SXSW: Design for Awareness: Mobile Technologies & Health

Live from SXSW in Austin TX, Saturday March 13, 2010

Presenting: Robert Fabricant, frogdesign

Growing appreciation of the need for awareness of health issues; people don’t work very logically.  Mobile technologies can provide awareness around our own understanding of situations and decisions of health considerations.

Four people in frog talking about this: Robert, Fabio (“Design for awareness”), Clay, Josh Musick (“Augmented mindfulness”)

Augmented mindfulness: ‘A growing field of UX design that brings together methods for recording, processing, and feeding back to the individual or group so that they can better understand what they are doing.’

“It would be a great tool for people who have a harder time feeling what’s going on in their body.  It gives people a way to ‘see’ the result of an exercise or activity in their body.” - Chiropractor reacting to early product design from Robert

Mindfulness includes:

#1 Feedback

Collection, processing, reporting, and (key) reflecting on the behavior and changing

Levels of effort vary; may end up with a system that focuses on Collection (with Reporting being minimal), or Reporting (with invisible collection).  These impact how people interact with the system.

Nike+: ‘Minimal effort to collect, beautiful ways to view data’

Airstrip: iPhone application for doctors, connects to bedside equipment, provides tools to physician to get alerts, check vitals, monitor multiple patients remotely

Design principle 1: Trust in the system is established through athe effective balance of collection and reporting strategies.

LoseIt: most popular health app in the iTunes app store currently

Choice by Choice: iPhone app to log emotional events; but challenging to stay on top of recording

FitBit: good job of being invisible, but there’s some challenge because “there’s not a lot of reason/investment to bring me into the environment to show me the data”

Design principle 2: Data visualization is not as easy as people think; doesn’t necessarily motivate people.  ”I’ll take a badge over a graph any day”

Foursquare: Makes the moment of collection fun; gets people into the habit of collecting, give you feedback and tips at the point of collection

Design principle 3: If you can’t automate collection, you’d better make it fun!

#2 Motivation

Three ways to motivate (BJ Fogg):

1. Pleasure and pain

2. Hope and fear

3. Acceptance and rejection

Design principle 4: Designers don’t really understand motivation. We talk about things being intuitive, but we don’t talk about what makes people want to engage

Triggers

1. Signal: ‘Vitality Glow Cap’ pill bottle cap, screw onto normal pill bottle, it can communicate with the network, first alerts with visual and then sound 

2. Facilitator: Prius dashboard, people are motivated to understand their fuel consumption

3. Spark: Person has high ability, but low motivation, need a ‘spark’ to get them started doing a particular thing.  Example of adding a message into the ‘footer’ of a normal message being sent via SMS.

Design principle 5: People don’t like to set ‘policies’ for themselves. And we’re not very good at it even when we try.  Our preferences change over time, so it’s difficult for us to predict how we’re going to want to behave in the future

How to design experiences that bring future selves to us in the present moment?

Dan Ariely, Predictably Irrational

Design principle 6: The most effective triggers come from other people (or at least appear to)

getupandmove.com: challenge your friend on Twitter, a trigger comes from within your community, not because you set an alert or the system told you to do something

Game dynamics can be very powerful: how can we match people together, take impulses people have, match with others who are likely to respond at a particular moment

Temptd: app being tested currently within frog, matching signals with others in the community

#3 Ritual

How do you build habit?  How do you build ritual?

Set triggers along a timeframe, around exercise, eating, any personal health topic.

BJ Fogg: “My upcoming class is all about using tech to create new routines. There’s a lot to explore here.”

Project Masiululeke in South Africa: building in triggers and events across a cycle

Oprah or local celebrity ‘sending’ you messages to help keep you engaged.

Remote Home Monitoring: project focused on remote monitoring of cardiology patients, to look at what happens to people after they’ve had an alert that increases their awareness and/or fear around their health.  Many components: sensors you can put into bandages people can wear, other sensors in home environment, feed into a smartphone hub, feed into providers, coaches, nurses, guides, and ER.  There’s fear after a cardiac event, people are worried about leaving medical care after they are ‘better’ - this concept provides them the reassurance to go back to normal life because they know they have somebody on the other side listening.  Sense of relief - both emotional and healing value.  Information is surfaced back to the individual in order to make sure they had the sense that the information was flowing to the doctor - not just happening in the background.  Also looked at doctors: don’t want to swamp them with data, but also want them to have a good understanding that they have filters and alerts so it’s only getting their attention if they need it.

Design problems: getting feedback right on smartphone; getting bandage right so it’s comfortable and reassuring.

It’s the design of the experience that is important.

Design principle 7: Knowledge is transferable. So try to find the A.M. opportunities in whatever you’re doing.

Mint: Has the advantage of a lot of quantitative data, but doesn’t yet ask you how you feel about that purchase.

Fiat EcoDrive: typical graph-type visualizations but also has a bit of a game, playful functions within the app: enhances the quality of the interaction

Smart Meter Yello Strom: frog worked on the interface, very data heavy, 

Technology that augments mindfulness can help us address problems we (humans) are not naturally good at solving.

Tom Igoe: “Understanding is important but it’s only the beginning … how can our work help people not only understand the change needed, but also to begin making it?”

Robert Fabricant on Twitter: @fabtweet

Audience questions:
Q: Someone is talking about making your whole life a game, from getting up on time (+5 points) to picking up the kids on time from school (good parent badge). Does this align with what you’re saying?

A: It’s one more lever we’re playing with, but at some point you hope that the points themselves matter less, and the social cohesion becomes the more valuable thing.

Q: Andrew Donahoe, writes social weight loss software for the iPhone. Most surprising thing: software is very masculine, but should be more feminine.  Women are much more interested in the social aspects of weight loss, rather than the data.

A: I’ve had same experience.  Hubs and organizers tend to be disproportionately female.  Leads to overabundance of graphs and data visualization tools, this leads to a data visualization split.  FitBit has flowers in it, EcoDrive has leaves in it, but I’m not so comfortable with that.  Badges and achievements need to have the right amount of support, recognition in them.

Q: Humans co-evolve with technology.  You can talk about broad aspects of technology, and people evolving with it.  If we’re designing so many tools that increase our awareness of things, there’s going to be an information overload problem.  How are we going to handle being aware of more?

A: My brain is pretty full most of the time.  I tend to be a little optimistic, information overload is already here, not going to get better any time soon, so do you use these layers of info in the most valuable and effective way?  So many pieces of data are feeding into our heads, we have a limited amount of data we can manage, but our brains are very evolved towards social dynamics, social navigation, social analysis.  We’ve got information overload, the more services take information that is relevant and feed it into that type of social dynamic, our brains are well adapted to handle that.  Create moments of reflection no matter what you’re designing, and make it part of normal social conversations.

Q: Are you familiar with socialworkout.com?  People who blog their workouts, monthly challenges, you can click a big “feat accompli” which broadcasts to everyone. Seeing an increasing number of men on the site, even Olympic weightlifters. What makes it work for everyone is accountability to your community as the motivation.

A: Best person to boost you and encourage you isn’t necessarily someone who wants to be part of a particular community, but someone who connects to you in general.  When they get workout messages, it can be weird, but eventually they can become more habituated to these and start to interact with them.  Funky hashtags can become habitual within a group, the trick is to try and make these more broad-based, and draw people’s interest.

Q: Seems like a vast problem dealing with all these elements: motivation, data collection and visualization.  Thought about ways that services can interoperate?  OpenAPIs to get data into datavis tool or similar?

A: There are two things going on in parallel: lot of effort within the traditional healthcare system, such as the Continua alliance, to get everything speaking the same language.  But the challenge is that people doing this are looking at this like infrastructure, automated backend systems.  There’s another movement around social technologies enhancing people’s awareness around decisions.  These two are not parallel efforts, but different communities with different values.  One company working in nursing homes is focused on people’s emotional state and process, approaching first as communication tools and secondarily as health monitoring. Get social engagement and communication to happen, and then get other tools to fit in.

Q: One thing is that technology really can provide better awareness of health. What are thoughts on how mobile technology can help people make the right decisions? Any specific examples?

A: Some of this is almost depressingly simple, like FourSquare and badges - inventor was stunned at how powerful badges were - and smoking cessation programs have seen just one SMS a week can provide major uptick.  Simplest feedback shown to be very effective in depression and smoking.  For food: point systems, social cohesion.  Don’t need to invent something new, but find ways to take existing methods and apply them in this realm.