THE PRESCRIPTION MOBILE APP: Productizing behavioral care for people managing a chronic disease and needing behavioral therapeutic support

1. PRESCRIPTIVE APPS: Delivering therapeutic behavioral
care to chronic disease patients, enabling personalized
self-management of
diet, fitness and stress.
Michael Eckersley, PhD
Designing
a
wellness
economy
THE PRESCRIPTION MOBILE APP: Productizing
behavioral care for people managing a chronic
disease and needing behavioral therapeutic
support
1
This work is licensed under a Creative Commons Attribution 3.0 Unported License.

2. Acknowledgements
The
following
summarizes
research
and
design
planning
undertaken
by
Interaction
Design
and
Design
Management
students
at
The
University
of
Kansas,
over
Fall
2012
and
Spring
of
2013.
The
project
was
developed
and
directed
by
Michael
Eckersley.
The
initial
work
was
presented
December
4,
2012
at
the
KU
Center
for
Design
Research,
Lawrence,
KS.
Subsequent
development,
editing
and
integration
was
undertaken
independently
by
Michael
Eckersley
thru
HumanCentered,
an
independent
research
and
design-­‐
planning
consultancy,
and
published
online
June
12,
2013.
Contributing
Authors:
Design
Management
Team:
Peter
Henne,
Nicolette
Niosi,
Justin
Powell,
Todd
Register,
Adam
Roush
Interaction
Design
Team:
Amanda
Boyd,
Ren-­‐Wei
Harn,
Tyler
Lagally,
Noah
Albro,
Casey
Franklin,
Karen
Moore,
Nicolette
Niosi,
Caitlin
O'Connor,
Trey
Toman,
Lauren
Bock,
Kaitlynn
Howell,
Sera
Lanzer,
Nicole
Luby,
Megan
Miller,
Nick
Troll,
Whitney
Whallon
Scenarios
&
Simulations
Team:
Petter
Henne,
Nicoletta
Niosi,
Todd
Register,
Adam
Roush
Program
Sponsor:
Thanks
to
Bayer
Healthcare
for
their
support
of
the
KU
Center
for
Design
Research.
Contact:
mde@ku.edu
or
michael@humancentered.net
0. Acknowledgements 2
1. Introduction & Background 3
2. Research Question, Chronic Disease Literature 5
3. The Project Twofold Objective 9
UX Scenario 1: “‘Ben’s’ Story” 10
4. On Human-Centered Design Innovation 11
5. Researching and Modeling the User/Patient 13
UX Scenario 2: “‘Eleanor’s’ Lifestyle Change” 16
6. Market Analysis:
Consumer Behavioral Health Trends
Personal Health Devices Consumer Market
Map
Market Analysis: Current Device UX vs.
Benchmark UX In Personal Health Devices
17
8. Business Modeling:
Stakeholder Maps
Proposed Managed Care System Map
Solution Strategy
20
UX Scenario 3: “‘Joe’s’ Osteoarthritis” 23
9. The Consumer App Suite: Early Development :
Top-Level Device UI Wireframe, Navigation
24
10. The Nutrition App: Features, Concept Wireframe,
UX Use-Case
25
11. The Stress Management App: Features 27
12. The Fitness App: Features, UX Use-Case
UX Scenario 4: “Adam’s Resolve” 32
13. Bibliography 33
2
Contents & Acknowledgements

3. 1. Introduction Background
This
research
builds
on
earlier
research
and
design
planning
from
2009
involving
"Service
Tools
For
Innovating
Chronic
Disease
Management".
The
present
study
explores
a
model
and
a
technology
platform
for
delivering
effective
personalized
behavioral
therapeutic
care
to
people
suffering
from,
or
at
risk
for,
chronic
disease,
with
the
purpose
of
helping
them
better
self-­‐manage
their
diet,
^itness,
and
stress.
Treatment
and
prevention
of
chronic
disease
is
a
largely
under-­‐utilized
component
of
Public
Health
policy
and
of
the
U.S.
Affordable
Care
Act.
By
modifying
the
behaviors,
lifestyles
and
cultural
norms
contributing
to
excessive
rates
of
chronic
disease,
overall
healthcare
demand
can
be
reduced
signi^icantly,
thereby
making
health
care
more
ef^icient,
more
affordable
and
ultimately
more
humane.
The
governing
agent
in
reducing
chronic
disease
generally
is
consumer
behavior.
Therefore,
effective
treatment
programs
and
incentives
should
be
developed
by
managed
care
providers
to
help
consumers
better
govern
their
behaviors,
thus
preserving
their
health
and
better
ensuring
their
own
economic
security
and
quality
of
life.
Modest
reductions
in
preventable
risk
factors
could
result
in
40
million
fewer
cases
of
chronic
disease,
and
an
aggregate
savings
of
more
than
$1
trillion
by
2023.
Stemming
the
demand
for
avoidable
health
care
services
is
the
silver
bullet
in
any
serious,
sustainable
health
care
solution.
–
Michael
Eckersley,
“Solving
The
Economics
of
Health
Care:
How
Employer-­
Provider
Partnerships
Are
Producing
Cost
Savings
and
Healthier
People”
CMS
3
source:
Centers
for
Disease
Control.
CDC's
Healthy
Communities
Program.
Brochure.
Atlanta:
Author,
2011.
Cdc.gov.
2011.
<www.cdc.gov/healthycommunitiesprogram/communities/pdf/hcp_brochure.pdf>.

4. About
Chronic
Disease
Chronic
diseases
comprise
a
group
of
noninfectious,
long
term,
often
preventable,
and
their
worst
effects
are
often
avoidable.
For
our
purposes,
they
include
Cardiovascular
Disease,
Diabetes,
COPD,
Cancer,
Asthma,
and
Liver
Cirrhosis.
Though
others,
such
as
Crohn's
Disease,
Epilepsy,
Hypertension,
Arthritis,
Chronic
Pain,
and
Parkinson's
Disease
are
often
included
in
the
list
of
chronic
diseases.
Determinants
include
poor
diet,
inactivity,
obesity,
smoking,
psychosocial
stresses,
genetic
predisposition.
Causes
or
compounding
factors
include
lifestyle
choices
and
behaviors,
lack
of
regular
health
checkups
and
preventive
care.
Chronic
diseases
cause
over
80%
of
deaths
in
the
US,
according
to
the
National
Center
for
Health
Statistics,
2006.
An
aggregate
focus
on
chronic
disease
makes
sense
from
a
public
health,
medical
management
perspective
given
how
many
of
the
same
behaviors
or
lifestyle
features
are
contributing
factors.
Though
each
disease
has
its
own
distinguishing
pathology
and
set
of
expressions,
many
chronic
diseases
share
many
of
the
same
basic
treatment
elements.
Source: Newsweek Web Exclusive
Source: The Miliken Institute
Source: National Center for Health Statistics, 2006
4
Background

5. Change
Motivation
and
Cognitive
Behavioral
Therapy
Because
behavior
and
lifestyle
factors
are
common
contributors
to
chronic
diseases,
appropriate
modi^ication
of
those
behaviors
can
aid
in
treatment.
Cognitive
behavioral
therapy
is
a
psychotherapeutic
approach
useful
in
treating
dysfunctional
emotions,
maladaptive
behaviors,
and
cognitive
processes
by
means
of
a
number
of
goal-­‐oriented,
explicit
and
systematic
procedures.
Based
on
a
set
of
basic
principles
and
techniques,
cognitive
behavioral
therapy
can
be
an
effective
tool
in
helping
anyone
reduce
body
weight,
improve
diet,
and
better
manage
stress.
The
is
a
transformational
process
for
the
individual
and
it
typically
involves
the
following
goals:
1.
Compliance
to
treatment
plan
2.
Symptom
Reduction
3.
Healthy
self
perceptions
(i.e.,
lifestyle,
activity
level,
life
meaning,
spirituality),
and
perceptions
of
the
illness
4.
Acceptance
of
loss
of
pre-­‐illness
sense
of
self,
lifestyle-­‐-­‐both
in
the
patient
and
his/her
partner*
5
2. Research Question
Q:
What
kinds
of
tools
or
aids
could
afford
chronic
disease
patients
the
ability
modify
the
behaviors
or
lifestyle
habits
(e.g.,
poor
diet,
overeating,
inactivity,
stress,
poor
habits)
that
contribute
to
their
disease
and
hinder
recovery?
A
transformational
journey
*Treatment
of
Chronic
Medical
Conditions,
Len
Sperry,
American
Psychological
Assn.,
2008

6. Awareness:
Knowing
what
their
dietary
habits
are,
and
how
those
are
affecting
their
health.
Becoming
aware
about
their
ability
to
control
their
health
through
choice.
Knowing
they
aren't
alone.
Relevance:
Understanding
the
affects
food
choices
make
on
their
health,
and
being
able
to
visualize
that.
Doctors
or
dieticians
being
able
to
interact
with
patient
choices.
ConEidence:
Gaining
motivation
through
feedback,
friends,
and
facts.
Being
in
control
of
their
own
health
and
weight.
Knowing
that
they
has
the
tools
to
make
healthy
choices.
Knowing
that
they
are
able
to
track
their
information
easily
in
a
way
which
^its
their
life.
Satisfaction:
Seeing
results
both
in
numbers,
and
photos.
Being
able
to
connect
with
others
and
share
their
success.
Source:
A
Persuasive
Model
for
Behavioral
Design
(Fogg,
2009)
An
ethnographic
photography
of
food
intake
allowed
patients
and
clinicians
the
opportunity
to
re^lect
on
patient’s
dietary
issues,
understand
the
context
of
these
problems,
and
gain
awareness
of
habits
that
contributed
to
unhealthy
diet
(Keller,
Fleury,
&
Rivera,
2007).
Another
study
found
that
dietary
self-­‐
monitoring(i.e.
self-­‐weighing
and
keeping
a
food
journal)
was
associated
with
more
successful
weight
loss
over
a
12-­‐month
period
(Kong,
et.
al.,
2012).
6
Behavior
ModiEication
and
Diet What
People
Need
To
Break
Unhealthy
Diet
Patterns

7. 7
Behavioral
Issues
• Inadequate
breathing
patterns
• Insuf^icient
^luid
intake
• Poor
appetite,
eating
habits,
&
nutrition
• Sleep
disturbances
• Substance
abuse
• Inadequate
or
inappropriate
exercise
Psychological
Issues
• Fatalism
• Chronic
Impatience
• Sustained
stress
• Protracted
grieving
• Depression
• Absence
of
purpose
&
goals
• Lack
of
self-­‐assertiveness
• Lack
of
trusted
support
• Poor
coping
ability
in
times
of
crisis
Medical
Issues
• Repeated
exposure
to
sickness
• Limited
capacity
for
self-­‐care
when
sick
• Limited
involvement
in
health-­‐related
issues
• Passive,
uninformed
relationship
with
primary
care
providers
Source: Jeffrey M. Leiphart, Ph.D. University of California,
San Francisco, HIVInSite: www.hivinsite.ucsf.edu
• Type
"A"
personalities
are
encouraged
to
develop
and
maintain
regular
routines
of
"deep
relaxation"
• Patients
with
chronic
high-­‐level
stress
are
encouraged
to
develop
a
concrete
plan
to
ameliorate
the
identiEiable
sources
of
stress
in
their
lives
• Patients
need
to
learn
to
be
aggressive
about
deElecting
stress
• Patients
with
inadequate
breathing
patterns
are
instructed
to
practice
simple
deep-­breathing
exercises
• Moderate
exercise-­‐a
walk
of
20
minutes'
duration
three
times
a
week,
for
example-­‐will
reduce
psychological
stress
and
improve
immune
function
(Fitness
Section)
• Patients
should
be
able
to
discuss
their
health
status
on
a
regular
basis
Stress
and
Chronic
Disease
Elements
of
Stress
Reduction
Counseling
How
Stress
Affects
the
Heart
• Heart
rate
increases
• The
rate
of
blood
^low
speeds
up,
increasing
blood
pressure
• Fatty
acids
are
released
into
the
bloodstream
for
energy,
increasing
cholesterol
and
triglyceride
levels
• Cortisol
is
continuously
released
into
the
bloodstream
during
times
of
chronic
stress,
affecting
the
where
the
body
stores
fat
-­‐
most
commonly
in
the
abdomen.

8. 8
Fitness
and
Chronic
Disease BeneEits
of
Quick
Exercise
Routines
in
the
Workplace
• Simple
cardio
routines
do
not
require
any
equipment
at
all.
• Exercise
can
boost
endorphin
levels,
relieving
stress
and
providing
a
boost
to
their
self-­‐con^idence,
which
can
bene^it
job
performance.
• Desk
jobs
also
increase
the
strain
on
your
back,
wrists,
eyes
and
neck.
• Research
shows
that
a
quick
^ive-­‐minute
workout
can
have
a
positive
effect
on
stress,
body
weight
and
energy
levels.
Fitness
is
more
than
losing
weight.
• Cardiovascular
Fitness
reduces
chances
of
heart
attack
• Muscular
Strength
ensures
mobility
and
independence
• Balance
reduces
fall-­‐related
injuries
• Flexibility
yields
freedom
of
movement
in
simple
tasks
• Body
Composition
increases
more
energy
and
improved
mood
Source: http://www.nia.nih.gov/health/publication/exercise-
physical-activity-your-everyday-guide-national-institute-
aging/chapter-5
“Marty's
‘Exercise
Buddies’
Keep
Him
Going”
"Every
morning
I
head
out
to
the
mall
—
not
to
shop,
but
to
join
my
mall-­‐walkers
group.
At
75,
I’m
one
of
the
youngest
members.
When
I
retired,
my
wife
Harriet
insisted
that
we
walk
every
morning.
Some
of
us
move
at
a
steady
clip
through
the
mall,
while
others
take
a
slower
pace.
We
count
our
laps
and
keep
a
daily
record
of
our
progress
—
pushing
ourselves
to
go
a
little
faster,
a
little
farther.
When
Harriet
died
unexpectedly,
it
was
quite
a
blow,
but
the
walkers
were
my
lifeline.
They
kept
me
moving
when
all
I
wanted
to
do
was
sit.
At
^irst,
I
walked
because
it
was
something
to
do
each
morning.
But
now,
I
realize
that
I
like
how
it
feels
to
be
moving.
Measuring
how
fast
I
can
walk
gives
me
goals,
something
to
work
toward.
I
walk
and
feel
stronger
every
day.
I
often
think
of
Harriet
and
silently
thank
her
for
insisting
that
we
walk
together."
Source:
http://www.nia.nih.gov/health/publication/exercise-­‐physical-­‐
activity-­‐your-­‐everyday-­‐guide-­‐national-­‐institute-­‐aging/chapter-­‐5
(2011)
Making
Fitness
More
Social

9. 3. The Project Twofold Objective
Objective
1.
Integrated
Personalized
App
Suite.
Create
a
product/service
application
available
by
physician’s
prescription
to
chronic
disease
patients,
enabling
them
to
set
goals
and
track
progress
in
relation
to
physical
activity,
diet,
and
stress,
thereby
improving
general
health
and
^itness.
Objective
2.
Business
Model
and
Channel
Strategy.
Introduce
a
new,
high
value
product/service
offering
into
the
personalized
health
care
marketplace
as
part
of
a
provider-­‐de^ined
medical
management
plan
and
treatment
formulary
that
incorporates
real-­‐time
back-­‐
end
connectivity
to
the
patient’s
medical
record.
9

10. 10
User Experience Scenario 1: “‘Ben’s Story”
A user experience scenario*
“downloaded from the future” tells
the story of “Ben”, a 28 year-old
athlete who confronted a personal
health crisis in the form of Type 2
diabetes diagnosis.
https://vimeo.com/61838968
“Ben’s Story”
*
Product/service
user
experience
scenarios
help
teams
see
the
context
in
which
a
new
idea
or
offering
could
play
out
in
the
marketplace
and
in
the
lives
of
customers.
These
advance
snapshots
enable
decision-­makers
to
assess
the
merits
of
a
value
proposition,
assess
its
implications
and
make
better
a
priori
business
decisions.

11. Design
is
all
about
looking
carefully
at
qualities
of
human
experience,
understanding
the
context
of
practical
considerations
involved,
then
designing
things–products,
services,
experiences–that
create
new
value
for
people,
change
markets,
transform
industries.
In
the
words
of
Tom
Peters,
"Design
is
only
secondarily
about
pretty
lumpy
objects,
and
primarily
about
a
whole
approach
to
doing
business,
serving
customers,
and
providing
value."
Thereby,
“(d)esign
has
become
central
to
enterprise
strategy."
11
4. On Human-Centered Design Innovation
“The
human-­centered
approach
puts
people’s
needs
Eirst,
technology
second.
It
focuses
upon
human
activities.
It
makes
the
technology
invisible,
embedded
within
activity-­
speciEic
information
appliances.
Simple,
powerful,
enjoyable.”
–Donald
Norman

12. 12
On Human-Centered Design Innovation Every
business
has
a
front
stage
and
a
back
stage.
The
front
stage
comprises
everything
about
the
brand
offerings
that
is
discernible
to
customers
and
to
the
public.
The
back
stage
is
made
up
of
all
the
people,
processes
and
operations
behind
the
scenes
that
deliver
everything
that
happens
front
stage-­‐-­‐good,
bad
and
in-­‐between.
Great
product/service
experiences
must
be
understood,
developed
and
delivered
as
an
integrated
system
solution,
not
as
discrete,
individual
parts.
This
involves
a
process
of
discovery,
synthesis,
construction,
and
re^inement:
1.
Discovery.
Identifying
the
environment,
customers,
and
stakeholders.
Understanding
essential
organizational
intent
and
core
competencies.
Discerning
brand
perceptions
market
conditions.
Clarifying
points
of
intersection
or
interface
between
company
and
its
various
constituencies:
e.g.,
markets,
customers,
stockholders,
competition.
2.
Synthesis.
Making
deep
connections
with
both
customers
and
internal
stakeholders.
That
means
clarifying
various
customer
types:
i.e.,
their
characteristics,
expectations,
goals,
tasks,
options.
That
means
mapping
pathways
processes,
customer
journeys,
points
of
friction.
It
also
means
getting
a
clear
^ix
on
the
organizational
culture.
Who’s
involved
and
engaged?
Who’s
not?
What
are
prospects
for
change?
3.
Construction.
Great
product/services
experience
means
understanding
customers
deeply:
Building
user
personas
and
archetypes,
stories;
understanding
crucial
service
moments;
clarifying
value
aspects;
prototyping
ideas;
creating
practical
value
scenarios;
planning
and
rehearsing
customer
interactions.
4.
ReEinement.
Every
piece
in
this
performance
has
to
be
piloted,
assessed,
tweaked,
communicated,
documented,
and
revised
as
necessary.
Start here

13. 13
5. Researching and Modeling the User/Patient Ethnographic User Research of Chronic Disease Patients
Individuals
with
one
or
more
chronic
disease
were
interviewed
by
students
to
explore
the
user
experience
of
the
disease,
symptom
management,
and
assess
general
and
speci^ic
requirements.
Information
and
insights
from
these
interviews
were
helpful
in
constructing
basic
user
persona
models
of
two
typical
chronic
disease
patients
who
we
named
“Sam”
(diagnosed
with
heart
disease)
and
“Jill”
(diagnosed
type
2
diabetes).
From
these
descriptive
models
we
were
able
to
embellish
with
plausible
personality
features,
needs,
and
user
requirements.
Cognitive
behavioral
psychotherapy
(CBT)
is
a
biopsychosocial
approach
to
healing
which
focuses
on
how
we
think
and
evaluate
ourselves,
others
and
the
situations
we
=ind
ourselves
in.
Treatment
involves
evaluating
the
patient’s
“explanatory
model”
or
personal
explanation
for
the
causes
of
their
problems,
their
symptoms,
and
impairments.*
*Treatment
of
Chronic
Medical
Conditions,
Len
Sperry,
American
Psychological
Assn.,
2008
Situation
Thoughts
Behaviors
Moods/
Feelings
Physical
Reactions
“Jill”
diagnosed
Type2 diabetes
“Sam”
diagnosed
heart disease

14. Patient
proEile:
• 56
yo
white
male
• Spouse:Margie,
a
48
yo
female
• Children:
“Beth”
19yo
female
(college);
“Riley”
23yo
male
• Formerly
prep
athlete.
Sedentary.
Limited
social
af^iliations.
No
close
friends.
Chiefs
fan.
Used
to
restore
classic
cars.
• Accountant.
Owns
own
^irm.
Works
long
hours,
especially
during
tax
season.
• Financially
stressed,
lost
much
of
retirement
nest
egg.
Retirement
is
a
distant,
fading
dream
Disease
context:
• Heart
attack
2004
(stent),
possible
mild
stroke,
high
blood
pressure,
obese,
stress
• “I’m
a
fat
guy,
have
been
overweight
since
high
school”
• Resistant
to
lifestyle
changes;
no
idea
how
or
where
to
start
• Struggles
with
balanced
diet.
Fast
food
meals
several
times
a
week.
14
**Keller (1983) ARCS Model
“Sam”
diagnosed
heart disease
awareness relevance confidence satisfaction
“Sam’s” transformational journey
Program
intro,
familiarization
Goal
setting,
Aligned
motives
Experienced
success
Reinforced
lifestyle
Gets
educated
on
nutrition,
healthy
cooking,
meal
plans.
Begins
moderate
exercise
regimen.
Margie
accompanies
Sam
on
daily
walks.
They
integrate
new
diet
patterns.
Attends
yoga
and
relaxation
class.
Sam
monitors
progress
on
mobile
device.
Bioinformatics
show
improved
cholesterol
levels,
heart
rate
reduction,
weight
loss.
Their
children
note
the
changes.
Key
goals
are
attained.
Both
Sam
and
Margie
sustain
new
diet
and
^itness
patterns.
Risk
factors
are
signi^icantly
reduced.
Musts Reduce
weight
Heighten
activity
Better
manage
stress
Shoulds Acquire
trainer/partners
Broaden
social
circle
Improve
self-­‐image
Enlist
family
support
Desires Gain
purpose,
af^iliation
Must
Nots
Continue
fast
food
pattern
Remain
sedentary
Give
up,
ignore
condition
“Sam’s” Health Requirements
5. Researching & Modeling the User/Patient: “Sam”

15. Patient
proEile:
• 48
yo
single
mom
of
three
• Children:
Ivy
17
(HS);
Eva
23
(college);
Robert
25
• Nurse
at
physician’s
of^ice,
Loves
her
job
• Socially
active,
outgoing
with
friends,
community
groups
• Good
cook,
loves
entertaining
but
rarely
has
time
• Facebook
user:
checks
up
on
kids,
friends
• Cares
for
aging
parents
living
nearby
(early
dimensia).
Filing
guardianship
papers
Illness
proEile:
• High
risk
for
diabetes.
Overweight.
High
blood
pressure,
cholesterol.
Knee
problems
• High
calorie
diet,
“grazer”.
Former
Weightwachters
success
story.
Relapsed.
Deterred
from
doing
it
again.
• Self-­‐doubts,
prone
to
depression
15
“Jill”
diagnosed
Type 2 diabetes
awareness relevance confidence satisfaction
“Jill’s” transformational journey
Program
intro,
familiarization
Goal
setting,
Aligned
motives
Experienced
success
Reinforced
lifestyle
Receives
her
MyWellness
device.
Visits
with
wellness
coach.
Assesses
life
and
wellness
priorities.
Enlists
help
of
friends
and
family.
Sets
modest
goals.
Schedules
weekly
yoga
class,
Weight
Watcher
class,
Healthy
Cooking
class.
Begins
tracking
^itness,
food
points.
Begins
Jazzercise
class
with
two
friends.
Exceeds
all
goals;
publishes
her
success
to
Facebook.
Sets
new
goals.
Buys
new
wardrobe.
Goals
are
within
reach.
Busy
with
work;
caused
her
to
back-­‐slide,
but
she’s
back
on
track.
Daughter
is
now
attending
classes
with
her.
Musts Reduce
weight
Increase
activity
level
Lower
blood
pressure
Shoulds Better
manage
stress
Increase
independence
and
self-­‐esteem
Desires Enlarge
social
circle
Must
Nots
Given
in
to
depression
Gain
more
weight
Over-­‐rely
on
children
“Jill’s” Health Requirements
5. Researching & Modeling the User/Patient: “Jill”

16. 16
User Experience Scenario 2: “‘Eleanor’s’ Lifestyle Change”
Eleanor’s Lifestyle Change
Another user experience scenario*
tells the story of “Eleanor”, a 65
year-old widow diagnosed as pre-
diabetic now adjusts to new lifestyle
habits in order to feel better and to
lower her disease risk.
https://vimeo.com/62761997
*
Product/service
user
experience
prototypes
help
teams
see
the
context
in
which
a
new
idea
or
offering
might
play
out
in
the
marketplace
and
in
the
lives
of
customers.
These
advance
snapshots
enable
decision-­makers
to
assess
the
merits
of
a
value
proposition,
assess
its
implications
and
make
better
a
priori
business
decisions.

17. 17
Social
trends
involving
health
accountability,
and
particularly
increased
ability
among
consumers
to
quantify
and
track
^itness
and
health
factors
fosters
increasing
consciousness
to,
and
control
over,
one’s
health.
6. Market Analysis: Consumer Behavioral Health Trends

18. 18
Bayer Contour
gap value transfer
Personal Health Devices Consumer Market Map
Fitness
and
health
tracking
apps
are
currently
focused
on
the
consumer
market.
There
is
a
sizable
gap
between
that
consumer
market
to
the
medical/health
care
industry.
Market Analysis:

19. The
quality
of
user
experience
in
many
personal
medical
devices
is
currently
poor:
informational,
but
often
burdensome,
confusing
and
even
intimidating.
Hardly
lifestyle-­‐friendly.
Tracking
and
monitoring
information
such
as
glucose
levels
and
nutrition
feel
very
clinical.
Currently,
the
focus
seems
to
be
more
about
journaling
data
than
changing
or
improving
the
quality
of
experience,
behavior
or
lifestyle.
19
Market Analysis: Current Device UX vs. Benchmark UX In Personal Health Devices

20. • THE
USER,
with
a
prescription
from
his/her
physician,
downloads
the
branded
app
suite
from
a
managed
care
provider.
She
gets
acquainted
with
the
app,
sets
very
basic
goals,
and
begins
to
use
basic
functions
• THE
PROVIDER
offers
programmatic
support
(e.g.,
user
group
sessions,
counseling,
documentation,
social
networking
and
feedback,
troubleshooting)
to
users
to
build
competence
and
lead
to
more
advanced
levels.
• THE
PHYSICIAN
follow-­‐up
with
patient
in
subsequent
visits
offers
professional
support
and
encouragement.
• THE
EMPLOYER
wellness
program
reinforces
program
goals
and
incentivizes
employee
success
• THE
BRANDED
APP
PROVIDER
continues
to
upgrade
product
platform,
improves
usability.
Premium
custom,
personalized
services
could
be
offered
to
“super
users”
20
8. Business Modeling: Stakeholder Maps
The branded product/
service suite
Physicians
Managed Care
Provider
Corporate Wellness
Programs
Patients/Insured Lives
effectiveness is
assessed and
program is tweaked
to maximize
performance
continue to
upgrade and
expand
features

21. 21

22. The
Suite:
A
web
and
mobile
app
that
focuses
on
improving
the
health
of
people
with
chronic
disease.
This
app
suite
will
work
to
condition
new
behaviors
surrounding
^itness,
nutrition
and
stress
management.
These
new
behaviors
will
result
in
increased
health
and
reduced
cost
of
care.
The
suite
dashboard
available
by
login
displays
app
engagement
analytics
and
health
impact
in
aggregate
(to
protect
privacy).
App
engagement
measurements
are
used
to
help
project
health
improvement
and
projected
cost
savings.
22
Business Modeling: Solution Strategy
1.
Incentivize
and
enable
healthy
consumer
behavior
vis-­‐a-­‐vis
stress,
nutrition
and
^itness,
thereby
improving
health
and
lowering
chronic
disease
risks.
2.
Promote
individual
accountability
for
health
insurance
biometric
tracking.
3.
Adapt
consumer
Eitness
product
innovations
to
the
medical
side
of
the
market
9. The Consumer App: Dashboard Interface Concept A

23. 23
User Experience Scenario 3: “Joe’s Osteoarthritis”
Another user experience scenario*
featuring “Joe”, a 25 year-old artist/
printmaker learning how to better
manage his health and his
osteoarthritis.
http://www.youtube.com/watch?v=u1KouGJitaE
MyHealth: “Joe’s Osteoarthritis”
*
Product/service
user
experience
prototypes
help
teams
see
the
context
in
which
a
new
idea
or
offering
might
play
out
in
the
marketplace
and
in
the
lives
of
customers.
These
advance
snapshots
enable
decision-­makers
to
assess
the
merits
of
a
value
proposition,
assess
its
implications
and
make
better
a
priori
business
decisions.

24. Slide-­In
Navigation
When
a
slide-­‐in
navigation
icon
is
touched
on
the
top
level
navigation
bar,
this
menu
"slides"
in
from
the
left,
pushing
the
current
content
to
the
right.
This
navigation
allows
the
user
to
quickly
navigate
to
anywhere
within
the
app,
down
to
the
secondary,
tabbed
navigation
level.
When
there
are
more
items
to
navigate
than
can
^it
on
one
screen
the
navigation
items
scroll.
Home
Screen
The
home
screen
offers
a
quick
glimpse
of
status
and
progress
The
three
upper
circles
represent
the
three
apps
within
the
suite
application.
Each
circle
show
current
point
information,
and
touching
a
circle
sends
the
user
to
that
app.
The
face
indicates
status
and
progress
toward
each
goal.
The
lower,
scrollable
section
is
con^igurable
by
the
user
and
can
contain
a
log
of
current
events
(shown),
a
photographic
timeline,
inspirational
photos,
etc.
24
9. The Consumer App: Top-Level Device UI Concept Wireframe, Navigation and Interaction
Navigation
Past
the
home
screen,
the
top
level
navigation
is
always
present.
This
bar
provides
the
title
of
the
current
section,
the
name
of
the
user
and
an
icon
to
activate
the
slide-­‐in
navigation.
The
secondary
navigation
allows
each
app
section
a
way
to
divide
content
and
functions
with
a
common
tabbed
approach.

25. 1.
The
app’s
main
navigation
bar
lets
the
user
tab
through
the
various
screens
in
the
nutrition
app
(home
screen,
meal
planning,
statistics,
favorites).
2.
"Enter
a
Meal"
lets
the
user
input
meal
info,
or
plan
future
meals.
3.
"Point
Circle"
gives
the
user
a
quick
reference
to
their
daily
point
count.
The
point
count
correlates
to
a
simpli^ied
dietary
system
that
represents
the
nutritional
goals
in
an
understandable
way.
4.
“Tracking
Table"
lets
the
user
check
overall
monthly
data.
The
"Points",
"Pounds",
and
"Both"
buttons
offer
alternate
views
of
data.
Nutrition
App:
Top
Screen
Concept
Wireframe
25
10. The Nutrition App: Features
Physician
Connection/Prescription
Health
Information
Imported
Existing
Health
Statistics
Dietary
Goals
Communicate
Updated
Statistics
One-­Week
Nutrition
Assessment
Patients
Have
Time
to
Learn
App
What
are
the
Patient's
Habits?
What
are
the
Patient's
Preferences?
Makes
Tracking
Easy
Simple
Point
System
Photo
Assessment
of
Food
Ask
Siri
If
Your
Meal
Fits
Save
Favorite
Meals
Suggests
Changes/Tracks
Progress
Suggest
A
Meal
Enter
a
Meal
Point
Limits
Photo
Log
of
Food
Choices
Photo
Log
of
Body
Image
Offers
Goal
Reminders
Visual
Reminders
Alerts
when
Points
are
Exceeded
Congratulate
Patients
When
On
Target
Ability
to
Connect
Socially
Ability
to
Plan
Meals/Grocery
List

26. Presses
"Enter
a
Meal" Presses
"Let
Me
Tell
You" Says,
"Chipotle
Burrito
Bowl" Presses
"Yes"
to
continue.
26
The
Nutrition
App:
Use
Case
Scenario
Concept:
“Sam”
visits
Chipotle
Customizes
meal
and
presses
"Add"Presses
"Log"
Pop-­‐up
alerts
user
to
options

27. 27
11. The Stress Management App: Key Features
A.
Tracking
and
Recording
Heart
rate
Breathing
B.
Stress
Management
Techniques
Breathing
exercises
Games
Calming
music
Information
and
Tips
C.
Anticipating
and
Redirecting
Planning
and
Scheduling
Reminders
A.
Tracking
and
Heart
Rate
and
Breathing
• The
highly
sensitive
camera
on
a
smartphone
is
able
to
detect
the
slight
change
in
skin
color
during
a
heartbeat.
• For
the
app
to
begin
tracking
heart
rate,
the
user
will
gently
place
the
pad
of
their
index
^inger
on
the
camera
lens
of
the
phone.
• Continue
to
hold
hand
still
until
the
app
can
get
an
accurate
heart
rate
reading.
• The
result
will
indicate
whether
the
stress
level
is
low,
average,
or
high.
• A
result
page
will
follow,
detailing
the
level
of
stress.
• This
page
will
also
allow
the
user
to
enter
in
where
the
sources
of
stress
are
in
their
life.
• This
data
will
be
recorded
and
saved
for
viewing
in
the
Aggregate
of
the
Data
section
of
the
app.
SOURCES: Web MD, Human Physiology (McGraw-Hill, 7th edition), The American Institute
of Stress, Mayo Clinic, eHealth MD, National Heart, Lung and Blood Institue, American
Heart Association, Yale Medical School

28. Recording
Your
Data
• The
data
derive
both
from
breathing
exercise
and
heart
rate
tests.
• Presents
a
"big
picture"
of
recorded
stress
levels
Graphing
Your
Data
• The
app
graphs
user's
past
and
current
stress
levels
and
heart
rate
• The
app
offers
a
look
at
the
past
week
or
month
of
stress
levels
and/or
heart
rate
Identifying
Sources
of
Stress
• Helps
user
identify
issues
causing
stress,
and
such
awareness
enables
user
to
make
changes
to
improve
coping
skills
and
life
balance.
28
A.
Recording
Heart
Rate
&
Breathing
1.
Controlled
Breathing
can
reduce
stress
levels
by
syncing
inhalation/exhalation
with
you
current
heart
rate.
2.
Simple
games
can
distract
from
stressful
situations
and
activities
and
create
a
calming
environment.
3.
“Stress
Tips”
offers
information
to
help
user
become
more
conscious
to
the
causes
and
effects
of
stress
in
daily
life.
4.
"Calming
Sounds"
enable
user
to
tune
in
and
relax
while
performing
other
activities.
Music
Therapy
can
be
helpful
coping
and
easing
the
progress
of
some
illnesses.
B.
Stress
Management
Techniques
SOURCES: Web MD, Human Physiology (McGraw-Hill, 7th edition), The American Institute
of Stress, Mayo Clinic, eHealth MD, National Heart, Lung and Blood Institue, American
Heart Association, Yale Medical School

29. Planning
&
Scheduling
• Conscious
awareness
about
past
and
present
stresses
is
bene^icial,
but
stress
management
is
also
about
anticipating
and
preparing
for
inevitable
stressful
situations
(e.g.,
deadlines,
tight
scheduling,
over-­‐booking,
holidays).
Reminders
• A
smart
stress-­‐management
app
can
sync
with
your
calendar,
look
at
your
upcoming
schedule,
and
check-­‐in
with
the
user
during
tightly
scheduled
and
stressful
times,
reminding
her
to
get
sleep,
take
a
break,
meditate
or
reschedule
accordingly.
29
C.
Anticipating
and
Redirecting
Stress
SOURCES: Web MD, Human Physiology (McGraw-Hill, 7th edition), The American Institute
of Stress, Mayo Clinic, eHealth MD, National Heart, Lung and Blood Institue, American
Heart Association, Yale Medical School
The
stress-­
management
app
aims
to
support
the
user’s
long-­term
health
interests
and
life
balance.

30. 30
12. The Fitness App: Requirements
Fitness
Setup
Wizard
Use-­Case
Scenario:
“Jill”
sets
up
her
Fitness
App
and
does
a
workout”
The
Fitness
App
employs
a
^itness
wizard
to
roughly
assess
a
user’s
overall
^itness
level.
It
begins
by
asking
the
user
to
do
some
basic
physical
activities
and
answer
some
questions.
Q:
How
often
do
you
run?
Q:
Can
you
lift
5/10/15
lbs?
Q:
How
long
can
you
balance
on
one
foot?
Q:
How
long
can
you
run
or
do
a
vigorous
walk?
Q:
Can
you
touch
your
toes?
Q:
What
is
your
height?
weight?
Impact:
• Cardiovascular
Fitness
• Muscular
Strength
• Balance
• Flexibility
• Body
Composition
New
personalized
homepage
for
^itness
app
Review
and
modify
points
for
daily
goal
Fitness
App
Setup Wizard
Queries Setup
Completion

31. 31
The
Fitness
App
Use-­Case
Scenario:
“Jill”
does
a
workout
“Jill”
begins
her
workout
by
selecting
from
three
Eitness
instructors.
Then
she
selects
a
series
of
exercises.
For
each
exercise
there
is
an
optional
“how
to”
instructional
video
clip.
Do you have time
to do more?
10 Lunges
More No
13/20
17/20
10/20
19/20
20/20
She
check
her
goal
and
sees
workout
history
After
completing
her
workout
“Jill”
clicks
to
review
progress
On
completing
the
workout
the
app
offers
option
for
more
She
selects
jumping
jacks
and
watches
the
optional
video
demo
“Jill”
selects
from
a
variety
of
routine
exercises

32. 32
User Experience Scenario 4: “Adam’s Resolve”
A final sample UX video* from
“Adam”, a 24 year-old shocked by
news of his high cholesterol levels
and increased risk for diabetes.
“Adam’s Resolve”
http://www.youtube.com/watch?feature=player_detailpage&v=gL8oy16hYXU
*
Product/service
user
experience
prototypes
help
teams
see
the
context
in
which
a
new
idea
or
offering
might
play
out
in
the
marketplace
and
in
the
lives
of
customers.
These
advance
snapshots
enable
decision-­makers
to
assess
the
merits
of
a
value
proposition,
assess
its
implications
and
make
better
a
priori
business
decisions.

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33

34. PRESCRIPTIVE APPS: Delivering therapeutic behavioral
care to chronic disease patients, enabling personalized
self-management of
diet, fitness and stress.
Michael Eckersley, PhD
Designing
a
wellness
economy
THE PRESCRIPTION MOBILE APP: Productizing
behavioral care for people managing a chronic
disease and needing behavioral therapeutic
support
34
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