Week 2
Interview Protocol
We interviewed three users. Each user was interviewed for approximately 45 minutes. Users were willing to answer us. From each of the users, we asked a specific set of questions (questionnaire can be found on this site). About half of the questions were aimed at eliciting information from user about their daily activities, their physical conditions, and their diseases/disabilites. The rest of the questions were about the usage of diabetes instruments, the problems they faced while using the instruments, and their suggestions about how those devices should be improved. Apart from those questions, there was an interactive session where we gave information to users about our product, discussed its features with them, and they provided us with their valuable suggestions on what features should be included in the product. These suggestions are discussed in the "Adjustments in Design" section.
questionnaire.pdf | |
File Size: | 188 kb |
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Tentative Design Decisions
This documents provides the details about tentative design decisons for our Diabetes Health Care system.
tentative_design_desicions.pdf | |
File Size: | 105 kb |
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About Users
User 1
Meng is a 14-years-old Chinese boy. He inherited diabetes from his father and now he has been a diabetic patient since the age of 6. His family felt grief in the beginning and thought that he will never be able to live a normal life like other children. But fortunately, his mother is a doctor who has taken great care of her son during the past years. Due to a good control of glucose level, he has no diabetic complications and lives a happy life. However, some things are very irritating for him. For example, he frequently becomes a victim to high- and low- blood glucose levels. So he has to take medicines and injections every day and also he cannot eat everything he likes to eat. He has to keep control on diet and continuously monitor his glucose level. Some instruments in the market have helped him a lot. He can estimate the glucose level and inject insulin by himself. A problem associated with the diabetes instruments is that they are not portable so he cannot use them when he is not at home. He is afraid of doing exercises because his blood glucose level falls drastically in no time and then he becomes faint. It is very painful for an active teenager who can only see others playing sports. During the telephonic interview, he told that he is looking forward to some new production which can help him overcome these problems.
User 2:
65-years old Naeem lives in Pakistan. He is suffering from diabetes for past 25 years. Initially he was suffering from Type-2 diabetes. His doctor suggested him tablets. But due to his busy daily routine, he did not manage his treatment properly. As a consequence, he developed Type-1 diabetes about 10 years ago. Now he had to start taking insulin injections. By that time, diabetes had caused too much damage. He got many other complications like impairment of eye-sight, irregularities in blood pressure; oedema in legs; and swollen heart. Three years before starting insulin injections, a nail penetrated in his right foot while he was walking in a street. It was beginning of a new health problem for him. Since he was suffering from diabetes and was not taking medicines regularly, his foot wound became very difficult to heal. With the passage of time, this problem worsened despite of all cure and then his two foot fingers had to be amputated in order to prevent infection from spreading in the whole leg.
Naeem is living a life of retirement in his home. He spends most of the time watching news on TV, reading newspapers, reading books, and performing religious activities. Because of dexterity, he is not able to take insulin injections himself. His daughter gives him the injection. He himself is not able to check his glucose level and blood pressure as well. Here come again the services of his daughter. Because of diabetes, Naeem gets frustrated very frequently. He starts a long walk in order to get rid of this feeling. Also he suffers from hypoglycemia (low glucose level) twice of thrice in a week. During this state, he feels like fainting, his eye-sight blurs, he gets headache, and suffers from loss of concentration. In such a situation, he takes some chocolate to bring blood glucose level at normal. He keeps chocolate bars with him all the time.
Naeem was interviewed using voice and video chat. So we could easily explain the design of our system to him. Naeem wants a device that can enable him to check his blood pressure and glucose level himself. He suggests that the device should be portable, easy to learn and operate, and should have clear and visible display even at night. He also states that it would be a good option if this device enables him to take insulin injections without the help of any other person. In this way he will become independent.
User 3:
M. A. -- a 45-year old married Palestenien male having 2 children-- is a victim of diabetes. M.A. has moderate knowledge of computer systems and internet. After his office hours, he spends time with his family members and friends. He is fond of watching movies and football matches. He enjoys social activities and gatherings. He has been infected with diabetes since past 20 years. In the beginning when he had Type-2 diabetes, he used to take tablets for controlling the amount of glucose in blood. After some years, his disease promoted to Type-1 and he had to start taking insulin injections. Now he takes two doses of insulin daily – one in morning and other in evening. The total insulin intake per day is 25-30 units. Initially when his doctor told him that he would have to control and restrict his eating habits in order to keep his glucose level at normal, he got very frustrated. But with time, he has developed a routine to properly meet his body requirements and control his diabetes. Still he wishes to live his life without diabetes limitations. He states that he cannot run because he quickly gets exhausted. So his exercises consist mainly of walking and some simple body movements.
This patient was interviewed indirectly by father of one of our team members. The father filled in the questionnaire which was sent to him by email.
2nd Iteration of the Design (before user interviews)
Color Scheme:
The red text shows the previously defined function which is removed.
The blue text shows the reason for removing the functionality.
The green text shows the new functionality added.
(1) Monitoring Health Statistics
(i) Logging the statistics e.g. blood pressure; glucose, ketone, and cholesterol amounts.
(ii) Reporting to doctor on weekly basis
(iii) Indicating the trend of health status to patient as well as to doctor
(iv) Added: Displaying previous statistics to user on demand (for reminding if user forgot at what time and what dose of insulin did he take last time or what was his glucose level when he last checked it)
(v) Added: Not only displaying the health statistics but also speaking it so that a person with eye-sight problem may hear the statistics
(iv) Removed: Informing doctor directly in case of emergency
(a) Removed: Redirect information to another doctor in case of non-availability of his direct doctor
Reason: Doctor may not be available all the time
Modification: Calling 911
(vii) Sending closer images of patient’s organs such as eye, feet, teeth etc to the doctor
(viii) Eye sight monitoring
(ix) Wound monitoring
(2) Medication Assistance
(i) Informing patients when glucose level tends to go below some threshold
(a) Removed: Suggesting diets to be taken immediately
(b) Removed: Alternatively, suggesting medications such as tablets to take
(c) Removed: Or in case if above two are not possible, injecting correct insulin amount automatically
Reason: Injecting insulin automatically is not supported by the design of the system. User manually has to inject insulin. Moreover there is no need of insulin injection in case of low glucose level/ unconsciousness. It requires taking some food.
(ii) If the glucose level is going high, suggest patient to do some activity like an exercise.
Apart from assisting in getting out of hypoglycemia, our system helps patients in administering their daily intake of medicines. Some of the functionalities are:
(i) Informing patient at the time of medication
(a)Redirecting the alarm to family member in case of above is not possible or feasible
(ii) Daily Insulin Administration
(iii) Determining the correct dosage of insulin on the basis of health statistics(iv) Removed: Injecting insulin directly
Reason: Automatic injection of insulin requires an insulin needle always in muscle. This condition is not acceptable to users. So the design of our system includes manual administration of insulin rather than automatic.
(v) Added: Logging the time and amount of insulin dose for each insulin injection.
(3) Motivation Assistance
(i) Mood sensing and suggesting different activities
(ii) Suggesting social activities
(iii) Connecting to Social Networks
(iv) Providing entertainment
(a) TV, music , games etc
(b) Videos of happy moments of past
(c) A virtual reality device that shows 3D sights depending on user’s profile information i.e. the kind of views he may like in case of mental stress or frustration.
(4) Meal Planner
(i) Modified: Suggesting daily meals on the basis of health statistics and activities
Modification of above: Determining how many calories and carbohydrates a patient can take on the basis of health statistics (glucose level, blood pressure etc) and physique (height & weight) and suggesting a list of foods. User can select the foods of his choice from the suggested list in such a way that total calorie/carbohydrate intake is in accordance with the calculations done by system.
(ii) Added: Indicating the amount to calories and carbohydrates in different foods.
(iii) Making meal plan flexible by incorporating foods of user’s desires.
5) Exercise Planner
(i) Removed: Suggesting daily exercise schedule on the basis of health statistics and meal plan
Reason: User will himself set the schedule of exercises.
(ii) Removed: Motivating patient at the time of exercise
Reason: Users do not like to be instructed by someone especially a device.
(iii) Removed: Suggesting proper exercise way by showing some videos
Reason: User can do any exercise on the basis of his mood, stamina, and environmental conditions. “Suggesting proper exercise way” is a broad term which is not useful to realize in our system. We want to keep the design simple with least amount of time required for learning.
(iv) Monitoring health statistics during exercise
(v) Added: Informing user to take exercise if the system detects high glucose level.
(vi) Added: Suggesting exercise alternatives like walking, simple body movements etc.
Adjustment in the Design (after interviews)
In the light of suggestions from users, the following modifications/enhancements are made in the design:
1. Users wanted periodic determination of health statistics like glucose level, ketone level etc. However doing so required getting a drop of blood for testing and supplying to the system. Users said they would be tired of manually carrying out this process so many times (also the thought of blood samples taken several times a day was scary for them). So we have made a major change in our design -- getting rid of the taking blood samples for determining the health statistics). Our system will now use an innovative technology of determining the statistics automatically without requiring blood sample.
2. Color coding will be used for the display of health statistics. Depending on the particulars of patient's physique(weight, height etc), our system estimates the normal values of blood pressure, glucose level etc. This coloring scheme will indicate the deviation of the user's statistics from the normal value. For example, blood pressure shown in green will indicate normal value. A red color will indicate that blood pressure is above the normal value. A yellow colored value, on the other hand, will signify lower than normal blood pressure. This will help patients in visually interpreting the meaning of the statistics, rather than memorizing the normal value of different statistics.
3. The system will periodically check the blood pressure by means of sensing pulse beats and will then analyze it. In case the system discovers a trend of blood pressure going very high or very low, it will alarm to the user so that he can take some preventive measures to bring the situation to normal (e.g. eating some high energy food in case of low blood pressure).
4. The system will keep alarming when user becomes unconscious. The state of unconsciousness will be detected by interpreting the blood pressure value. Too low value of blood pressure is an indicative of unconsciousness.
5. In diet plan, the system should provide suggestions for alternate foods available as substitute if user does not want to eat some food and wants another for exchange.
6. Since users did not like the idea of automatic motivation (e.g. the system virtually showing a relative of the patient to motivate him for exercises, diet control etc), we have removed this option from our system.
7. Users also did not appreciate the idea of automatic mood assistance (e.g. the system detecting the conditions of frustration and depression and playing music etc to enhance mood of user). We have removed this option too from our system.
8. Users suggested that the functionality of the system to speak the statistics loudly (so that people with eye-sight impairment may not have problem in getting values from system) should be made optional so that those who do not have eye-sight problem may not be bothered by the sounds. So now we have made this functionality optional -- only for those who want to take advantage out of it.
9. Users were of the idea that "exercise scheduler" should not suggest hard exercises. Instead the exercise should be simple like walking, simple body movements etc. for bringing high blood glucose level to normal. They stated that too difficult exercise can lead to the situation of hypoglycemia which can result in unconsciousness. So our system has removed the difficult exercises. Only simpler exercises are offered now.
10. The display of the system is made luminescent so that patients with weak eye-sight may not feel uncomfortable when using the system at night.
11. The portable module of the system (which is worn on wrist) is made waterproof in order to prevent any damage caused by water while user is doing some activity using water.
12. We presented users with the option that whether the portable module of the system should be like a wrist watch or a mobile. Some users were in favour of watch-like device while others in favour of mobile-like device. In fact we had made this component as a watch-like device. On asking those who were against watch-like device the reason for their choice, they said that they have to wash their hands frequently so there is a risk of damaging the device. Now we have made our system waterproof, the reservations of those people are satisfied. So we retain the design of the portable component as a wrist-watch.
13. We got a suggestion from a doctor that one system should be used only by one patient i.e. there should not be switching of the same system between two or more patients. This is due to the fact the system is customized in the beginning according to the health statistics of the patient (weight, height etc). Switching of the system between patients of different physiques will result in erroneous results.
design_after_modifications.pdf | |
File Size: | 38 kb |
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Design Principles
1. The system should provide clear display of health statistics with coloring scheme for easy interpretation of the statistics.
2. The system should be water-resistant, portable, accurate, and reliable.
3. The system should continuously monitor the health statistics without bothering patient for blood samples i.e. the testing should be done automatically without taking blood samples.
4. The system should detect the emergency situations (e.g. unconsciousness) and should alarm (a blinking light as well) so that people may come for help. Alongwith that, the system should inform some close relative.