Design for America (DFA) has been a great promotional partner of BarnRaise 2015. We had the pleasure of hearing directly from student participants of their 2015 Summer Studio about the excellent design work they did in the Access to Care space around sustained care for liver transplant patients with type 2 diabetes.
Tell us a little bit about yourselves; your various backgrounds and why you decided to join the DFA 2015 Summer Studio?
We are all undergraduate students at Northwestern University; Ashley is a senior studying Computer Engineering and Design, Robert is a sophomore studying Mechanical Engineering and Business, Vincent is also a sophomore studying Chemical Engineering, and Eleni is a junior studying Comparative Literature and Global Health/Medical Anthropology. Even through each one of us joined the Summer Studio for slightly different reasons, we were all driven by our interest in human-centered design and the desire to create social impact, to design something that people will want to use to improve their day-to-day lives.
This year at BarnRaise we are focused on improved access to care. We've heard a lot about your work this summer in patient care as it relates to diabetes. Tell us more?
We partnered with a research team at Northwestern Medicine to improve transitions of care and education for liver transplant patients with type 2 diabetes
Liver transplant patients have a uniquely challenging transition of care after surgery because the operation is high risk and complications are common. After surgery, patients are required to be on as many as 10 different medications to deal with the pain and prevent the new liver from being rejected. However, these medications, in combination with the added stress of surgery, cause 50% of patients to have elevated blood sugar levels and to eventually get diabetes post-op, Typically, patients have poor mental cognition for days after surgery which makes listening to the important instructions given by doctors and nurses impossible to comprehend. They are completely dependent on a caregiver who has to learn not only how to take care of the patient's post-op recovery, but also how to manage their diabetes. After 2-3 months, the patient can begin to take charge of their new condition. 6,000 patients go through this process every year, The transition out of the hospital is confusing, frustrating, and scary. We chose to ask:
"How can we ease this overwhelming transition to promote better health after transplant?"
What were some of the insights you uncovered in your user research?
For the first couple of weeks, we tried to see the problem through the users’ eyes; we interviewed patients, their caregivers, and providers, conducted secondary research, and detailed personas and timelines. We soon realized that some of the issues these users were facing were due to standardized healthcare protocols.
For example, diabetes education management training happens at discharge, when patients are also receiving an overwhelming amount of information from different groups of providers. When they go home and take charge of their condition, they have to re-learn how to monitor their blood sugar, administer insulin, and take all their medications on time. They use equipment, such as glucometers, that may not be the same as what they were trained on.
Perhaps the most overarching insight though, is that learning to manage diabetes can be extremely hard. Even though this project is focused on liver transplant patients with type 2 diabetes, what is great about it is its scope; liver transplant patients have about a 50% risk of developing type 2 diabetes, which makes them the highest risk case of diabetes. They are prescribed many medications, some of which have blood sugar related side effects or prolong the post-op low cognition state. They may not be leading the healthiest lifestyles, which also doesn’t help their diabetes management. So if we can teach this population to manage their diabetes right out of the hospital, then we can teach almost any other population to do so.
How has the Human-Centered Design approach helped your work specifically as it relates to your problem space?
The human-centered design process is focused on the users in every stage. We began by empathizing with users and reframing the problem space; does the problem lie within the hospital and its methods of care, or does it lie within a patient’s interaction with his or her health provider? Our insights led us to focus on the patient’s transition from hospital to independence.
We took these insights to the ideation phase, and formed questions centered around our user based on our insights to guide our brainstorming. For example, one insight we uncovered was that people with type 2 diabetes have trouble organizing information given to them in the hospital. Then, our user-centered question might be: “How can we empower liver transplant patients during their transition out of the hospital to easily comprehend their medical instructions?” We brainstormed answers to each of these questions and came up with hundreds of solutions. We then synthesized and eliminated ideas by determining how well aspects of each design addressed user-needs we had identified through our research.
As we moved on to the prototyping and testing phase, we received constant feedback from users; we observed them interacting with our low-fidelity mockups and gained insights from their interaction and comments. It has been extremely valuable for us to have direct access to liver transplant patients with type 2 diabetes through our community partner, the Northwestern Medicine Research Team. They have played a very important role in acquiring resources and feedback on our designs.
The Human Centered Design process has provided an invaluable framework for us to immerse ourselves in the problem space, uncover insights, and test our mockups. The focus on the end user and approach that we followed has set VERA up as user-centric and user-friendly system of products to help liver transplant patients with type 2 diabetes transition to independence.
We heard that your team has recently made a pitch to your community partner at Feinberg School of Medicine. What are your next steps?
We’ve discussed our goals moving forward and have made arrangements to meet regularly with a faculty advisor to apply for grants. Additionally, Eleni will be applying for an Undergraduate Research Grant through Northwestern University to conduct ethnographic research on diabetes narratives and do product archaeology. We have an independent study planned in the winter to refine our prototypes and conduct more user testing. We continue with support from our community partner, the endocrine research team at Northwestern Medicine, and will be working with them on our prototypes and user sessions.
As a team working to influence this space of patient care, what do you hope to see in the area of accessibility in the future?
We hope that patients will have better access to personalized health care for diabetes management. There’s lots of incredible technology being developed that can make diabetes education more intuitive. However, it’s very important that innovation addresses the needs of the targeted user groups, and that’s where user-centered design really comes in. Every patient is different, not only in a medical sense, but also as it relates to their context, be it social, educational, or cultural. We are really excited to see technology being used to span these differences while creating effective individualized solutions.
Thanks for sharing with us, Ashley, Robert, Vincent and Eleni!