“Once they get the box, it can be a little overwhelming because they don’t realize how important each step is in order for the patch to be successful. When they have done all of these things, they need to wear it for the 14 days. They need to know what happens if it falls off or it’s not working as they expected. This is the paradigm we needed to understand for someone going through this process,” she says.

Creating a New Experience

All of the pilot testers positioned the patch correctly using the visuals and the paper template. (Credit: UEGroup)

Taking the current box and contents, UEGroup identified some of the opportunities where the experience could be changed to make it accessible for use by the patient. They also interviewed the team at iRhythm to integrate what they thought needed to be improved for the next version. Those steps led to some initial design decisions. The UE team targeted the older user population to make it as easy to use as possible.

“If we can make it easy for the 70 year old, then it should be easy for the 60 year old. This is using the universal design principle that we incorporated into this process,” says Nicodemus. “The [original] language and the visuals — and even the way the visuals were oriented — were targeted at a nurse applying it to a person instead of a person applying it to themselves. The language was too technical, and the illustrations weren’t mirroring what you would do to yourself,” she says.

The mobile app was designed to be consistent with the printed materials. (Credit: UEGroup)

To recast it for patient use, she says they focused on making it a much more linear experience. In this way, the patient can feel like they’re being walked through the process. UE decided to test three different concepts.

“We really wanted to understand what the boundaries were. We have design goals of what this product should do, but we had to prioritize those to understand what matters to the user. The best way to do that was by showing people extremes that push toward these different facets that we identified,” says Nicodemus.

The first concept was a simplified product that removed anything extra and made it as traditional as possible. All of tools and instructions were in one place. One of the downsides of this concept, says Nicodemus, is that the patient was faced with everything at one time, which could be overwhelming.

For the integrated concept, UEGroup brought in the notion of “progressive disclosure,” which she says is something that is often considered for interfaces, but not very often in product packaging or product design. With this concept, they were bridging the gap between industrial and interface design. The instructions would be printed on the box and as the patient opened it up, they were shown a new item to use and what to do with it.

“One of the things we liked about this is that it eased [the patient] into the process. What we thought might be an issue though is that someone could open the box, take all of the contents out, and then not know what goes with what instruction and would have to take time to figure it out.

The third option was a little bit crazier, says Niceodemus. The team presented different scenarios depicting when people might use the product and how a person deals with all of the different packaging, especially if they don’t have a lot of counter space. The concept included a notepad of tear-off instructions that the patient would dispose of as they used them.

During this phase, the team was also continuing to work on the mobile app, which she says also integrated idea of a progressive disclosure of just-in-time information.

Evaluating the Results

One concept provided an easily movable workspace due to the rigid box with minimal flaps and a quick start guide that could be read as a booklet or used as sticky notes, removing a step at a time. (Credit: UEGroup)

With the first round of testing, Nicodemus says they found something that isn’t really new news: people don’t like to read instructions. Rather, she says, they prefer dumping out the box and figuring out what happens with things. In addition, she says people clung to the familiarity of the instruction booklet. But they also liked having the information right next to the item in the box because “it gave them context of what that item was for. The progressive disclosure was helpful for people.”

“So those were the two most popular concepts. When we asked people what they wanted to do, they wanted to combine the progressive disclosure concept with the printed booklet,” she says. “We found that when we did that, it was obviously going to be too much information. So instead of giving them what information we thought was going to be best, we specifically showed them a concept that we knew was going to be too much so they could tell us where that line was. And we watched them to see where they were looking for what information. We got much richer information that way.”

For that app portion, she says the team shifted to more of a “news feed style” because it was similar to what people were used to looking at in their email or on Facebook. They opted to use very large action buttons to indicate something patients might need to do.

The Biggest Takeaway

Nicodemus says it was crucial to provide a consistent voice from the first interaction with the product to the end of the process when the patient would get a diagnosis.

“That consistent voice walking them through the process was the big ‘ah-ha’ that made this so successful,” she says. “Integrating the progressive disclosure method into the life cycle of a product really made a difference for the people exposed to it.”

She believes that this approach could be applied universally to medical devices, especially when the device is patient-facing and being used in the home.

“Having a clear voice helps the patient feel empowered and helps them feel inspired by this new technology they have in their home. Any way to give that feeling to the user is really important for an at-home medical device.”

This article was written by Sherrie Trigg, Editor and Director of Medical Content for Medical Design Briefs. She can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.. For more information about UEGroup, visit here .

Medical Design Briefs Magazine

This article first appeared in the January, 2020 issue of Medical Design Briefs Magazine.

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