ReproAnswer
Communicating the
effects of drugs on the
developing embryo


Role Interaction Designer
Design February—March 2019
Testing June 2019 — ongoing
Clients RightAnswer & University of Washington Medical Center


Intro

Process
User-Centered Design
Surveys
Usability testing
Deliverables
Design system
Interactive prototype Usability findings
Tools

   


60% of pregnant women take at least one medication during pregnancy. Therefore, pregnant women and their physicians are frequently concerned about the possibility that a treatment that may be needed to improve a woman’s health may harm her pregnancy. Sadly, roughly 40,000 infants are born each year in the US with birth defects directly attributed to medication exposure during prenatal development.
Counseling pregnant women regarding the risks or safety of drug treatments is often complicated. There is a lack of information about the nature, magnitude, or even existence of a drug’s risk in humans. To address this issue, experts from the Department of Pediatrics at the University of Washington constantly review and summarize scientific literature to build a database with reliable information regarding the effects of over 1700 drugs and chemicals on the developing embryo.

The database is currently distributed globally by RightAnswer via a desktop experience. However, the information is most often useful in patient appointments or in-home visits, when clinicians may not have access to a desktop computer.





Process




I solely created the design system, all features, and risk visualizations following a user-centered approach.
Our team surveyed clinicians to understand their goals and needs. Based on formative research results we defined 3 project goals based on common use scenarios, as well as personas. We used the goals and scenarios to develop a prototype, which will go through in usability testing soon.


1. Risks
Given their constrained time, health providers want the right amount of information to estimate teratogenic risk. Compressing a large body of complex (and often conflicting) data for quick decision aid without sacrificing critical aspects was mandatory.
2. Speed and mobility
There is a need to quicken access and information consumption. We want to explore features that provide access to information when providers are on the go.
3. Sharing
Health providers want to inform their patients with appropriate resources. There is a need to build the ability to directly email or text pieces of information to patients, while protecting the privacy of both patient and provider.



Personas




Scenario 1. Communicating risks accurately for rapid decision-maing



The main challenge in using mobile technology to assess potential teratogenicity of a medication is how to compress a large body of complex (and often conflicting) data for quick decision aid without sacrificing critical aspects of the risk-benefit discussion.

I soon discovered that designing drug risk information was beyond my ordinary knowledge on information visualization. An effective design could potentially save lives. I’d hear Uncle Ben telling me “with great power comes great responsibility.”

I turned to Tufte’s seminal book on Information Vizualization for insight. Reading this book is essential for anyone designing to display data.


The Visual Display of Quantitative Information
Edward Tufte


See some of my initial sketches for the risk visualizations below.



As much as the ideas above seemed exciting, I needed expert advice to know if they were going in the right direction. Fortunately, the Division of Developmental Medicine at the University of Washington was available to provide feedback. A big accomplishment I had in this project was developing a strong relationship with stakeholders. I’d meet with them weekly to touch base and discuss the designs, and constantly send them updates via email.


My conversations with the medical experts made clear that the design had to accurately reflect:
9  risk levels 
  • None
  • None to minimal
  • Minimal
  • Minimal to small
  • Small
  • Small to moderate, Moderate
  • Moderate to high
  • High
Aside from the 9 risk levels, there are 3 other classifications:
  • Unlikely risk
  • Unknown risk
  • Multiple risks (e.g., Small risk or High risk depending on dosage, timing, etc.).

There is also an additional scale representing the quality of scientific data available for experts to define teratogenic risk.




I noticed that the risk scale made the interface look crowded; also, colors didn’t help users differentiate risks when quickly scanning a list.


I moved away from the scale and focused on labels to precisely define risks, with a simpler palette. Blue means “probably ok,” amber, “attention” and red, “careful!”


Finally, I removed the information on each agent to facilitate comparison of drug risks. I also tweaked the colors with help from color-blindness simulators.




Then, I designed the article pages. Each article has 4 main sections: Summary, Risks, Data, and References, where healthcare providers can learn all about the potential risks of drugs and chemicals. Below, see a prototype of an article on Cytarabine.


A few design elements that can facilitate finding information quickly, while highlighting important details. Note the Animal Data section divider, and reference key.




Scenario 2. Accessing information on-the-go


In our study, time-constratined healthcare providers talked about using mobile apps as they moved between rooms at the hospital, as well as in home visits, since phones fit easliy in their pockets or purses:
“I attend out of hospital births and d in-home visits. Which is another reason that having many of these tools not on a laptop is helpful.”

To tackle this goal, I created the Bookmarks and Recent features to facilitate information retrieval. I defined that the search functionality should be emphasized in different moments of the interaction with this app.





See the mobile application informational structure on the left. Emphasis is on quickly acessing articles from multiple entry-points.




Below, see the main screen, which shows bookmarked articles. The prototype shows the side menu design after a few seconds.



I used the floating button pattern to make search prominent. It is placed on the bottom of the screen, closer to users fingers. I designed a custom icon for the FOB.



In terms of main navigation, I turned from using mostly blue on navigation to an understated visual system using white.

This decision kept navigation design elements from conflicting with the color-coding created for risk visualizations.




 
I also proposed a feature for version 2 of the app that could read articles and risks to users. This could make it easy for busy healthcare providers to obtain information on the go.



Scenario 3. Sharing, but not oversharing


Healthcare providers in our study mentioned the need of designing the app to help better explain risk to patients. In our
design, we have included handouts that providers can print out or directly send to patients. Obviously, this raises privacy concerns.

In the app, clinicians can review resources before sending them to patients. I also designed a secure sharing feature that protects users’ contact information. Resources will be sent to patients via an alias.





Conclusion


First, my biggest impact in this project was stablishing a relationship with all stakeholders. I see this as a key skill in the UX field, as UX professionals often have to integrate multiple perspectives. In this project, learning from stakeholders was incredible. I engaged with medical experts with 3 decades of experience, clinicians, and midwives.

Second, this project helped me to get up to speed on modern design tools such as Sketch and Principle, as well as learning how to communicate and present work to non-design stakeholders in a real project. There is always anxiety to show finished screens or interactions for stakeholders to provide better feedback. That said, I would have spent more time getting the entire team on the same page with low-fidelity prototypes, especially for complex features that inevitably go through many rounds of iteration.

The prototypes shown on this page will be used in usability testing in the coming months. After the tests, there will be a new round of redesign before launching the app in the last quarter of 2019 in the Play Store and App Store.







In closing, I acknowledge the expertise of my collaborators from the University of Washington Medical Center. It was inspiring to work with world-renowned medical researchers passionate about improving population health. I am grateful for working in a project with such an amazing societal impact.
“This is the best risk visualization that I have ever seen!”

Janine Polifka
Clinical teratology and teratogen risk communication expert. Janine has authored over 60 scientific publications in these areas.





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