Service design | ux | Design Strategy
On behalf of Philips Healthcare, Breezely is a digital therapeutic service designed to help doctors, parents, and young asthma patients better communicate and exchange information during an initial asthma diagnosis and treatment process. This project was completed in six weeks on a team of four graduate and undergraduate designers.
LED DESIGN RESEARCH & STRATEGY
CLIENT MANAGEMENT + PITCH
How it works
Through the story of Breezely the Bear, the Breezely service improves a physician’s diagnostic confidence and better engages and educates patients and parents throughout their experience with asthma.
an asthma diagnosis through the story of Breezely the Bear
symptoms and medication compliance in an interactive Nightly Journal
during an attack with visualization techniques within the Breathing Buddy app
physicians' treatment plans with aggregated data from the Nightly Journal and Breathing Buddy app
From the perspective of a child with asthma the experience looks like this:
The Breezely ecosystem includes four main components: a physical storybook and accompanying teddy bear to introduce an asthma diagnosis, an interactive Nightly Journal to track symptoms over time, a Breathing Buddy app to support a child during an asthma attack, a companion app which aggregates all of the data for a physician.
The Breezely Storybook + Bear
Read in the doctor’s office during an initial diagnostic appointment
Asthma can be a confusing concept, even for adults, and we heard from parents and physicians that kids feel more empowered when they know what is going on. The Breezely storybook explains asthma in a language kids can understand and includes educational elements, such as how to properly take an inhaler.
Children also receive their own Breezely Bear to take home. It is the hope that by providing a physical version of the storybook character, children will stay engaged with the story through play and use the bear as a source of comfort during an attack.
Tracking symptoms and medication compliance
Tracking a child's asthma symptoms and medication compliance is one of the biggest challenges for physicians. Parents often have a hard time recalling symptoms beyond a 48 hour window, but longitudinal information is needed create an effective asthma management plan. The Breezely Journal is a nightly interactive journal that brings the character from the storybook home, and establishes a playful routine of recording the information doctors need to best manage a child's care.
Breezely prompts kids with questions about their day, any symptoms they may have experienced, and whether they took their prescribed medications. While a young child's sense of time can be warped, we learned through a service experiment that young children really delight in recalling events from their day and calling out specific events helps trigger more detailed information.
The interface uses simple drag and drop gestures suitable for 4-6 year olds and features instant playful feedback, similar to many app-based educational games.
Moments of surprise & delight are integrated into interactions to help keep children engaged
A star chart help kids and parents alike track their medication & symptom recording compliance
Asthma is a condition that can be controlled, but compliance with medications is often low, so we embedded motivation within the Breezely Journal to reward positive behaviors.
Support during an asthma attack
Asthma attacks can be scary, and inhalers and nebulizers for small children often require masks, which kids find uncomfortable and try to fight off. Inspired by mindfulness and meditation apps that help slow down breathing, the Breathing Buddy helps children visualize controlled breathing during an asthma attack.
If a child needs to take their inhaler, Breezely visualizes that action and the bear appears in an underwater scene, just as in the storybook, activating a child’s imagination.
We also heard from doctors that even when patients report taking their medications, it is nearly impossible to tell if they are taking the inhaler correctly. To address this, the Breathing Buddy records video of a child while they are taking their inhaler, giving doctors visibility into their inhaler technique in action.
Animations mirror deep breaths and taking inhalers to help calm kids and visualize what to do during an attack
Informing physician's treatment plans
We heard from doctors that there is virtually no communication between primary care doctors, specialists, and ER doctors. Information is siloed, but each specialist needs the same information to help treat a patient. Because of this, data is aggregated from the Breathing Buddy and Nightly Journal and is housed within the Breezely app so that it travels with the parent and child at all times, whether they are going for their regular check-up or have an unexpected visit to the ER.
The Breezely app aggregates and visualizes data from the Nightly Journal and Breathing Buddy for doctors to help inform their management plans. Doctors can see trends of symptoms, compliance with daily meds, and instances when the Breathing Buddy is used.
Philips Healthcare approached our team to help design a service-based business offering outside of their traditional hardware product line. With this in mind, they tasked our team with the following HMW statement:
Design a service that helps support the transition of children (4–10 years) from parental management to self-management in their asthma care.
Initial research & brainstorming
We began by familiarizing ourselves with the asthma space through secondary research and conversations with our client representatives to better understand the tone and approach of their brand and existing products.
While mapping the journey of an asthma patient from symptom discovery and diagnosis to long term management, we realized there was a really interesting time period when a child is put on a trial treatment for 4–6 weeks. The child’s symptoms and responses to medication during that period ultimately inform the physician’s diagnosis and longer term treatment plan.
This can also be a time of uncertainty for the parent and the child, as they are having to quickly learn how to manage new medications and deal with the emotional implications of having asthma. This process can be even more challenging for children between the ages of four and six. We decided to dig into this process and age group further.
Interviews with physicians & parents
Having honed in on the initial diagnosis process as our area for intervention, we interviewed physicians to better understand the diagnosis process, what challenges they experienced, and the types of information they needed to best manage a patient's asthma. We were lucky enough to access three different physician perspectives: a primary care doctor, a specialist pulmonologist, and a pediatric emergency room doctor. Since we were planning to design for children, we also reached out to parents to better understand what a day in the life of a 4-6 year old is like and the types of communication and activities that work well with this age group.
Insights from physicians
It is Hard to get an
accurate report of symptoms
Parents have a hard time recalling symptoms > 48hrs prior, and without an accurate report of symptoms over time it is difficult for physicians to establish the severity of asthma and create an effective management plan.
asthma medications a big issue
Asthma can be managed, but all of the doctors reported that non-compliance with medication regimens was their biggest challenge in managing asthma.
Patients often have improper inhaler technique
Even when patients do take their medications, it is impossible to know if they are doing it properly. Inhaler technique can be tricky and if not taken properly, the medicine will not do any good.
There is a Lack of communication Between Doctors
There is virtually no communication between doctors. If you have a chance visit to the ER, those doctors most likely do not have access to any of your patient history and have to start from square one.
Insights from parents of 4-6 year olds
mornings are chaos, nightime is slightly better
Morning routines are particularly challenging times with trying to get dressed, fed, and out the door. The nighttime can be a better place to introduce something new.
Kids' reactions to things are unpredictable
"It's like playing roulette, one day they are fine taking their medicine and the next they throw a fit."
Explaining what to expect helps kids prepare for something new
Four to six year olds can understand more than you think. Explaining what to expect from a new situation or the sequence of upcoming events can help quell anxiety in situations like the doctor’s office or taking a bath.
TRacking and rewarding progress works
Kids are really excited about tracking their progress over time - whether it is a homework sticker chart about practicing the piano or a board at school that color codes their behavior in green, yellow, or red throughout the day.
Backdoor research method
Since we did not have direct access to any families managing childhood asthma, we explored other ways to learn about parents' experience with managing their children's asthma and discovered insights in an unlikely place - Amazon reviews! Reviews left by parents on products and books about asthma provided incredible perspective into the emotional experience of managing asthma with a small child.
Putting the required mask on his face had become quite a battle and made taking his treatments that much worse. Then we discovered The Lion Who Had Asthma. Our little boy responded instantly to Sean who is the main character in this book. The idea to treat the mask from his machine as the mask to a jet fighter plane was ingenious. Now we read this book during his treatments and using the nebulizer has become less of a struggle."
Ideation with scenarios
We were inspired by the asthma storybooks being a core of the service and began to explore when and how the story could be introduced and used. How could the story be interactive and collect data over time? We thought about things like an asthma lunch box, with an asthma report card, that children could take to school.
We eventually narrowed our focus to three key moments and touchpoints in our service experience: at the doctor’s office (storybook), during a daily story time (interactive journal), and during an asthma attack (app).
We were excited by the premise of using an interactive storybook or journal to collect data about symptoms, but had serious questions about the feasibility of being able to collect meaningful data from a parent and child at the end of each day.
In order to test this, we developed a service experiment to assess 4–6 year olds' ability to:
Sequence events from their day
Report emotional states from their day
Call out specific activities that happened during their day
We were not able get access to kids with asthma, but realized that tooth brushing could be an analogous example to taking daily medications, and could be used to check recall of events. We designed a sticker and coloring activity to ask kids about their day and recall of brushing their teeth.
We conducted the service experiment on a sunny afternoon on a playground at city park. Setting up at a picnic table adjacent to the playground, we recruited families through signage and asking parents if they would be willing to participate as they arrived at the park.
We learned some interesting things about kids through this experiment, which informed the design of our service and underlying components:
They really love telling you about their day
Their sense of time can be really warped
But, when prompted, they can effectively recall a sequence of activity
The activity was most effective when done in collaboration with a parent
Prototyping & body storming
We took what we learned in our service experiment and went back to the drawing board to refine our approach. We decided that educating, tracking symptoms, and calming during an asthma attack were the goals we wanted our service to achieve. The storybook, phone, and tablet app rose up as the most natural touch points to fully develop.
It can sometimes be helpful to physically act out interactions, or body storm, to see how they flow together. With paper prototypes of each of our touchpoints we body stormed scenarios around doctor conversations and parent-child interactions to help us find the right tone and flow for our content. After a few rounds of this we were able to hone in on our core interactions and finalize our wireframes so that they could be taken to the next level of fidelity to pitch to the client.