Fostering well-being in healthcare through experience design

Designing technology for a positive user experience is critical to ensuring the success of modern projects; merely providing valuable functionality is insufficient. And beyond user experience, as awareness grows about technology's broader impact on users, there's a rising appreciation of the importance of shaping positive effects and minimizing negatives.

In 2014, the book Positive Computing: Technology for Wellbeing and Human Potential argued that digital technology should enhance happiness and health, not just productivity, and laid out a theoretical framework for achieving that goal. Following suit in 2018, the Center for Humane Technology was founded to promote creating technology that values users’ attention, enhances well-being, and strengthens communities. The same year, Apple introduced screen time controls in iOS, and Google introduced digital well-being controls in Android.

While designing interactive technology, it is now important to look beyond usability and user experience. It is equally critical to inquire about the impact on users’ emotional and behavioral well-being.

Well-being and healthcare technology

Prioritizing the impact of technology on well-being in the healthcare industry is essential for several reasons, including: 

• The explicit purpose of the healthcare industry is to support well-being, including its physical, emotional, and behavioral aspects.
• The technology used by healthcare providers significantly influences their well-being and behavior, impacting their interactions with patients. Those interactions, in turn, impact the well-being of both patients and providers.
• Healthcare technology users often face emotional stress, increasing the importance of thoughtful design.
• Mobile applications provide opportunities to support user well-being at low cost and with greater interaction frequency than is possible through direct contact with healthcare professionals.

When executed effectively, experience design focusing on well-being offers a substantial opportunity to amplify the value delivered by healthcare technology. 

Which technology projects relate to well-being?

When considering well-being as a project goal, assess the potential impact of the technology on users’ well-being and behavior. For some projects, such as Happify, supporting well-being is the primary purpose. Other projects may support well-being while pursuing a different primary purpose. Some indications of technology affecting well-being include: 

• Providers or patients are likely to use it while under acute or chronic stress
• It supports behavior that patients often find difficult, such as exercising, healthy eating, or keeping to a challenging treatment regimen
• It mediates interactions between people
• It is used by caregivers
• It provides feedback, such as a test result, often triggering an emotional reaction
• It mediates financial interactions, triggering the patient’s stress

Support for well-being across a healthcare journey

Let's consider a fictional healthcare scenario. After a routine physical exam, Mary receives an alarming email on a Saturday morning indicating that her Hemoglobin A1C is in the "Prediabetes" range. However, her doctor is unavailable for comment until Monday.

Mary calls for a follow-up on Monday and seeks her doctor's input. The receptionist advises her to wait for the doctor's email later in the day before she schedules another appointment. Mary receives the doctor's message mid-morning on Tuesday. It recommends lifestyle changes and a follow-up test in three months. Also, it suggests an option to try continuous glucose monitoring (CGM) for detailed feedback on her blood glucose levels throughout each day.

Mary opts for CGM, scheduling and completing an appointment smoothly. She familiarizes herself with the CGM app and the periodic monitor replacement process. Within weeks, Mary receives an insurance Explanation of Benefits and bills for the CGM setup, equipment, and supplies. Facing a substantially higher-than-expected cost, she promptly settles the bill online.

Benefiting from the CGM system's guidance, Mary adjusts her diet and exercise routine. After a few months, the CGM suggests that her Hemoglobin A1C is likely normal. Subsequently, Mary gets the follow-up test done and is delighted to find that her blood test result is back in the normal range.

Where in this fictional healthcare journey can experience design influence well-being?

The primary opportunity lies within the CGM app, which impacts Mary’s daily emotions, thoughts, and behavior. Design that supports positive mental states, such as feelings of competence and self-determination, enhances the CGM system’s success and Mary’s overall well-being.

The other pivotal touchpoints in this journey where experience design could impact well-being include the web portal providing test results, the system the receptionist interacts with, the doctor’s messaging system, the appointment check-in and questionnaire systems, and the insurance Explanation of Benefits and billing processes.

Is the business model aligned?

Once the project’s potential to enhance well-being is recognized, the next step is to assess how goals for well-being may align or conflict with the business model financially. Establishing clarity on the financial alignment upfront maximizes the chance of success by ensuring stakeholder support.

For example, when creating a patient app, a subscription-based model aligns well, as satisfied users will likely remain subscribed and recommend the app. In contrast, an ad-based business model is likely to conflict. If the project’s business model conflicts with some of your goals for supporting well-being, consider designing to support well-being as well as possible while still aligning with the business model, or explore redesigning the business model for better compatibility with well-being goals.    

How experience design can support well-being: Attitude 

If the project has substantial potential to impact well-being and a sufficiently aligned business model, the next question is how to integrate experience design and related approaches to support well-being. 

First, we need to consider ‘how’ in terms of attitude. The basics of user-centered design apply here: empathy, humility, care, and a focus on learning from users rather than dictating to users. Systems thinking approaches build on those basics, inviting technology creators to widen their lens and attempt to understand the larger system context before diving into the specific problem space the technology is intended to address.

It's essential to genuinely earn the user's trust, ensuring the technology you create, along with any supporting communications, makes its trustworthiness evident. For instance, if the technology requires users to acknowledge having read the terms and conditions and privacy policy, it is essential that these documents, when thoroughly understood, do not include anything that would undermine the user’s confidence that the technology deserves their trust.

Be mindful of the risk that your technology's efforts to provide psychological support could be mistaken for psychological manipulation. The risk is dynamic, evolving as the manipulative methods people encounter elsewhere change and public awareness of the problem grows. A good starting point is to ensure nothing your technology does could be mistaken for a known deceptive pattern.

How experience design can support well-being: Expertise, tools, and techniques

Once you have a relevant project, a sufficiently aligned business model, and an attitude conducive to successfully designing for well-being, you’re ready to consider 'how' in terms of expertise, tools, and techniques.

Regarding expertise, it will be beneficial if your team can involve someone with psychological or other mental health training, especially in areas closely related to well-being, such as positive psychology, clinical psychology, or social work. It is also advisable to have at least some team members take the free Foundations of Humane Technology course.

Regarding tools and techniques, start by grounding your approach in design thinking, enhanced by the larger context of systems thinking. Then, look for applicable frameworks and design patterns specific to designing for well-being. As mentioned, the book Positive Computing Technology for Wellbeing and Human Potential provides a helpful and thorough framework. Design Patterns for Mental Health and Humane by Design are two collections that can provide inspiration and examples. 

In conclusion, designing technology for the healthcare industry often presents opportunities to go beyond providing valuable functionality that is easy and pleasing to use. Making active efforts to design the technology to support the emotional and behavioral well-being of both patients and providers can greatly increase the value provided by the technology you create.