After years of sports injuries and resulting physio treatment, I noticed there was an inefficiency with the way in which the NHS and private physiotherapists were communicating rehabilitation information to their patints. In 2015 I decided to research and design a product that would create positive change to outdated treatment methods, whilst helping to refine my lean product design techniques through the guidance of General Assembly, London.
Whether it was a torn ACL or dislocated shoulder (the list goes on!), there was a common routine to the treatment; a short hospital stay and minimal time with a consultant that would refer you on to a physical therapist. If on the NHS be prepared to wait, or seek private help at a cost. Contact time with the physio was variable, and we would typically rehearse one of many exercises to be repeated in my own time.
In between periodic contact time with my physio I would be supplied with 2d printed workout routines that were both difficult to follow and ambigious in their required actions, or 'form'. In a bid to remember this form in repitition, I took photos of the individual programmes on various sheets of paper and stored them on my phone.
It was often a struggle to motivate myself to exercise when debilitated, which was at times quite an isolated experience, especially when I wasn't feeling confident in how well I was progressing. It left me wondering whether this was a common issue, were all physiotherapists practicing in this way, could digitalising this process aid patient recovery times, and how could the experience of being injured be less isolating?
I wanted to create a product that would remind me when to carry out my exercises, motivate me, track my progress and reinforce the correct movements taught to me during my physio sessions.
The design of Physio Focus was undertaken during my study at General Assembly, London. In order to help develop my knowledge of lean-startup I set myself deadlines for discovery research, analysis and design to a point at which this product could be potentially pitched for further investment, based on the testing/validation of a clear user demand for the product as a business investment.
Hypothesis and assumptions
Before commencing discovery I set assumptions on user need, hypothesising where value could be created in theory. I created proto-personas to help capture my assumptions and identify user groups for participant recruitment.
I conducted contextual interviews and work shadowing in order to help prove or disprove my assumptions, and capture context of use. In discovery I successfully:
- Identified current challenges physiotherapists and patients encounter during a rehabilitation journey from injury to recovery.
- Explored the behaviours and motivations in context of the use of my intended product.
The "5 W's and How"
I visualised what I needed to know during my discovery phase by mapping out research framing questions; Who, what, when, where, why and how?, and propopsing assumed core user needs. For example;
- Who are my users?
- What are my users trying to accomplish?
- When would the product be used
- What features would be important
- How should the product look and behave?
- What form should my product take?
I constructed proto-personas based on assumed behavioral and motivational characteristics, and the factors that differentiate these patterns, whilst using them as screening criterea to select interview subjects. The personas were then refined and updated as I progressed through the discovery phase.
Exploratory interviews and synthesising personas
Given that the problem was isolated to my own at this stage, and the ideas about how to solve it were based on a set of assumptions, I decided to kick off user research with contextual interviews with assumed core user sets. I sourced participants at my local gym, and the physio practice where I had been previously treated. Research framing questions were used to structure the interviews.
I maintained some basic principles throughout questioning, to help ensure quality.
- Interview where the interaction happens
- Use open-ended and closed-ended questions to direct discussion
- Assume role of apprentice, not expert
- Encouraged storytelling
- Probed for potential goals, motivations and pain points
I created the minimum amount of artefacts in order to communicate what the user experience ought to be, and what my key learnings were. My original persona hypothesis consisted of 3 different archetypes which I used to facilitate discussion about needs and frustrations in varying contexts of use.
Through interviewing these key user sets I obtained valuable insight that I otherwise hadn't considered, or wouldn't have been aware of.
Key patient insight:
- Patients discussed a lack of motvation when tasked with intensive rehabilitation workouts
- Clear tendancy to lose or misplace the paper-based workout sheets
- 2d images innefective as technique reinforcement, which is a crucial factor in muscular recovery
Key physical therapist insight:
- There exists an inability to track patient progress outside of face-to-face contact time.
- Physio's in the NHS are experiencing increasing pressure to be more cost effecient whilst being overwhelmed by the demand for patient contact time.
- Existing methods within the NHS to record patient progress are outdated, 'time consuming/arbitary' to use due to free text input.
- There exists software to rapidly create workout programmes, but they are not often shared with the patient
Training programmes have been traditionally been created under the NHS using UKROC software, which also collects data and stores patient data. Through talking to multiple physiotherapists, there was shared frustration at the speed at which they could enter and retrieve data due to the fact that it was built in an excel framework and was all free text.
"It's very hard to find a picture that matches specialist exercises, and they are difficult to describe in free text should there not be an accompanying image."
"2d diagrams are often time consuming to create and potentially innefective as technique reinforcement tool - a crucial factor in effective muscular recovery."
NHS vs Private
There was a noticable difference in the sophistication of software being used when comparing NHS based physio's to those conducting their own practice. A number of private physio therapists where using competitive workout builders that offered patient sharing - serving as a great opportunity to probe for potential product frustrations.
NHS based physiotherapists were all aware of the potential technology, but discussed the cost/difficulty in shifting to a different method, whilst working in an already pressurised timetable. Any software I plan to build would ideally need to easily transfer existing data from UKROC.
When gathering these results, I found it useful to both experience map the journey for patient and physio from the time of injury, to full recovery. Whilst doing so, I was also considering what would potential solve these core target user pain points in the form of product requirements.
Conducting competitive analysis helped me to take a stance on the viability of the product, and to make recommendations on how to move forward by fulfilling actionable learnings. Key questions about the marketplace included:
- Which competitors are closest to delivering a similar value proposition?
- Who is succeeding and who is failing, and why?
- Of those competitors, how do I think users are discovering them?
- Which products offer the best user experiences and why?
Introducing Physio Focus
An easy to use mobile app for physiotherapy exercises, that provides videos and text instructions on how to perform your routines and rewards you for doing so.
FOR THE PATIENT
The app provides daily exercises at a glance, complete with clear instructions, images and videos that ensure the exercises are performed correctly.
People are not always motivated to actually do the exercises they have been prescribed. Physio focus aims to add an element of fun to encourage dehabilitated users to reach a daily exercise target by unlocking badges, prompting them to share their success within the app-wide community feed.
- Daily exercises at a glance, complete with clear instructions, images and videos that ensure the exercises are performed correctly.
- Set daily workout and appointment reminders
- Track and analyse your progress, and what your targets are for the weeks to come
- Readily available advice on walking with a frame or crutches, hip precautions, breathing exercises, managing pain and self assessment, as well as recommended technniques for getting in and out of vehicles.
FOR THE PHYSIO
Create an individual exercise program or use the comprehensive workout library, send it to your client within the app and monitor their progress. This gives you a great opportunity to review your clients training programme and assess their activity.
- Create professional exercise programmess tailored to your clients’ needs
- Transfer patient data from UKROC
- Engage and motivate your clients using cheers, and congratulatory messages
- Select from a range of exercises in different specialist areas
- Reduce appointment no-shows through alerts, and an easy booking/cancellation service
- Create and manage client lists
- Set appointment reminders and use the daily calendar to prepare for client treatment sessions
- Create new exercises, and build your own library if required
Beta user testing
Conducting task-based interviews
I am now in the process of repeating the ethnographic interviews I conducted at the start of my discovery based research, but with more focus on specific functions and task-orientated issues. My aim here is to further clarify user roles and behaviours, whilst fine tuning the prototype to their needs.
I have also begun usability testing the prototype at a high-fedility stage, by participants to attempt product tasks in both specfic scenarios and free browsing.
Common questions included; What would you expect to happen? Where would you go? What would you do? in an attempt to facilitate conversation and feedback, whilst avoiding leading questions and interrupting the user mid-task. I took notes throughout the short testing sessions.
Interviewing where the interaction happens
Following the first principle of contextual inquiry, it is of crucial importance that subjects be interviewed in places where they are most likely to use the product, allowing for even more detailed insight into potential product constraints.