Healthscribe

Problem Background

The digital age has ushered in an era of cutting-edge healthcare technology and tools. Life expectancy has been steadily increasing from the 1950s, and people are living healthier lives due to advances in medicine. However, the busy, erratic and largely sedentary nature of people’s lifestyles has resulted in the proliferation of chronic diseases and recurring health issues. Data reported by the CDC shows that 6 out of 10 Americans have chronic diseases and 4 in 10 adults in the US have multiple chronic health issues. The data also shows that the leading causes of these health issues are poor eating habits, lack of physical activity, and excessive use of tobacco and/or alcohol.

For effectively treating these recurring health issues, it is important for both doctors and patients to know how a patient’s symptoms have changed over time, what changes have they made in their lifestyle, and what medication has/has not been effective in the past. The use of patient diaries, or symptom trackers, can offer valuable insight into understanding the correlation between symptoms, individual lifestyle and food choices, and medication over a period of time. This can help both patients and doctors make more informed decisions on a potential diagnosis or course of treatment.

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High Level Research Plan

We conducted customer interviews with 8 users who have recurring health issues to understand the problem space better. Some of the questions that we asked our target users were as follows:

• How often do you track your health?
• Generally, what kind of health information or data do you generally log? (Hint: things like symptoms, medication, vaccinations, doctor visits etc.)
• Can you share some challenges that you’ve had with logging and tracking your information?
• Do you use any existing tools (Excel, paper diary, notepad, apps) to track your health and health issues?
• Do you set any reminders for vaccinations, regular checkups etc? 
• What approach did you take when you faced a recurring health issue in the past - did you try to research the symptom? Did you try to self-assess what might have caused it? Did you go to see the doctor directly? 
• If you do try to self-assess and research prior to seeing a doctor, are there any specific methods/approaches you follow?
• Any specific challenges you encountered while trying to self-assess and understand your symptoms better?
• Do you collect any facts before you go to the doctor? What tools (if any) do you use (e.g., document, app, mental note)?  
• How do you communicate these facts (e.g., email, verbally, document) with the doctor?
• After you meet a doctor, do you try to keep a note of your symptoms to see if they recurred?
• Do you have any experience with health and symptom tracking apps?
• What did you like/dislike about the app?

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User Pain Points

Research results from our customer interviews on how users currently keep track of their health-related information gave us some interesting insights: 

1. All the 8 users said that they rely on their memory/physical notes to record symptoms, mood, potential triggers, or medications.
2. 90% of the users said that they misplace, lose track of, or forget relevant information related to past symptom occurrence (such as intensity, frequency, potential triggers etc.). This indicates that not having the ability to easily log and retrieve health-related history is a major pain point for users
3. 75% of the users said that for recurring health issues that are correlated with their habits, the user is unable to pinpoint what habits exacerbate their condition. 
4. 50% of the users said that there is a variety of conflicting medical advice/information on the internet. They would like a curated and reliable database of self-help medical information.

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Competitive Landscape

We also conducted some preliminary analysis of the competitive landscape to understand how crowded the solution space for this product is, and to get an idea for what features our competitors have or lack. For our competitor analysis we mainly focussed on Android/iOS apps:

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From our analysis, we discovered that there are not many apps that completely solve the problem of health tracking and insights in a holistic and affordable manner. Most of the above apps either have missing features, cluttered or non-user friendly UI choices, or are too expensive for continued use. 

We also went through the user reviews for the above listed apps to get more qualitative data on user pain points and needs. 

Solution Explanation

Our proposed high-level solution is to build a mobile-first web app that provides users an easy way to record and track illness symptoms and their intensity, food, drinks, medication and other health information all in one place. The user will also be able to see charts based on their past health records providing useful health insights.

Based on user pain points collected from our initial research, we prioritized the features we want to deliver based on the following parameters:

• Impact - how useful it is to an individual user? 
• Reach - how many users would it benefit?
• Effort - how long would it take to build?
• Dependency - does one feature depend on another?

Must-haves

• Log all symptoms, potential triggers, mood and medication information in a single place
• Have an easy way to look back on their health history records using an intuitive timeline.
• View charts relating dates, symptoms, intensity and frequency so users are continuously aware of how their health has been trending.

Good-to-have

• See graphs relating potential causes for each symptom based on previously entered data so it encourages users  to take charge of their health and change their habits for the better.
• See graphs showing mood trends based on previously entered data.
• Ability to set automatic reminders for immunizations. 

Future backlog

• Share all health information and history with a doctor to help them make a more effective diagnosis.
• Provide curated medical information/links to reliable websites so that users can self-research their symptoms.
• Integration with other popular calorie/fitness tracking apps so relevant data can be auto-imported. 

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Lo-fi Mockups

Log Event

Log Event_Symptoms

My Timeline

View Analysis

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Hi-fi Mockups

Log Event

Log Event_Symptom

Timeline

Insights

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Iterative Design Learnings

Low Fidelity: Since 91% of people own mobile smartphones, and 90% of mobile time is spent using apps, we took a mobile first approach to designing the HealthScribe web application. Early usability testing with a low-fi prototype validated that we had achieved our goal of designing a minimal and fluid user experience. 100% of users were able to quickly create a profile, log and edit a symptom, and view their information in a visual format.

Despite the ease of use, most participants articulated they still expected to receive more guidance as they navigated through the screens. We added coach marks to explain the primary actions that users can take in the app.

• “It was easier than I thought”
• “The process is pretty straightforward.”

A/B Testing: We conducted A/B testing to establish branding that would appeal to users. Two designs were showcased: a natural design with muted colors and images of real people, and a colorful design that included illustrated characters. 57% users found the colorful design more engaging and user friendly.

Hi-Fidelity: After testing our high-fidelity prototype, we gained insight into the user’s preferences for the overall aesthetics of the HealthStream web app. The participants helped us identify errors, shared their preference for a lighter, more modern interface.

Hi-Fidelity v2: There are so many benefits to using Healthscribe that we wanted to ensure that all users could access it. We added an aspect ratio of 2:1 to the screens to account for users with feature phones (e.g., BlackBerry, flip phones) or older devices.

Our primary  focus shifted to balancing the user’s needs and our wants with technical constraints. To stay on track, we categorized and prioritized the user feedback so that we could identify immediate fixes and estimate the time needed for more complex improvements.   

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Implementation Details

• ‍Where is it hosted?  The app is hosted on Railway.‍
• What is your tech stack? Ruby on Rails/Bootstrap/Stimulus.JS
• ‍What was the hardest part of development? Deciding how to save certain data and retrieve it back to the UI was challenging (this requires multiple data saving and validations).
• ‍Does your app have any scaling issues? There are no known issues, but as the app grows challenges with data caching, database primary/foreign key indexing as well as background jobs for some features will be considered.
• ‍What are some key takeaways? Working in a cross-functional team requires high-level communication, this is one thing we have learnt and will keep improving as developers. Making sure your team knows what features you are managing and when you reach a dead end is critical if you are to move forward as a team.

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Future Steps

We will be continuing this project together in the near future. Below is the Go-to-market Plan and the product roadmap:

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Go-to-market Strategy

Product Roadmap