EoE Squad is a mobile health app designed to support children, caregivers and healthcare teams managing eosinophilic esophagitis (EoE).
My Role
I designed EoE Squad in collaboration with Dr. Peggy Marcon from SickKids Hospital and under the supervision of Dr. Robert Fleisig from the W. Booth School of Engineering Practice at McMaster University. This mobile app was my Master of Engineering Design thesis project in 2017.
I was responsible for project planning, project management, design research, user experience design, user interaction design, and branding.
Background Information
Eating and drinking are some of the most basic human needs. Eosinophilic esophagitis (EoE) is a condition that causes inflammation in the esophagus, making eating and drinking difficult, or some times just not possible. Although a relatively rare condition, EoE prevalence is increasing rapidly. This condition is difficult to diagnose and treat because every case is different. Every patient experiences different symptoms, different triggers, and each treatment program must be custom and unique.
Stakeholders
EoE affects people of all age groups, including children. However, because I worked with industry partners from SickKids Hospital in Toronto, the primary stakeholders were narrowed down to patients with EoE between the ages of 0 to 18 years old. Through early interviews with healthcare professionals, it was understood quickly that this condition not only affects the quality of life of children with EoE, but also their families. Families are also primary stakeholders in this case. The healthcare team is involved in the process of diagnosis, identification of triggers, management of the disease and improvement of quality of life. In this context, they are secondary stakeholders.
Secondary Research
To understand the nature of EoE, I immersed myself in the subject for months by reading journal articles, community and hospital websites, interviewing healthcare professionals, observing medical procedures EoE patiens have to undergo, such as endoscopies, and completing an online course by the University of East Anglia about dysphagia (difficulty swallowing).
I also participated as a subject in a dysphagia research study where videofluoroscopy was used to analyse my physiological swallowing patterns.
Several problems that youth with EoE and their families face when trying to manage EoE were identified. All problems were analysed and categorized into 4 main groups:
Adherence: Problems relating to compliance with treatment and/or diet.
Self-Reporting: Issues related to human memory. Treatment of EoE relies heavily on patients reporting information to the healthcare team.
Knowledge: Problems related to patient’s and family’s understanding of the condition as well as the treatment.
Anxiety: Issues related to anxiety as well as anxiety’s worsening effect on swallowing difficulties.
Primary Reserach
To further understand the needs of the patients and their families, and be able to interact with them directly as patients of a hospital, I administered a quality improvement project directed by Dr. Marcon at SickKids. Several children and families were interviewed. They were asked about their EoE history, symptoms, diet, medications, seasonal and weather changes, resources/information needs, preferences and habits related to EoE and their technology use. Due to confidentiality, individual responses cannot be shared but these interactions shed light on many insights and clarified design opportunities.
To address the barriers to successful EoE management, the following needs were identified:
1. Help patients and families understand and follow their treatment
2. Engage young patients to gather important data from them in a fun way
3. Eliminate reliance on human memory for self-reporting
4. Allow researchers and healthcare teams to access available air quality data to explore the relationship between pollen and EoE
5. Provide reminders for repetitive tasks that may be forgotten and affect adherence to treatment (e.g. taking medications, tracking symptoms and intake)
6. Enable patients and families to understand where they are in the treatment process
7. Save time for the healthcare team by providing reliable data quickly and conveniently
8. Offer clear, informative and trustworthy resources to patients and families
Concept Development
As research progressed, design concepts were developed using sketches and wire-frames. These were used to obtain feedback from Dr. Marcon and a few gastroenterology dietitians.
Feedback from stakeholders and especially the healthcare team was crucial in the refinement stage. Their feedback and early testing of prototypes defined the direction of the design.
Final Design Features
My Treatment
This feature guides the patient and their family. It enables the patient to keep track, understand and access their treatment instructions and information at any time.
My treatment feature is valuable for the healthcare team as well. They save valuable time by being able to quickly access the entire treatment plan of each patient.
Game
The game engages young patients in a fun way to acquire important data needed for treatment. Each game is a custom experience based on each individual’s’ dietary restrictions. It is a learning opportunity for young patients.
Points
Points keeps patients engaged and motivated to self-monitor often throughout the day. Research has shown that more frequent self-monitoring results in better likelihood of achieving dietary goals.
Tracking
The tracking feature allows patients to enter their symptoms, intake and medication use in real-time, which eliminates the need to rely on human memory for self-reports to healthcare teams.
The app also tracks pollen count based on patient location. This air quality feature provides the healthcare team with information to explore and better understand the relationship between local pollen count and EoE.
Accountability
A compliance meter and a daily progress bar provide quick visual information to patients and families so that they can stay on track with their treatment.
Reports
The reports feature provides the healthcare team with complete data they can use to make treatment decisions.
Resources
This feature empowers patients and families with accurate information they can trust.
