MGSO4 Calculator
Domain: Graphic Design, UX Design, Development
Team Size:  01
Organization:  University of Washington, Path
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MGSO4 Calculator is an android mobile application solution that assists community health workers and members to perform certain tasks in curing diseases of pregnant women in developing regions across the world. This started as a research project with Path, a social non profit organization based in Seattle. The application is being built to assist the paper based job-aids (manuals that health workers and representative refer to follow steps to cure the disease) in decision making and calculating dosage solutions required to be given to patients.

In rural regions, there has been lot of problems for pregnant women who face pain and other difficulties during their period of pregnancy. During the pregnancy, there is a rare disease that these women face called Eclempsia. Eclempsia if not diagnosed in a defined and proper way, can proof fatal.

Why a digital Solution?

In the current system, nurses and medical representatives follow paper based solutions laying out the steps for diagnosis. There are varied problems to this:

1. Low literacy of nurses and community health members.

2. Paper based job aids are generally posted on wall

3. Eclempsia is a rare disease so generally health practitioners forget some of the steps involved and hence cannot immediately act if no paper aid available

4. They don't have enough expertise and knowledge to make proper calculations to dilute certain solutions to be given as part of the treatment

5. Papers generally get lost or torn and rusted in time and hence may not be helpful after a quite while.

6. In most of the settings, clinics just have one big poster that is being hung on the wall at the entrance and the medical persons refer to it every time they need to do so. In such cases it may become very cumbersome to diagnose keeping in mind they have to always go to see the next steps an reply on a single value concentration that is printed in the poster.

Mentioning the aforementioned problems that paper based job aids have, I worked with PATH, a non-profit organization in designing and developing a digital based mobile solution that would entail all the steps in more organized and procedural manner.
The digital based solution is a mobile application that is being built in Open Data Kit, also known as ODK, an open source framework for data collection). The mobile based solution was an outcome following the success of penetration of mobile based health solutions in rural environments (supported through various research papers) and various interview sessions with some of the community health workers at PATH and GLOBAL2LOCAL (another non profit that works in the Tacoma regions of Washington state in US).

Why an ODK platform application?

The following are the primary reasons for choosing an ODK based mobile health solution:

1. ODK is an open source software and has proven to be very helpful for remote data collection. It also provides a very intuitive and easy framework to build mobile based user interfaces. I used the advantage of the building the form using XLSFORM in an excel sheet.

2. Mobile phones are very handy and most of the community health workers we interviewed had android smartphones being given to them form the organizations they have been working with.

3. Digital based job aids can be carried in mobile phones with no fear of getting dusted or worn and aged out with time. Moreover, the job aid can be accessed whenever and where ever needed.

4. ODK provides widgets like Alarms and phones have calculation support that can automatically calculate the dosage concentration required to be given with no prior knowledge of calculations required.

Thus keeping the above benefits in mind and feedback and initial thoughts from the interview sessions, I designed the wireframes in Photoshop and then later developed the application using XLSFORM in excel sheet. Nathan Briant, a contractor and an DOK development specialist, working with the Computer Science department at University of Washington, was my throughout aid how helped me in solving some of the problems that came in my way.

Team Size

One



My Role

Visual Designer, User Experience Designer, Development (Using XLSForm)



Tools Used

Graphic Design: Adobe Photoshop
Wireframes: Paper Sketches, Adobe Photoshop,
Development: Open Data Kit (ODK), XLSFORM



The project was part of my Research Assistantship with the computer science department at the University of Washington. I have been working with Professor Richard Anderson and Professor Gaetano Borriello in this project for a year in partnership with PATH.
It was my first initiative to work with targeted users from developed world and learn the different needs and requirements and perception of technology in them. It was also my first venture into health care designing and developing a mobile based application. The user centered design paradigms for a web based application running on computer systems is very much different than from the mobile ones.

I learned a lot during the course of project - How to think simple and innovative ways to solve a problem in a constrained environmental space and limited scope of detailed interactions. Having done subsequent interviews and conduction of usability studies, I could acknowledge the usefulness of these design principles for developing a good user centered product.

As part of this project, I conducted various formal usability studies with the community health workers and interviewed them about mobile technologies and their perception about mobile phones being helpful in aiding them for their medical needs. It was a new experience working with people from developed regions who had pre-conceived knowledge about how touch works in smartphones and my first intervention in medical field. I have not worked previously in the domain of health care and hence the project was challenging in a sense to design for a new environment.

Design Idea

The idea was brought to us by our industrial partner Path, a non-profit based out of Seattle who wanted us to develop an ODK application to digitize job aids that medical clinicians could use in their day to day operations and also help in trianing other professionals. ODK has not been the perfect choice owing to many constriants, the first being it has been built to collect data and hence its user interface is not rendered to provide visual aesthetics. But what was done was diverting from its sole purpose to create an interstructural flow of process steps to be followed by the user.

In implementing the idea, I started with eveloping paper sketches based on the interviews I had it hfew community members working in Healthcare with Path. I then create statis mockups to demostrate user flows and interactions between screens in Photohop. Later, I used XLSform templates and ODK development tool to create a running application.

Literature Study

To gather information on the job aids and understand the difficulties faced by the clinicians, I worked with Adam Taylor, Program Manager at the Global2Local, another non profit based out of the Seattle region who has been working actively for the marginalized communities in developed regions. I interviewed two community health workers, understanding their experience in this domain. One of the health workers was from Aritria where she had been working in Eclempsia treatment for five years before joining Global2Local at Seattle. It was an interesting interview that brought up many challenging issues to the forefront. In parallel, I also worked with representatives of Path to create a flow diagram that entails all the steps to follow and could act as a paper based job aids that could be used for training purposes and also serve as a medium of instruction in replacement to the mobile based job aids. At Path, I also met with one of their highly experienced community worker who had immense knowledge in the Eclempsia subject and she became our subject expert and also a dignificant crtique whom we subseqently inerviewed as we progressed in the product development. Her feedback proved highly beneficial to be able to design a more user centered product.

Pilot

As for our first pilot study done with the alpha version of the applcation developed using ODK, I worked with three other team members from the Computer Science Capstone class to perform usability test for the application. To visualize the real life scenario, we prepared physical containers, injection syringes, a dummy foam as hands for injections and beakers with different concentric water solution(that acted to represent MGSO4 solution). We also prepared a short post test questionnaire. I was mainly the observer and taking noted on activities that were performed by the participants over the test phone they wee handed during the test.

We worked with seven community health workers: two from Global2Local, four practicing nurses from the Bates Medical School and one community health worker from Path. The community health worker from Path, our earlier contact, had been a great resource for us given her expertise in similar field for decades. She provided us with valuable feedback during the entire period of application development. The pilot studies highlighted some of the limitation of ODK that we originally had come across and we reaffirmed by the interviews. Some interesting observations that caught my attention were:

1. Paper based job aids were still preferred as they give a quick glimpse of the entire process as a whole where as working on mobile involved progressing through steps.

2. On the other hand, one of the participants preferred mobile based aids as they could refer them any time of their needs and would not needs to carry sheets of paper with them, that eventually torn away or get rusted in time.

3. Every one really liked the application, mostly the calculation part where any input of solution get autmatically calculated to be accordingly diluted as per the needs. This really would helpe clinicians from developing regions as most of the recruited members are low literate and calculations seem to be cumbersome job in circumstances when they need to attend the patients immediately.

4. Our study was also affected by the age group as we saw a trend where elderly women still preferred paper based job aids. Besides their preferences, the elderly had huge problems navigating through the screens and reading smaller text. They rather preferred printed out sheets of information.

5.Even most of the community health workers we interviewed had been using personal phones, they really lacked the intuition to swipe screen to go to the next task. This affirmed my Photoshop designs which have explicit "Back" and "Next" buttons to confirm actions.

6. Everyone preferred to have some visual cues to establish the specific steps as mentioned in the screen. Every one felt that visual cues really assisted them in making decisions.

Currently, the application is being tested in the fields of Eothpia by Path organizaiton and I am waiting to hear from them on the pilot results. Although having left the RAship with the department, I am invloved in providing any assistance I can to help pilot the project.

The project was part of my Research Assistantship with the computer science department at the University of Washington. I have been working with Professor Richard Anderson and Professor Gaetano Borriello in this project for a year in partnership with PATH.

It was my first initiative to work with targeted users from developed world and learn the different needs and requirements and perception of technology in them. It was also my first venture into health care designing and developing a mobile based application. The user centered design paradigms for a web based application running on computer systems is very much different than from the mobile ones. I learned a lot during my course of project in terms of design ideology for a constrained environmental space and interactions. Having done subsequent interviews and conduction of usability studies, I could acknowledge the usefulness of these design principles for developing a good user centered product.

As part of this project, I conducted various formal usability studies with the community health workers and interviewed them about mobile technologies and their perception about mobile phones being helpful in aiding them for their medical needs. It was a new experience working with people from developed regions who had pre-conceived knowledge about how touch works in smartphones and my first intervention in medical field. I have not worked previously in the domain of health care and hence the project was challenging in a sense to design for a new environment.