Setting up users for success with an app that monitors their cardiac device

Because of confidentiality I’m only able to share a high level overview and describe the process and value I brought to these projects.

Apps for Medical Devices - Not your typical app

Medical device apps require additional testing and rigor around the safety and efficacy of the products to meet FDA approval. These apps prioritize safety, effectiveness and ease of use. Once met, the NEXT STEP Is to FIND WAYS TO delight the user.

Product Timeline: May-Dec 2017 (~8 months)

My Team:
Sr UX Designer (1)
*UX Designer + Human Factors (Me)

How might we improve the account creation and log-in experience for patients?

The sign-up and log-in process for the MyCareLink Heart App was confusing and users could be led to areas with no option to recover. I joined a Tiger Team who was tasked with improving the entire sign-up/log-in workflow with the goal to prototype, test, and deliver a final design within several months to meet project deadlines. This included improving the messaging to users to provide more understandable, less technical language.

Target Audience

Patients with an implanted Bluetooth cardiac device, their caregivers, and healthcare professionals (cardiac nurses, physicians)

My Role

In collaboration with a fellow Sr UX designer I created discussion guides and facilitated user testing with around 40 users across the U.S. We worked together on improvements as we received feedback. After each round of testing we shared the results with the project team to ensure the design we were proposing were technically feasible, especially with the security requirements needed.

User Research

Participant Demographics

We conducted four rounds of user testing across the U.S. In each session we met with users who were 50+ years old. This was based on the typical age group of patients who have cardiac devices, but there was also concern from the team that users in this age demographic would have more difficulty with a smart phone. Although this concern came from 4-year old research, we wanted to make sure to address this in our testing to prove out that the process could be understandable across all age groups. We also made sure to meet with a variety of users who already had a cardiac device or had heart failure but no implanted device (who may need one at some point). And finally we met with both Android and iOS users.

Location

Atlanta, GA (10 users)

Interview Questions

First, we wanted to understand how many users download apps on their own with or without assistance, as well as if they check email or texts on a daily basis. Then we moved into the flows we wanted feedback on, including:

• Scenario 1: App device pairing and account set up

  • Placement of ID card example on screen

  • Placement/treatment of message to keep phone close by

• Scenario 2: Account lockout and password reset

  • Flow of Password Recovery

Scenario 1 Results

• ALL users correctly entered First/Last Name and Email Address

• 9/10 users correctly entered Password with correct reqs

• 9/10 users were able to enter Device SN

  • 5 users = success with zero errors

  • 4 users = success with typo (thought “i” was “1”)

  • 1 user = tried pressing on “SN” symbol instead of boxes

• 10/10 users would be comfortable allowing MDT Rep, Nurse, Doctor, or family member help them set up app with password

• Additional findings: the users had to refer to their medical ID card to locate their device serial number and enter it into the app

  • Users were frustrated by card legibility since the printed numbers were very small. The labeling was also confusing and it was hard to identify which number was correct

  • Users thought the “i“ was a “1” in the serial number (example: RNl881082U)

    
    

Scenario 1 Recommendations

• Improve Temp ID card layout:

  • Include labels to identify Medical Device and Lead(s)

  • Break-up SN

• Improve Permanent ID card layout:

  • Use BIGGER font size

  • Include labels to identify Medical Device and Lead(s)

  • Break-up Device SN

Used Boston Scientific ID card as an example of how we could improve our design

Scenario 2 Results

• ALL users were able reset password

  • Updated flow to be reset password vs. recover password after 3rd participant

  • Increased font size and made minor adjustments to language used based on feedback

• Users would call the clinic if they saw the account deletion message and had not talked with their doctor about discontinuing (see below under Recommendations)

• Additional findings:

  • Users typically write passwords down to remember them

  • 8/10 users find having a password makes them feel secure

  • Users comfortable having a MDT Rep, Nurse, or family member help them set up account with password.

Scenario 2 Recommendations

• Updated title on message to “Note,” since original title, “Your account will be deleted shortly” was alarming to some users.

OTHER LOCATIONS

We continued to reiterate on the design and further test it in the next several months in the following locations:

• Chicago, IL (10 users)

• St. Louis Park, MN (9 users)

• Nashville, TN (10 users)

Iterations based on user feedback

Medical ID card needed

We redesigned the Medical ID card - both the temporary version they get in the clinic/hospital and the permanent one that gets mailed to them. We also wanted to create an alternative card for the Heart Device Serial Number. This would be used if we couldn’t make changes to the current permanent card - when we discussed making updates with the team there was concerns over the expense of changing the font and layout of the existing template.

Dynamic and Connectivity Messaging

We retested the error messaging that may be presented to users during the sign up or log in process if there were issues. These were easily understood by the users and they successfully identified what they needed to do next if they encountered them.

Conclusion:

The sign-in and log-in flows were significantly improved through user testing and implementing familiar language so the user could easily understand what was going on and how to fix any issues that were shown. The medical ID card was not in scope for the initial version of the app, but was kept as a future enhancement based on our recommendations.

We successfully showed that a user population of 50+ was able to set up their account on their own. We also discovered unexpected results, as always, by meeting with users and having them share their stories of having a pacemaker or heart failure. Keeping their experiences top of mind helped to inform a successful design.