The Challenge
knowRX Health created The Owl App to empower patients and their medical care providers by increasing drug knowledge and communication, as well as increasing health awareness and general well-being. This medication adherence app schedules, reminds, and reports on medication intake and any associated side effects. It also has a built-in daily check-in that inquires about patient mood, pain levels, vital stats, and physical activity. Patients can then share this information with their designated medical contacts.
My design team was given the challenge to both gamify the patient experience on the app as well as incorporate incentives and rewards for medication adherence. Our clients at knowRX Health were also interested in our UX/UI recommendations for the app as a whole. Our team of three had three weeks to complete the project.
My role
As the UX research lead, I…
Performed competitive research
Designed and conducted user interviews
Synthesized results of all user research activities
Built personas and their user journeys
Conducted usability testing, developing phase 1 and phase 2 recommendations
Feature Analysis
There are a lot of medication adherence apps on the market. I sought to understand where The Owl App fits within its competitive set as well as its unique value proposition. I downloaded eight of the most popular medication adherence apps to experience them as a user. While the multiple reminders became a bit of a nuisance, the benefits were clear: the reminders and streak notifications kept my wellness routine on track. Early on in my research, I observed that The Owl App was the most comprehensive in its approach. I will go into more detail about this later in the case study.
Gamification
Our client had requested we incorporate a gamification element to The Owl App. To understand how gamification is successful, I studied Yu-kai Chou’s Eight Core Drives of the Octalysis framework: Epic Meaning and Calling, Development and Accomplishment, Empowerment of Creativity and Feedback, Ownership and Possession, Social Influence and Relatedness, Scarcity and Impatience, Unpredictability and Curiosity, and Loss and Avoidance.
Four of the Core Drives that directly applied to The Owl App were:
Development and Accomplishment: The Owl App can provide users with rewards—both encouragement and tangible rewards—for taking action that supports their health. It also allows users to share their performance with their care team and loved ones.
Empowerment of Creativity and Feedback: The Owl App can provide users with the opportunity to earn points in different ways, e.g., tracking their medication and supplement intake or their fitness goals, and providing them with the opportunity to take surveys and pre-screens for research studies (surveys and pre-screens are on the knowRX Health development roadmap).
Ownership and Possession: The Owl App can provide users with the opportunity to both view reports tracking their wellbeing and share them with their care team and loved ones.
Loss and Avoidance: Tracking streaks addresses users’ aversion to loss. The Owl App could choose to put expiration dates on users’ points to create a sense of urgency to accumulate and use them.
User Research Goals
The key areas of inquiry that we identified included:
Users’ medication needs
Their barriers to medication adherence
Users’ potential motivators or responses to gamification principles
Any other healthy habits they’d like to track
What We Learned
Our user research validated the need for a comprehensive app that tracks both medication adherence and well-being more broadly. It also affirmed the value of incentives—both tangible and intangible.
Medication Adherence: Needs and Barriers
Users taking more than 1-2 medications have difficulty remembering to take them regularly and on time. This is even more true of the elderly population.
Taking care of family members/loved ones’ medication adherence is overwhelming.
Travel and routine interruption can be barriers to medication adherence.
Pillboxes are helpful but often not enough to support users with a more complicated medication regimen.
Users can mix up medication when it is not in its container. They need color and shape information.
Users want easy access to drug information. The print on medication packaging can be too small to read and it is not comprehensive.
Motivators
Tangible incentives, e.g., gifts, discounts, and donations
Gamification, i.e., streaks and challenges
Other people, their communities
Information and tracking
Related Behaviors
Many users use apps to track their health, e.g., exercise, water, food, and their menstrual cycle.
Many users want more information on how to be healthy and fit.
Some users need a simple, basic UI—they are turned off by app complexity.
Some users don’t want to download and use “another app.”
What We Heard
“My pain meds are as-needed, but sometimes I don’t remember if I have taken them.”
“I stay with my family and I am the one in charge of their medications. I am finding it hard to be organized. I just keep track by checking my calendar and reminders. But still, I miss the doses most of the time if I am busy.”
“Incentives like gift cards might be exciting. I also enjoy the streaks. If a streak is broken you lose them all - that also kind of keeps me motivated.”
“Because of the incentives, I make sure that my things get logged (food, water, exercise, sleep).”
Our User Personas
Meet Sara, a family caregiver
Sara, a 28-year-old web designer, lives with her aunt and her family in San Francisco. Her aunt has just had ovarian cancer surgery and needs a lot of support. Because Sara is local and has flexibility as a freelancer, she moved in to help care for her. Sara needs a better way to track her aunt’s multiple medications and symptoms. It is too easy to miss or mix up a dose and keeping track using a pen and paper is inconvenient as it requires her to have them nearby.
Meet Jake, a construction worker managing a back injury
Jake works in construction and tends to do a lot of physical work throughout the day. Due to a previous back injury, he needs to keep track of his daily physical health. When Jake isn’t working, he loves to hike and be outdoors. He prefers holistic healthcare and would like to stop taking pain medications for his back injury. Jake needs reminders and incentives to maintain his healthy habits.
Meet Leena, a retired librarian living with Type 2 Diabetes
Leena, a retired librarian, lives in the city with her two dogs. She suffers from Type 2 Diabetes and wants to keep it under control. Leena has lost track of her medications in the past, so she needs a better way to track her meds and daily habits. She would also like to learn more about her disease and connect with other Diabetics for emotional support.
Note: We developed Leena’s persona based on our research, but recommend meeting her specific needs for community support in phase 2 of the project.
Common User Needs
User Journey Maps
Sara’s Journey
At the beginning of Sara’s journey, she is both struggling with her aunt’s diagnosis and overwhelmed by her responsibility as her live-in caregiver. Keeping track of medications, supplements, side effects, and vital signs is very difficult using a pen and paper or a whiteboard. On the recommendation of a family member, Sara downloads The Owl App, enters her aunt’s medications and supplements, then begins to use it daily to track her aunt’s care and well-being. She discovers that she can share this information with her aunt’s doctor and family members as well, making Sara feel confident that she doing everything she can to care for her aunt.
Jake’s Journey
Jake’s back injury from a few years back is still bothering him, interfering with his active lifestyle as a construction worker who likes to get outdoors and stay fit. He relies on pain medication but wants to keep good track of what he takes, as well as his physical activity so that he can work toward living without it. Once a friend recommended he download The Owl App, Jake began to use it regularly to track his wellbeing. The incentives motivate him to stay on course toward his goal of life without pain medication.
Moving to the Design Phase
We found that both from user interviews and our own research, a clean, simple UI with minimal colors was very important for a medical app. This type of UI caters to users of all ages and abilities.
We renamed the “Hi. How are you doing?” button to “Daily Check-In” based on survey data that supported this change.
We focused on designing high-fidelity prototypes for two user flows:
Sara’s focused on medication adherence and reporting
Jake’s focused on medication and fitness tracking and incentivesThe pages we focused on for our design were: Login, Home Page, Daily Check-In Flow, Add and View Medication Flow, Medication Tracker Flow, and the Redeem Points Flow.
Usability Findings to Inform Phase 2
User Profiles: Upon login, provide the option for people to use the app for themselves and/or as a caregiver for others.
Medication Tracker: Make the Medication Tracker more prominent on the home screen to boost adherence. Consider displaying one status at a time (e.g., Overdue).
Fitness Tracker: Consider building out the fitness tracker so that it also generates push notifications and provides the opportunity to track activity toward user goals.
Daily Check-In: Streamline the Daily Check-in form in order to meet user needs for convenience and increase adherence.
Home Screen: Emphasize the high-priority features from a user perspective in order to simplify and improve the UX.
All Screens: The simpler the interface, the more successful users of all ages and abilities will be.
Closing Thoughts
It was an honor to support the mission of The Owl App to empower patients with life-saving information and support their wellbeing. I look forward to following their further development as a user, as I know they have exciting growth plans!