Exercise RX is a mobile app that supports patients to engage in physical activity and meet their health goals
January 2022- Present
Lead UX Designer and Researcher
What I did
UX / UI design
User research strategy
1 x Engineer
2 x Project Manager
3 x Designer
1 x Physician
1 x Medical Student
2 x Business Strategist
In conjunction with UW Computer Science & Engineering Ubicomp Lab and UW Department of Human-Centered Design & Engineering, The Sports Institute at UW Medicine developed Exercise RX. Exercise RX is an app that supports sedentary patients in increasing movement in their daily lives through behavior change interventions, physician feedback, and tracking.
Lack of physical activity is a health problem
Sedentary lifestyle affects 80% of Americans who do not meet the US National Physical Activity (PA) Guidelines. Research has shown that physical inactivity contributes to over 40 chronic health conditions, including diabetes, heart disease, hypertension, cancers, mental illness, and obesity.
While it is well known that PA is effective in managing and preventing these conditions, it is under-discussed and prescribed in clinical practice.
When I joined the team, I was tasked with assessing the efficacy of the Exercise Rx platform in supporting insufficiently active patients to increase their mean daily step count.
Hence, I led the design team in conducting user research and analysis to derive insights into the experience of users who used the application. In addition, I also led the design process by formulating design recommendations for the redesign of the application.
To better understand how patients stay motivated and the problems of increasing their step count, I worked collaboratively with the team to define the goals of this research study. The main objectives are as follows:
Evaluate the app’s usability and evaluate associations between app engagement and step count changes
Understand the barriers, opportunities, pain points, or hesitations patients experience with the app’s use
Conducting surveys to evaluate usability
ThemHealth app usability questionnaire (MAUQ)was also used to evaluate the app's usability. I used it to support the data from the interviews and perform a psychometric analysis.
I analyzed the survey data, which I later used to support the findings derived from the data analysis process. The questions asked during the survey were aimed at identifying the apps:
Ease of Use
Interface and Satisfaction
Speaking to patients during usability interviews
To better understand how the app supported patients in achieving their goals,15 usability interviews were conducted with patients who had used version 1 of the Exercise RX application. The interviews lasted from 45-minute to 1 hour.
The participants were recruited from the physician involved in this project. The objective was to identify user needs and opportunities for redesigning the Exercise Rx patient-facing mobile application.
Speaking to the patients revealed information about the application's impact in motivating them to achieve their health goals and objectives. I also learned the challenges they faced external to the app that influenced their experience with the application.
What went well and what can be improved?
After the interviews were concluded, I led the data synthesis process. Upon joining the team, some interviews had not yet been transcribed. In addition, I had new interviews to conduct and analyze. Hence, I decided to break the affinity process into 2 phases.
The first phase involved analyzing previous interviews and analyzing them. During the second phase, new interviews were conducted and analyzed in addition to the analysis done in the first phase.
Both phases started with the design team extracting quotes from the interviews and mapping the quotes against the "main buckets" we derived from the interview stage. We used Miro to gather our research findings. Afterward, we broke down each primary bucket to reveal sub-categories and identify our themes and findings.
How did the app support users goals?
The entire affinity analysis process revealed 6 key themes. These were then broken down into 16 detailed findings with corresponding design recommendations. For this portfolio, I will be focusing on the findings that directly influenced my design process. The key findings are below :
Participants found the app rudimentary and not intuitive to use
10 participants cited that the application was difficult to navigate and understand. They were unsure about the actions to take and did not find their experience intuitive.
2 participants cited that the app's functionality was basic hence not providing enough value
" I did not know how the app was supposed to be used
UNDERSTANDING THE PARTICIPANTS MEANS OF COMMUNICATION
This insight led me to conduct a heuristic evaluation of the application. I wanted to uncover elements of the app that did not provide clear direction, increased cognitive overload, and identify aspects of the app that would benefit from an improved visual design.
The following are the heuristic findings on the home page, trends page, and messages page:
" I could not visualize how far I had to walk to achieve the goal
Participants could not visually understand their progress, specifically graphs, and different metrics
Exercise RX is primarily a step count application; hence the metric used to measure progress is step count.
However, participants often cited that having solely a number of steps were challenging to estimate how much more they needed to walk to achieve their goal.
Participants want input in the goal-setting process and want their barriers and facilitators to be recognized
ExerciseRX sets step goals based on a patient's ability to reach previous goals. However, participants cited that they wanted to be able to either increase or decrease their step goals. This was due to barriers such as time, health concerns, bad weather, etc.
" I wish the app asked me if I wanted to increase my steps per week
How can we give users control over their experience
Regarding the last insight, that patients wanted more control over their step count target, I recognized an opportunity to solve this problem through another product in the Exercise RX ecosystem; the provider dashboard.
During hospital appointments, providers log onto the dashboard to view their patient's activity progress and their barriers to achieving their goals. With the addition of a step count slider in the dashboard, providers can define the step count target which would be reflected in the patients mobile facing application.
This demonstrates my ability to connect my work with other related initiatives across the company.
Hence, providers and patients can discuss and collaboratively set the step count target during clinic visits. This way, providers can rest assured that allowing patients to control their step count target would not lead to instances where a patient drastically reduces their target. It also gives patients some degree of control.
While this recommendation was well received, it was not implemented in version 2 but was put into the feature backlog to be revisited due to time constraints.
DESIGN AND ENGINEERING COLLABORATION
Presenting research findings to the team
I then presented the first phase's insights to the team via a workshop I conducted over Zoom. I designed the workshop session and solicited feedback from the team about emergent themes and subcategories. It was also helpful to gain insight and further understanding of the insights from a clinical standpoint provided by the domain expert, the physician.
For the second phase, I led another design workshop with other team members, including software engineers, doctors, business strategists, professors, and a project manager, to present the final/ aggregate insights and corresponding design recommendations.
While the data analysis process uncovered various areas of opportunity, such as creating personalized provider messages, displaying alternative exercise visualizations options, and allowing for journaling and messaging between provider and patient, I had to keep in mind the business goals and organizational capacity.
The project was running on funding from Seattle Children Care Alliance, and the release date for the next version of the app was set for July. Hence, we needed to push out the most "effective" design recommendations and changes. Therefore, the team decided to prioritize:
Improving user experience through user interface design
Facilitating progress tracking on a daily and weekly basis
Empowering users with control and freedom to perform actions
How can I make progress tracking more intuitive and discoverable?
When users log into the app, they first see a progress chart, and below are sections that provide additional progress information. However, users expressed confusion because there was a lot of information on the screen, particularly step count numbers.
Therefore, I tried differentinformation architectures and designs to inform users of their progress as well as their daily and weekly goals to make the flow clearer and more intuitive:
In the daily targets achieved section, users are supposed to identify the days they did not reach their step count goal, the days they met their goal and the current day. However, the original design failed to signify thisaffordance.
To begin, I explored various ways of representing this information that the user can easily understand. They are below:
The design team best understood the second iteration as meeting the requirements for the design. However, we continued to iterate on how best to design the daily targets achieved section and other screens.
The iterations helped me to confirm the team's design decisions before we spent more time refining the final prototype.
A vibrant new look
I also built comprehensive components librarywithin Figma that would later reflect in various parts of the app, i.e., colors, typography, grid setting, etc. This included icons, buttons, form elements, graphs, selection tools, and content cards.
One critical feedback from the interview session revealed that participants thought the app was dull and not exciting. Hence, for this redesign, I wanted to preserve the primary color and incorporate more bright and complementary secondary colors to the general visuals of the application.
Resolving information density and complex flows
I refined the concept with research outcomes in-line with our business goals and went through a few rounds of iteration using hand sketching. I also devised arevised and simplified information architecture focused on progress discovery and tracking, straightforward understanding of step information, and provision of flexibility and control to users.
With the critical components identified, I brainstormed flows that aligned with the patient's use cases and sequences that can help them quickly and smoothly navigate between different features. Below are the information architecture of the homepage and trends page.
In addition to adding a new container to highlight the weekly step goals, I added an edit functionality that allows users the freedom and control to modify their step count figure based on their personal wellness needs.
From the insight of “providing more ways to visualize goals,” I added two more progress spheres to provide varying visualizations that users can use to understand their progress.
I added “miles left” and “times left” to allow users who might have difficulty conceptualizing how many steps they had to take, especially when the numbers were large. I chose time and miles as they are commonly used metrics in exercise applications and are easily understandable.
I added a calendar input field where users could manually insert dates. In addition, with the calendar icon, users can click on it, browse through the entire calendar, and select their desired dates.
I redesigned the bar graphs to be interactive so that users could view their step count for that day. The weekly goal was also clearly stated by creating a container element that displayed the goal.
I added additional containers such as the “ Distance Covered” and “ Steps Completed” that provided more information on the user's progress. This was in response to the need of better visualization, which I derived from the interviews.
I changed the visibility and hierarchy of step count information. With the new screes, users first see how many steps they covered and can also view steps left within the progress chart.
I also redesigned the daily and weekly progress bars to make progress easily understandable. Here users have a clear understanding of the steps they have taken as well as their goals.
Communicating with non-designers
As the lead designer on the team, I faced several hurdles, trying tocommunicate the rationale behind specific design recommendations and advising why some suggestions made by the team might not be the best approach to take from a usability and design standpoint.
I learned that when working with an interdisciplinary team, it is necessary to communicate findings, results, etc., in ways they best understand. I also found it helpful when showing designs to include what things can "ideally look like" and “what is possible” to enrich their understanding of the design capabilities.
Working with limitations
Surprisingly, I loved working on this project because of the restrictions we faced as a team. The team needed to release the product to clinics and was also operating under a tight budget; hence the most ambitious ideas had to be put to rest for the time being. This forced me to think more critically and make better decisions that serve both the organization and the users.
It was initially challenging to part ways with several design recommendations that I felt would significantly impact the user experience. Still, I learned that the best solutions are ones that align with a company’s object and user's needs.