Improving the at home physical therapy experience.
Patient adherence is widely problematic in the medical field and physical therapy is no exception. Failure to complete exercises as prescribed slows a patient's recovery, wastes money and causes lasting health consequences. With the help of Premera Blue Cross, this project addressed:
How can I motivate adult physical therapy patients with acute, orthopedic injuries to adhere to their home exercise programs?
To better frame our project, I began with secondary research in the form of an academic literature review and a competitive analysis. I learned that current tools for physical therapy adherence are not working because they:
The primary research was framed by my secondary research and offered rich, first hand accounts of stories and experiences. My team and I employed the following techniques:
I began with an empathy building activity to familiarize ourselves with the process. A licensed physical therapist walked me through a typical first appointment and assigned us exercises to practice.
By conducting interviews in people’s homes, I observed environmental factors that may have affected their adherence such as what it's like to complete exercises while being walked on by a cat and a toddler.
After hearing from healthcare providers, we interviewed 6 patients ranging in self-identified adherence levels, and stages of treatment.
To help the team scope the problem space, we interviewed 6 physical therapists with a diverse set of specializations.
At several points along the way, the team discussed our findings and used affinity mapping, interview coding, concept diagrams and discussion to evaluate our results. Below are journey maps and design principles.
Prior to our primary research, I was under the impression that the patient experience looked like the first diagram. The patient would visit a physical therapy clinic, be expected to complete their exercises at home, and return for assessments until they were healthy enough to stop.
However if we pull apart the treatment phase, we see instead of being a consistent loop, little breakdowns along the way start to compromise a patient’s path to recovery. My research showed that patients did not feel confident remembering their exercises, were unaware of their progress, grew bored, and struggled to communicate their concerns during appointments.
The ideation process followed three phases of individual expansion and group contraction phases.
The team and I began with individual sketching with broad ideas created from a set of ideation prompts, drawn from the user research. Through the multiple week process of storyboarding and imagining what each final product might look like, I was able to discard and collapse features and interactions into our final direction.
In our ideation process, I created a list of values that reflected qualities the solution should have. I vetted solutions we had against these values and arrived at our final product, Motive.
To test these ideas, we built prototypes of the Motive system. First though, I used user flow diagrams to select what paths were most pertinent to testing. Next, the team and I created mockups and a research protocol to run participants through.
To improve and validate these ideas, I recruited former physical therapy patients for testing after running a pilot test.total of four participants tested the prototypes in either a private room set up in a campus library, or in the living room of their home. Participants ranged in gender, age, self-identified adherence rates, injury type, and current status of treatment. Testing through a scenario based, semi-structured interview allowed us to have participants interact directly with our prototypes in an imagined context (i.e. at the clinic, in their living room). They responded with quantitative scales and qualitative evaluations.
My hypotheses were the following:
After testing, I gathered responses to the prototypes for validation or challenging of the goals of the prototype. These are the results of the testing.
— Participant 2
— Participant 1
— Participant 1
— Participant 2
— Participant 2
The final design is a physical therapy assistant that motivates patients to complete their home exercises through reference videos, exercise reminders, engaging gameplay and progress reports.
The mobile data is then synced to a motion tracking device in the patient’s home. Here, motion based exercise games are generated to break up the monotony of physical therapy. Progress reports likewise reassure patients that they are on the path to recovery.
Ultimately, Motive succeeded in adding value to the physical therapy experience by empowering patients to take ownership of their recovery, providing confidence building reference materials, visualizing progress and breaking up the monotony of physical therapy -- as confirmed by experts and physical therapy patients. Unlike existing products, Motive accomplishes all of these objectives without requiring additional work on the part of physical therapists.