I started today off by reviewing Rebecca and Evan's blogs. I figured it would be nice to catch up on what they have been up to and learn from what they discovered, From Rebecca I learned everything Hep C. There is no doubt in my mind that within the next few weeks she will have the knowledge necessary to be considered a regional expert on the virus! Reviewing Evan's blog, I really enjoyed his link to the Health Design Challenge that showcased innovative new ways to design electronic medical records.

As I scrolled through some of the winning designs, I began to second guess an earlier decision. When first designing the home screen, I realize that the app can be created in one of two ways. It can be designed for inputting information (how I have been working so far) so the primary purpose for a user is to record information. Or it can be designed as a an app that presents information, and simply notifies a user when and where they need to update their inputs. As I looked at these Electronic Health Records, I felt that it is too difficult on our app for users to get to their information. We constantly ask for information but do we take the information and provide something with obvious value to the patient?

I began mocking up designs of a new home screen to replicate what I saw for the electronic health records.

As I began thinking up different ways to portray information, I was having trouble deciding which information is most important to include. I realized the patient report card was the summary I was trying to produce and so I shrunk down the picture from the grant and opened it up on my iphone.

The screen was too crowded; a big NO-NO in home screen design. While everything fit and was legible, the screen could not function as a "terminal leading to  information inputs." I settled down. For now, it will have to be fine that the information is two clicks away (About me --->My Charts--->). Identity crisis over and time to move on.

Next, I began reviewing the designs that I have so far and attempted to go deeper into the app. I drew up sample screen shots for the "my care" and "resource utilization" components of the app. While I knew from the start that I would not have enough information to complete these pages, I am happy I explored them. I gained an understanding of what decisions need to be made to complete these deeper layers of the app. Do we want to have our Users undergo a large scale data extraction or do we want to ask the minimal amount of questions-just enough so we can fill up the patients report card?

No matter how we answer the question, we will have to decide what the "minimal" or "crucial" questions" are so that I can mock up the final screen shots.

Before I talk about the new pages I have

My hands look like I just finished a day at nursery. Colorful ink marks decorate my fingers as a testament to a job well done.  Today I finished designing what I have termed the "main screenshots"- Mrs. Peppers would be proud of my work!

My "main screenshots" are the screenshots directly linked to the home screen and are therefore the first functional pages of the app. For some of these, I have come up with ideas I am excited about and for other I feel that I have settled, which means more brainstorming is in order.

Before I talk about the new pages I worked on today, I should first update my loyal fan base about the changes I have made since yesterday. In my last blog post I talked about the CNN scroll down menu that I thought was an innovative space saving tool. As I drew up what this would look like, I realized that we have another option. We can use the "Facebook-Like" scroll-out menu. Though I first saw this feature on Facebook, the three lined logo on the top left of the Facebook app screenshot has become a frequent tool to access a main menu page within an app. We can use this technique to create shortcuts back to the main menu and other important features of our Crohn'sPROMISE application.
            NICE RIGHT??- guess we will have to make some decisions!

My next innovation of the day came with re-working the Quality of Care portion of the app or "My Care." I realized that yesterday, I skipped a screen! We cannot have patients immediately plugging in the care items they received/scheduled to receive/want to talk about receiving. First, we must show a summary of precious entries of these categories. I was having a lot of trouble figuring out a way to organize these three separate categories. Should I show past entries in a chronological order but mix up these categories or should I group categories together but have them shown all over the time-space continuum?!?! Then I remembered: Tabs Tabs Tabs. I constructed three tab system (one for each category) and organized each category in chronological order. Now I got the best of both worlds- You can always get the best of both worlds if you set your mind to it! (just hope Milan or whomever else can program this... but for now, I pretend there are no limits!)

Having this summary screen first with an option to "log new treatments" made me much happier with the my care section of the app. The next screen will contain a simple two questions about a treatments status (completed, recommended, want a discussion) and what intervention we are talking about. I will need a list of all potential interventions to make screenshots for this-I would like to make this app dynamic which means each intervention may need it's own secondary screen to be designed and programmed. I also want to think of a better way to organize all of these interventions but I am satisfied with how this page stands.

The next screenshot I drew up is that of resource utilization. Right away I had the same question as the last few screens- Do I want this to serve as a summary of past resource utilization or a terminal to input new ones. I decided that patients would not be as interested in seeing their resource utilization and therefore have this screenshot with three text buttons (accompanied by pictures of course!) labeled "Emergency Department," "Hospitalization," and "Office Visit." These buttons will lead to a screenshot where the patient can detail each of these visits. We will need to decide what information we want to extract for each of these sections ie. the date, number of days, why they where there, who they saw... we don't want to over-ask but I need to know this to make the next screens. At the bottom of this screen, under the choices, I added a button "Past Utilization." This button can lead to a color coded line or bar graph to show a patient their resource utilization should they be interested in it.

And this is where I settled. The last "main screenshot" is for Quality of Life inputs. I have a nice design, but I think it is missing something or just not enough. Instead of explaining what I do have, I will write out the challenges that I feel come with this specific screen.

First, I need to choose what QOL indicators to include. The Harvey-Bradshaw Index can only be used as a guide, so we need to come up with our own set of indicators that will present QOL in an accurate fashion. I will need direction on this, as I only have a slight idea of where to start...

In addition to this pre-set group of QOL indicators we want to be filled out, we also decided that a patient should have freedom in inputting how their disease is making them feel. We recognized from reviewing Patients Like Me, that we will not think of every symptom! So not only do we have to create a system of overall QOL measurement, we also have to leave room for a user to create their own response.

Thirdly, we have to make a presumption before this part of the app is completed. Are we assuming patients will be willing to open the app every day and input information? This would be better, but can we really expect such devotion? My question is: are we going to ask a patient to input information each time they go to the bathroom, just one inclusive input for each day or maybe only weekly or monthly? The type of user we are designing for will produce much different types of questions when measuring QOL indicators.

These issues have made the design difficult as there is a lack of focus. I will need to have a better understanding of what we are aiming for if I am to create the design we are looking for. Overall, I think I am in a good place going into the July 4th break. I hope the time off will produce some artistic inspiration in design and looking forward to seeing what unfolds next week!

Yesterday I created screenshots for almost the entire app in just a few hours. While this work is a strong outline, today, I started from square one and proceeded at a much slower pace. Starting with the homescreen, I thought out what the main segments of the app should be. I had two options with the home screen- should it present a summary of the patients information or should it be an easy access way for patients to input information? I decided that the goal for the home screen is to create a terminal. A one way intersection that leads to the many branches of the app.  After a brief brainstorm, I decided to split the home screen into a category of "My Care," "Hospital/Doc Visits," "How I Feel," "About Me" and an "Other." This orginization would create an intuitive manner to input information on treatments/interventions, resource utilization, quality of life, personal information and access to any additional features we may feel are valuable. The home screen will have have five clickable square icons, one for each section, to access the rest of the app.

A final feature I am considering for the home screen is a Quality of Life (QOL) indicator. I do not want to distract from its purpose as a terminal, but I think it would be powerful if the home screen can relate information. At the center of the home screen, the logo for the "About Me" section is a picture of the patient. I will have to think about the best way to do this, but it would be great if we could make the picture change depending on the patients QOL. For example, it can become more blurry when their score is low and more sharp when their score is high. Or the color scale of the picture can change with their QOL score. This feature would immediately enable the patient to track their well-being just by opening the app. 

The next screen shot I worked on is the result of clicking on the "About Me" section. This section is where a patient can enter their personal information. They can enter the information we want them to input about themselves, their PCP and their specialist. I will need to know what information we want to get regarding their doctors and I have formulated a small list of the information we will probably want from each patient (address, gender, birthday/age, weight, height, date of diagnosis, medications-and can offer an reminder function for medications). I also think their should be a large button for "MY CHARTS" on this page that will lead to any charts, graphs or other informative features we can provide the patients. Maybe we can have a mock version of the patient's report card show up here in an interactive form; so they can click on any part of the report card and link to the section of the app allowing them to edit that specific information. Again, I will need to know what we will be able to provide on the app so I know what screens can proceed from clicking "My Charts."

`The last section I worked on today was that of "My Care." I had a little trouble for two reasons:

1. I do not know all of the potential prevention and interventions that we want to be recorded
2. I have not been able to come up with a simple intuitive way to group different care measures

This is an important page in the app that will create the checklist item at the top of the Patients Report Card. We need to make it easy for patients to find the different interventions that are either in their care plan or that they have experienced. I want to make a pre-compiled list that a patient can scroll through, but I do not want to throw everything together because this would produce too intimidating a list. If we can come up with an intuitive way to break this list into even two categories, I think that would do the trick.

The reason we are asking about their care is because we want to have a checklist at the top of the patient's report card. We need to know what a doctor plans on doing and what they have completed and I want to integrate this information into this screenshot. I also realized that we can add one more criteria. A "yellow -dash-"  on the checklist can mark an item that a patient is interested in discussing with their doctor. At the top of the "My Care" screenshot, I put a scroll menu with three options: ""Completed Intervention" (and then a date input will pop up), "Recommended Intervention" and "Want to Discuss". These options will sort the different interventions and orgnize the checklist on the Patient Report Card. 

All in all today was a productive day of design. I went much slower and think I found great improvements from the screenshots I created yesterday. I will continue on this path as I finish up the remaining screenshots. 

I assume there is because I sat down this morning to begin designing and at first I just stared. I know all about design. How to format a screenshot, when to incorporate aesthetics, what my tools are to accomplish these task; but I never did this from scratch. The past couple of weeks my job has been to critique the work of others. I have thought many many times "good job, just change this," but I have never began with a blank slate. That is never, until today! 

Whenever I am stuck: I stop, I plan, I outline and then I start again. After 40 minutes of holding my pen to a white sheet of paper (this paper remained white and pristine for the entirety of the 40 minutes), this method finally gave me progress. I looked over the final report card that we want the app to produce and broke down the information it contains into different categories. Once I had distinct categories, I was able to sketch out a potential Home-Screen. With a home screen done, I could make another screen, and another, etc, etc, etc, There are still some challenges in front of me. What are the right questions to ask (I don't want to be asking too many)? How can I make it obvious which information we want a patient to fill out without forcing them through to rigid a process? How can we design a platform that gets the information we require, while allowing a patient to add their own symptoms and concerns?

As I begin today drafting a second version of designs, I am sure these questions will find a way to work themselves out! I will be scanning in the different versions of designs to keep track of progress and the evolution of ideas and I am sure the progression that takes shape will be very interesting.

During last Friday's team meeting I presented Patients Like Me and reviewed the conclusions that are most applicable to our project. We had a small discussion regarding the strengths of a patients like me design, highlighting their immense collection of and strength in organizing data. Below, I have attached the presentation file as well as a sample "doctor visit sheet."