Synthesis

Sorting

As I read through the transcriptions of each of my interviews I grouped my data into 6 categories:

  1. Problems (magenta)
  2. Insights (lavender)
  3. Quotes (salmon)
  4. Disease-specific information (purple)
  5. Diagnosis (yellow)
  6. Treatment (teal)

My challenge was how to identify patterns in the research. I discovered many different issues relating to problems with diagnosis, challenges of animals with comorbidities, expense, and inconvenience of treatment.

When I focused on the emotions and problems described by the people I interviewed I was able to find denser areas of interest.

Brainstorm

Some of the themes that I identified were: problems that caused the most distress, methods of record keeping, and outstanding vs. terrible experiences with veterinary care.

The following needs emerged as ones that I could make the biggest impact with my project:

  • Treatment at home was isolating and anxiety-producing for owners.
  • Adapting to a schedule that necessitates medicines, injections, or other treatment at specific times was difficult.
  • Vets were unsure if owners were complying with the treatment and would often get irrelevant information from owners.
  • Vets spend a lot of their free time corresponding with owners.
  • My brainstorm mostly happened with numerous pencil sketches. I focused on how might an interface make an owner feel less anxious and alone? How might it help her form a routine? For vets, I considered ways they could contain conversations with owners and still get the information they needed.

    Goal Statement

    After my brainstorming phase, I found that I was most interested in ideas that supported both vets and owners. Although convenient remote care, social support, and education often came up in my research, I knew these areas would not make as direct of an impact on vets as they would on owners.

    I crafted this statement to focus my project:

    Create an interactive tool that supports veterinarians and pet owners of cats and dogs with chronic conditions adapt to an unfamiliar care plan by making behavioral and symptomatic patterns obvious using data, forming a routine, and facilitating better communication outside of the clinic.

    This statement identified the needs of the veterinarians who desired more accurate information about their patients, and better communication with owners. It also acknowledged the needs of the owners who wanted more support from their veterinarians, and help adjusting to a new routine.

    Personas

    Pam Vega

    Age: 41

    Profession: Pediatric nurse, Boston Children’s Hospital

    Education: Simmons College, School of Nursing and Health Sciences, class of 2005

    Salary: $65,000

    Experience: 12 years at 2 hospitals and one small practice clinic

    Family: Divorced. One 6-year-old dog with Cushing’s Disease, Winston, and one 13-year-old cat with IBD and chronic kidney disease, Margot

    Read more about Pam

    Pam is a pediatric nurse working at a large hospital in Boston. Pam has had her cat, Margot, since her senior year of nursing school. She recently adopted Winston from one of her neighbors who recently had twins and could no longer devote time to his care. Pam is very dedicated to her animals. She often says that she doesn’t have kids, her pets are her kids! Margot has been a huge support for her when she was going through a difficult time with her divorce. Typically Pam gets up very early in the morning to go to work, and is usually home before 5pm, however, at times her work schedule can be unpredictable.

    A few months ago, Pam started to notice that Margot was looking thin, and she was vomiting a couple of times per week, which was unusual. After taking her to the pet hospital and performing a scope, bloodwork, and urinalysis, she was discouraged to learn that Margot was diagnosed with inflammatory bowel disease and stage 1 kidney disease. Unlike Margot, Pam knew about Winston’s Cushing’s disease, and that his condition was being managed with medicine. The meds help Winston, but sometimes he still loses patches of his hair, gains weight, or pants heavily. Pam struggles to get Margot to eat, but treats her other symptoms with steroids and a prescription diet.

    With two animals with chronic conditions, Pam started to work with Dr. Joy, an internal medicine specialist, at the pet hospital where she receives her care. Once, when Dr. Joy asked Pam how many times Margot missed a meal, Pam couldn’t remember. Now she tracks notable changes in Margot’s behavior or symptoms in a journal, and and will communicate them to Dr. Joy via phone call. As a medical professional, Pam feels confident in administering pills, and likes to experiment with adjusting her animals’ medication and diet on her own. Although her veterinarian is located close by, her busy schedule often prohibits her from finding time to take her pets in to be seen, or even to be available for a callback. She would prefer to have a record of her communication with Dr. Joy that she could reference to help her remember what treatment worked well last time. Pam is concerned with the big picture, and sometimes is wary of putting her pets through rigorous tests, which might aggravate their conditions, or be inconclusive at best.

    Nadine Thompson

    Age: 32

    Profession: Associate Director of Development, Boston University

    Education: Boston University, undergraduate class of 2007

    Salary: $48,000

    Experience: 5 years experience fundraising at universities and non-profits

    Family: Single. One 15-year-old cat with diabetes mellitus, Cesar.

    Read more about Nadine

    Nadine has worked in development at her alma mater, Boston University, for two years. Nadine adopted her cat, Cesar, from an old roommate who moved abroad four years ago. Currently, Nadine lives by herself in a studio apartment in Allston near her job. Part of the reason Nadine took this job was so she could take graduate classes at the university for free. She typically works 9am-5pm, but sometimes needs to stay late for special events, or to attend class.

    A couple of weeks ago, Nadine started to notice that there was a lot more urine in the litter box than usual. After taking Cesar to her vet for a check-up she learned that he had a condition called diabetes mellitus, and was prescribed a twice daily dose of insulin after mealtime every 12 hours. Getting Cesar to stay still during the insulin injections has been challenging. And, once Nadine came home for lunch to find Cesar unresponsive on the floor. She was able to get him to the pet hospital, and Dr. Joy, an internal medicine specialist, said that Cesar had gone into insulin shock.

    Nadine has been doing a lot of reading online to learn about how other pet owners cope with diabetes. She is willing to do what’s necessary for Cesar’s well being, but she is stressed by the financial strain of unexpected visits to the hospital, and management of his treatment while also balancing her work and school obligations. Nadine wants more support from her vet so she can avoid causing insulin shock in the future, but she’s not always sure that calling her vet for every abnormality is the best way to communicate. She worries that the desk staff aren’t capturing details, or that she will miss a return call from Dr. Joy. She’s also not sure what type of information is most helpful to share with her regular vet, or with Dr. Joy.

    Dr. Joy Schneider

    Age: 38

    Profession: Veterinary Internal Medicine Specialist, Blue Pearl Specialty and Emergency Pet Hospital

    Education: University of Pennsylvania School of Veterinary Medicine, class of 2013

    Salary: $150,000

    Experience: 5 years at 2 different hospitals

    Family: Married to Doug Schneider, no children, 4 pets of her own (3 cats and 1 dog)

    Read more about Dr. Joy

    Dr. Joy has been an internal medicine specialist at Blue Pearl for the last 3 years. She enjoys the hospital’s environment and feels comfortable with the systems and staff. A typical week for her consists of three full days at the hospital in which she sees a mixture of scheduled patients and emergency cases. She often consults on cases from the ER after animals are stabilized. On her days off she travels for conferences and consults at other sites. Caring for hospital patients bleeds into her days off, and she will often spend any free time she has checking in with owners via email.

    For Dr. Joy, getting to know the owners is very important because she often gives them complex home-treatment plans for her patients’ care. These plans are only successful if the owner is able to perform them, so during her initial appointment Dr. Joy tries to create a transparent environment where the owner feels comfortable speaking candidly about their concerns. Dr. Joy will tailor her plans to what she believes the owner will actually do, but this is often guesswork and she would prefer to have a better sense of how compliant owners and pets are.

    Dr. Joy uses a variety of methods to check in on patients. Email works well, but if she doesn’t get the level of information she needs, she may call them, or ask them to come into the hospital for a follow-up appointment. Sometimes her job is especially challenging when she suspects that her patient may not be getting quality care at home.

    Persona Creation Process

    Behavioral variables

    To craft my personas I created a rough hypothesis based on my impressions after sorting and brainstorming.

    To test my assumptions I synthesized my qualitative data into 4 main variables: activities, attitudes, motivations, and skills. These categories are recommended by Robert Reimann, Kim Goodwin, and Lane Halley in Alan Cooper’s About Face: The Essentials of Interaction Design. In his “constructing personas” section, the authors note that “creating believable and useful personas requires an equal measure of detailed analysis and creative synthesis,” and that a persona hypothesis must hold up against the results of the data. Using these variables I narrowed my focus to 10 behavioral variable ranges, noted in the chart below. These included variables like care-consciousness vs. cost-consciousness and trusting attitude vs. skepticism of the vet.

    Mapping each of owner users to these variables helped me to challenge my persona hypothesis and craft behaviors, attitudes, and motivations, supported by demographic information, species of pet, and type of condition, to create a persona authentic to my user research.

    Pam Vega and Nadine Thompson resulted from this process. Dr. Joy is based solely on the internal medicine specialist I interviewed.

    Vet behavior

    Activities
  • Treating pet
  • Managing staff and delegating responsibilities
  • Care plan creation
  • Owner follow up
  • Data logging
  • Medical record updating
  • Attitudes
  • Awareness of owner discomfort/comfort with expense
  • Quality of care, best type of care for situation
  • Keen sense of owners’ skills and motivations
  • Trust in staff (vet techs/nurses)
  • Motivations
  • Professional drive
  • Frustration with bad technology
  • Sense of what treatments owners will tolerate
  • Desire for a better work/life balance and setting boundaries for owners
  • Skills
  • Technical skill at administering meds and treating animals
  • Experience with a variety of medical record systems
  • Intuitive sense of owners’ abilities, anxieties, and motivations
  • Digital native
  • Owner behavior

    Activities
  • Pill giving
  • Insulin injection
  • Blood glucose testing
  • Subcutaneous fluid injection
  • Data collection
  • Following up with vet
  • Reaching out to community for assistance
  • Feeding and regular caretaking
  • Attitudes
  • Concern about expence
  • Skepticism about high dosages
  • Sensitivity to pet’s wellbeing
  • Concern about not putting pet through too much stress
  • Motivations
  • Love for pet
  • Determination to be a good caretaker
  • Routine follower, planner
  • Skills
  • Technical skill at administering meds from experience
  • Deep knowledge of her own pets
  • Tips and tricks
  • Education from community (neighbors, family)
  • Training from vet and vet techs
  • Professional skills in medical field
  • Comfort with using mobile (apps, phone, text) to communicate
  • Empathy Maps

    I used empathy maps as a tool to help me write believeable scenarios for my personas.

    Scenario Maps

    As I was writing my scenario stories I jumped between writing and creating a modified journey map to help me ideate all of the steps my personas would need to take, and how they might feel along the way.

    Scenarios

    These scenarios went through several revisions. This is the version I used to structure the flow of wireframes. In them Pam only treats her cat and not her dog, and Nadine's pet, Cesar, becomes a dog.

    Adjusting to a new care routine (Nadine and Dr. Joy)

    When Nadine took her dog, Cesar, in for his annual visit, she was shocked to discover that he had diabetes mellitus. She hadn’t noticed any odd symptoms or behavioral changes at all. When the internal medicine specialist, Dr. Joy, explained the required treatment plan for Cesar, Nadine felt extremely overwhelmed. Nadine was trying to listen, but felt distracted with worry about her ability to give injections, and the cost of all of the supplies. Read more

    Dr. Joy discussed the treatment options with Nadine and they agreed that Nadine would take regular blood glucose readings and curves at home. This would help cut down cost of care substantially and help Nadine and Cesar adjust to their new routine. Dr. Joy set Nadine up with the app service that would give her a list of to-do items for Cesar’s care every day. Dr. Joy and her care team would be available to assist as needed and support Nadine throughout the adjustment process.

    During the same visit one of Dr. Joy’s nurses showed Nadine how to inject Cesar with insulin. She could tell that the needle in his scruff didn’t bother him, which was a relief. Despite this, Nadine felt that the nurse made everything look so easy. She worried whether the process would go as smoothly at home? When the nurse showed her how to take Cesar’s blood glucose by laying him on his back and pricking his paw pad, Nadine filmed the process using her phone and added it to the resources section of her app.

    The next day Nadine wakes up early to start Cesar’s treatment. She sees that her first step is to take his blood glucose. It’s challenging for her, but the Nadine gets the hang of taking the blood glucose readings. She learns a couple of tricks by perusing the resources that Dr. Joy has added to her app, as well as reviewing the video she took at the hospital. Next, Nadine feeds Cesar breakfast and prepares his insulin, then hops in the shower. When she returns, she finds him polishing off the last of his meal. She logs his breakfast, and since he ate his whole meal, she is able to administer his full dose of insulin. As she’s walking to work she sees the alert to log his insulin, which she forgot to do earlier. She logs that in the app.

    Nadine encounters a new challenge a few days later when she oversleeps and is late for an event at work. Nadine scrambles to get herself up and test Cesar’s blood glucose level before his breakfast. Using her tried and true method, Nadine takes Cesar’s glucose level and finds that his blood sugar is really low. She decides to go ahead and feed him without preparing the insulin. She sets a timer to check his blood glucose again before she leaves, but she has to run to work and decides to forgo the insulin altogether. When she returns from work to take his evening blood glucose, she finds that his blood sugar is very high, though Cesar is behaving normally. Nadine feeds Cesar, logs dinner and gives his insulin injection while he eats. She logs the insulin as well. Nadine suspects that Dr. Joy may want to know about these numbers outside of Cesar’s normal range, so she writes a message to Dr. Joy and shares the latest data.

    The next morning Dr. Joy sees an alert message that Cesar’s blood glucose levels have been really erratic and when she views the blood glucose chart in Nadine’s record, she can see that Nadine missed an insulin dose. She responds to Nadine, encouraging her to keep the treatment consistent, and confirms that she would monitor the glucose closely for the next week to see if this erratic numbers are becoming more frequent.

    Data collection, (Pam and Dr. Joy)

    Recently Pam has noticed that her cat, Margot, has begun to look thinner than usual. Her stomach looks sunken in and her face less full.

    Three months ago, Margot was diagnosed with inflammatory bowel disease, which means that she often vomits and has low appetite. Pam worked with Dr. Joy, an internal medicine specialist at Blue Pearl Pet Hospital, to get the initial diagnosis after doing a scope of her GI tract. While doing blood work Dr. Joy also determined that Margot has mild kidney disease. Now Pam has been managing Margot’s care with a special diet and medication for both conditions given twice daily. Read more

    After she received the IBD diagnosis, Pam bought a baby scale to weigh Margot, but with Pam’s busy nursing schedule, and a second pet with Cushing’s disease to take care of, she often forgets to keep an eye on Margot’s weight. Pam feels guilty that she just noticed Margot’s physical changes and wonders if she has missed other signs.

    Pam writes to Dr. Joy using her mobile app expressing her concern about Margot and sending her current weight.

    Dr. Joy replies within a couple of hours that she doesn’t believe Margot’s weight loss is critical, and before she decides on a treatment plan, she wants Pam to monitor certain criteria at home before coming into the hospital for a follow-up appointment.

    To make this process straightforward for Pam, Dr. Joy pulls together a chart of everything she wants Pam to log. Dr. Joy opens Margot’s patient record on her desktop computer in the hospital and customizes her IBD chart template to work for Pam’s situation. Dr. Joy includes the following information in her chart: morning and evening medications, how much Margot is eating, her weight, and any times she has stomach distress. Dr. Joy adds it to Pam’s profile and after receiving an alert on her phone, Pam sees the updated chart on her dashboard.

    For two weeks Pam tracks the data that Dr. Joy has set up for her in the app. She weighs her every day. Three times she comes home to discover that Margot has vomited, so she adds that to her record. One morning she’s running late and forgets to give Margot her medicine on time. She receives an reminder that jogs her memory. Pam feels hopeful that this log will enable her see patterns emerging with Margot’s conditions, and help take some of the guesswork out of tracking information now that she knows exactly what data Dr. Joy’s wants to see.

    After the two weeks is up, Dr. Joy reviews Margot’s record in the hospital before Pam. is scheduled to come in for her appointment. On Margot’s record she can see the last correspondence with Pam, as well as Margot’s intake information, and the results from her data collection. Because all of the necessary information is in one place Dr. Joy has more time in the office to consult with other physicians, her appointments are shorter and more efficient, and she has more time to spend time with her patients. When Pam and Margot arrive for their appointment, Dr. Joy pulls up Margot’s chart on the desktop computer in the hospital room so that she can reference Margot’s data.