Epileptic Connection is a mobile application created for physicians and medical staff in rural Ecuador to routinely check in with epilepsy patients and keep patients accountable when it comes to taking medication. The initial concept was developed by a team of biomedical engineers at Washington University in St. Louis and was given to me for design and prototyping.
I created a user persona, created a site map, established features and interactions, created wireframes, prototyped the design on an Android LG 8” tablet, and conducted user research, before sending the design to engineers to integrate with an SMS messaging system.
The Epileptic Connection app was enthusiastically received by the physicians in rural Ecuador and increased medical adherence among patients.
Physicians and medical staff in rural Ecuador
Pen and Paper, Adobe Illustrator, Unity
The Design Process
Defining the Problem
Epilepsy is one of the world’s largest non-communicable disorders. It is estimated that the condition affects approximately 50 million people, around 40 million of them living in developing countries (1, 2). Medical non adherence among epilepsy patients in rural Ecuador is a huge problem. Due to the stigmatization of the neurological disorder, low prioritization, poor healthcare system infrastructure, and several other factors medication adherence is extremely low.
Communication with our Ecuador contact, Dr. Paciorkowski, was sparse, so I contacted the Director of Clinical Research in the Department of Neurology and Rehabilitation at UIC, Dr. Pandey, to gain insight on what a physician treating epilepsy patients focuses on and how an app would solve their needs. A user persona and site map were developed from our interviews.
Site Map: General Overview of How the Physician would Enter/Look Up a Patient
Sketches of App Designs
To figure out the content and its placement, I quickly work through potential features and positions of those features using pen and paper. Below, I’ve provided visuals to depict the process.
Buy In from Engineers and Dr. Pandey
After going through a number of iterations, we settled on the content and user flow of the application.
Logo & Color Scheme
Through research and iterations of the application’s potential logo, I chose a color scheme and logo that emulated the colors of the Ecuador flag (blue, red, yellow) while also focusing on a deep cultural connection (circular form). Below, are the various logos considered. Option #5 was the final logo design chosen.
Once both the concept and the content design of the application were approved, it was time to pull the design together. The screens were developed and exported from illustrator as pngs and brought into Unity to be prototyped on an Android LG tablet “8”.
Testing the Prototype
The prototyped app, was tested on Dr. Pandey and one of his graduate students to gain feedback and improve the overall user experience. They closely worked with epilepsy patients and were the closest we could come to testing out the prototype on our end users.
User Research Method: Usability Study – Participants were asked to complete two tasks:
Task 1 –
You are new to the Epileptic Connection app and need to create an account. After creating an account, you are asked to log in, and you would like to input your first patient with the information below:
Patient Name: Patient X
“This is a reminder to take your Topamax. Text ‘yes’ to confirm the pill was taken.”
Task 2 –
You need to change the number of times per day that patient, Jane Doe, takes Klonopin. Currently, the patient is taking the drug once a day. You want to increase this to 2x a day. Navigate through the app to make this change to the patient’s medical record. When you’re done, you should log out of your account.
Below, I have included the notes taken while taking both users through the app.
Flow of Screens: Log in Screen -> Register -> Log In Screen -> New Patient Screen
-> Home Page Patient -> Message Page
Didn’t initially click on register - wanted to tap on the main screen and just type where said username and password - needed to be directed to register to figure out what to do.
Comment to use dots for filling in password instead of seeing the password typed out.
Very easy to decide which icon is new patient
Message screen - couldn’t figure out how to edit the message - wanted to tap into the message
Once got into message - would have liked to be able to have an automated message ready to go, and to have a drop down to change for medication, frequency, dosage, etc.
Flow of Screens: Current Screen -> Current Patient -> Medication -> Edit Medication -> Back to Home Page (using back button) -> Log Out
For medication could navigate to page where changes would be made. Confused by the inability to just click on medication name, dosage, frequency icons. Couldn’t move on without redirection to bottom of page where edit button was.
For logging out proceeded to press the back button until reached patient home page. Didn’t consider the hamburger button as an option.
Physician Epidemiologist - Dr. Pandey
Flow of Screens: Log in Screen -> Register -> Log in screen -> New Patient Screen -> Home Page Patient -> Message Page
Prompt asked to create a new account - first reaction was to click Log in, when didn’t work looked to see what other options available
Trouble typing on tablet
would have liked the date to be more automatic where slashes would be incorporated
Pressed rectangle to change text before seeing the edit button at bottom of screen to press first
commented on how no one should be typing that much into a message
Would like to see a message already there with dropdowns for the medication and other influencing factors
Flow of Screens: Current Screen -> Current Patient -> Medication -> Edit Medication -> Back to Home Page (using back button) -> Log out
On medication page tried to click on icons and words to change them
very intuitive to press dropdown for frequency
Wasn’t sure whether to hit back button or hamburger button to log out - a bit hesitant
Would like there to be more follow up questions for the purpose of medical compliance. Patient could be asked how they are feeling etc so that there is more conversation with the patient besides whether they took their medication, since epilepsy patients have other symptoms besides seizures to take into consideration such as depression.
The app was updated and successfully integrate with the SMS messaging system. The app was deployed and available for physician’s in Ecuador. Ecuador physician’s reported an increase in physician/patient communication, leading to an increase in medical adherence over the course of 3 months.
It’s important to be in touch with your end user, but when your contact is unreachable, the next best thing is to find individuals who represent your end user.
If you are making assumptions about your end users, because you aren’t able to get in touch with them, prioritize more research and ways to simulate your end users to further elucidate the problem and effectiveness of your solution.
Prioritizing communication, when the production team and client are located in different cities and countries, is essential for the success of the product.