer will make the work to exercise transition seamless.
Melinda. The Repeat Customer.
As she improves, she pushes herself and ends up re-injuring herself. She needs to have quick and easy access to her clinician to ask questions and to be able to schedule additional appointments when she feels new or increased pain.
Ken. The Athlete.
He likes to keep active. He hopes the rehabilitation means he can avoid cortisone shots or surgery and help him regain his strength and endurance.
User Flows
I diagramed out each step the user needed to take to complete their goal.
Task Flow 1: Log into the app
Task Flow 2: Launch exercise program
Task Flow 3: View progress stats
Card Sorting
The next step was doing a card sorting exercise on Optimal Workshop. I created a list of 20 words and asked testers to organize and sort them into groups that they thought were appropriate. This exercise helped me to refine the information architecture, workflow, menu structure and navigation paths.
I built out the information architecture (IA) to help me figure out the content strategy by identifying word choice, and to guide me when I would begin the wireframing and prototyping processes. It also helped me organize my app views into groupings that made sense to my customers and would allow them to find the information they were looking for.
I decided to base my IA with having an Index Page. Visitors will first land on a home page that’s higher than all other pages. From here, they can navigate to different areas. Each of these areas are of equal importance in the site hierarchy.
20 cards
Associations are grouped
Information Architecture
I modified my sitemap to align with the key findings from the card sorting exercise.
DESIGN
Wireframing and Testing
Lo-fidelity
I sketched out a low-fidelity prototype of the high-level functions of the app.
Mid-fidelity
After identifying the top features and the user flows, I was able to design pages that showcased the individual components each step that would allow the user to complete the goal.
The interactive prototype focused on building out the features based on the user personas’ expressed needs.
FEature: user wants to schedule appointments online
User persona Melinda The Repeat Customer, would like to be able to quickly schedule an appointment without having to speak to a live person.
FEature: user wants to see care plan and progress
User persona Ken The Athlete wants to see his progress stats so he knows he when he can return to the exercise routine before his injury. The Care Plan feature provides a comprehensive report of the user’s compliance rate, pain levels, range of motion and strength ratings.
FEature: user wants visuals to guide exercise execution
User persona Michael The Workaholic wants to have easy to follow visual aids to guide him through his exercise routine.
User Testing
At this stage, it was time to conduct user testing. This would help me discover usability and design issues.
Usability Test Plan
Prototype: Mid-Fidelity (no color)
Moderator: Debbie Dare
Date: November 10, 2021
Participants: All the participants have experience with physical therapy.
Number of sessions: 6
Number of persons: 1 each session
Time: 30 minutes
Methodology: Moderated remote
Ranking errors: Jakob Nielsen scale
objectives
1: Can they find the Start button and begin the program.
2: Can they successfully change an existing appointment.
3: Can they find the Week 1 button in the Care Plan section.
4: Can they find the Notes section.
5: Can they find the Chat button.
Key Findings
Errors, comments and observations from each task from the tests were clustered into themes to identify usability issues and errors.
Four out of six participants were able to complete all the tasks.
Design changes needed to address the following issues:
Issue 1: Users could not easily find the Chat button.
Issue 2: Users could not easily find the Week 1 progress report button.
Issue 3: User wanted videos to auto advance.
Issue 4: Users didn’t immediately notice the navigation bar.
Test Participant Profiles
Each participant was assigned a color. After the tests were completed, I recorded the results in a spreadsheet, and marked by color which participant experienced which errors, observations, and comments.
Top-Level Categories: Observations, Positive Quotes, Negative Quotes, and Errors
Clustering the information into Observations, Positive Quotes, Negative Quotes, and Errors allowed me to discover connections and patterns of user pain points, emotions, needs and behaviors.
I identified and clustered the high ranking errors and determined possible solutions.
Changes made:
Dashboard
User concerns:
Found Resources button confusing and thought the contents belonged in the Progress Tracking section.
The button descriptions did not provide enough information to let the user know which button to press.
The “Us” in “Contact Us” was unclear to users who "Us" referred to.
The Resources button looked out of place because it was not a color.
Changes made:
Cleared the top area of visual clutter to draw the eye to the buttons.
Font in the navigation bar is in a heavier weight to make it more visible.
The buttons increased in size to allow for more helpful content to be added such as better written section descriptions, an icon and a call-to-action link.
Colors better define each button.
Appointments landing page
User concerns:
Did not like the two buttons at the top and felt buttons should be at the bottom.
Wanted to Chat with clinician but couldn't find the Chat button.
Wanted a way to contact the clinic but didn’t know how.
Changes made:
Changed the upcoming appointments to cards to make it clear they are clickable.
Buttons are moved to below the main content to maintain the style used in the app.
Chat button added to raise visibility of the Chat function.
Contact Clinic button added.
Care Plan landing page
User concerns:
Did not understand the Exercise Streak information breakdown.
Felt the information showed past events but failed to explain physical progress.
Wanted a short explanation for each section.
Did not like all the different colors because the sections blended together.
Felt weekly progress reports were buried at the bottom of the page.
Wanted to see a reward for their work to help motivate them.
Changes made:
Each section now contains the target goal so patient knows what to aim for.
Header changed back to Care Plan and now provides a list of the user’s comprehensive care journey, including quick access to notes written by the user and the therapist.
Appointments section added to the top. Since no-shows are a problem, having this information repeated emphasizes its importance. It also provides the user with a complete history of their physical therapy sessions.
The sections are explicitly contained in white boxes with links to access more details. The clean look makes the density of the information less overwhelming.
An Achievement button is added to bring more attention to the reward system, which aims to help incentivize the user to complete their exercises as prescribed.
Chat
User concerns:
User confused by the word “therapists” because they associate it with mental health.
User thought the input box should be anchored at the bottom instead of floating.
Changes made:
During usability testing, the majority of testers looked for the Chat function in the Appointments section, so I moved Chat to that location.
Condensed the information at the top and added a status indicator so the user knows when the clinician is online.
The message input box is moved to the bottom.
Additional messaging icons removed and simplified with a plus symbol.
Rewards
User concerns:
Rewards section was not easy to find; seemed buried in Profile section.
Did not understand how to know where they are in the process of obtaining the reward.
Changes made:
The Rewards are removed from the Profile page and made into a separate section. This allows for the content to contain a singular message.
The reward boxes are enlarged to allow for clearer instructions on how to obtain the reward.
Style Guide
After solving the usability issues, my next step was to refine the style guide. I looked back at the quotes from my Usability Test #1 and found a lot of positive comments about the look and feel and the tone of voice, so I continued the style forward. I chose a bright, but calming color palette and inserted appearances of the egg mascot, often animating it to make it more playful. I made sure there would be multiple interactions of positive reinforcement to encourage the user to continue using the app as a tool in their physical therapy journey.
Final Prototype
Moving Forward
Improving the Process:
Usability Tests:
Since my last redesign of the UI elements, I am ready to perform usability tests on my high fidelity prototype, all with people currently undergoing a physical therapy program. This time I want to record the user so I can observe and note their body language, facial expressions, and emotions. Doing this exercise will provide me with qualitative data that I am missing. If the tester wasn’t talking me through their thought-process during the test, I wasn’t always able to get them to verbalize their frustration; learning how to be a better test facilitator is something I need to prioritize.
user testing and card sorting:
I did not pay enough attention to the external reward system. I should have asked more questions in the user testing on this subject. I would consider doing another card sorting exercise to test how users want to categorize an external Reward system.
Next Phase:
Validating hypothesis:
The app has to be built and released to a control group. These usability tests will measure compliance rates and validate the hypothesis, reveal pain points and features that are most used. The testing would last 4 weeks. Changes would be implemented and tested for another 4 weeks. The cycle could repeat one more round before releasing to more physical rehabilitation clinics for more user testing.
Evolve the hypothesis:
According to this article, people are motivated to exercise through external rewards versus being self-motivated:
“In the fitness tech industry, however, behavioral science focuses on motivation, and for good reason. When it comes to exercise, most people are extrinsically motivated, meaning that they exercise for some sort of external reward. Intrinsic motivation has to do with working out solely for yourself…Thing is, intrinsic motivation is really difficult. It’s not always possible, and you can’t expect everyone who uses technology to go from an extrinsic to an intrinsic source of motivation to work out. When it comes to fitness tech, behavioral science is built on the assumption that most of us are extrinsically motivated to work out. This can help us dictate the design around our fitness tech products.”
This observation means I should consider how to build out the Achievement section. My hypothesis could evolve to include a new metric: how many users utilized the rewards system to motivate them. Things to test: is the reward universal or is it specific to the user? How to customize the user profiles?