Support in Your Pocket

Building a social platform to empower people living diabetes

Living with diabetes is hard. Any given day can surface a new set of challenges can arise – a new medicine that comes with debilitating side effects, a new exercise that drops your blood glucose to a point where you feel foggy or a new food that unexpectedly causes your numbers to rise and leaves you lethargic and groggy. The experience can feel isolating and overwhelming.


In an attempt to help people catch these effects upstream, Livongo set out to create a community where our members could talk openly about living with diabetes and strategies. We set out with the following objectives:

  • Increase member engagement by creating a social experience structured around trustworthy content.
  • Create a new navigation framework to surface social content while maintaining scalability into other product offerings.
  • Establish a common experience across mobile platforms (iOS, Android)*

*Both Android and iOS were completely redesigned in the course of this project.

We knew we would be hitting the mark if we had an impact on the following metrics:

  • Overall Engagement (DAU / MAU)
  • Number of Mobile Active Members per Month
  • Number of Blood Glucose Checks per Active Member

Maintaining a Diabetes Focus

As the main indicator associated with diabetes, the bread and butter of any digital diabetes has always been blood glucose data.

Due to the evolution of our product and FDA regulations, members check their blood glucose with our blood glucose meter, a separate piece of hardware. When a member comes to the app, they expect to see all of their readings, associated metadata and compare trends day-over-day.

Blood Glucose Channel

We observed that the most common time a user would want to interact with their blood glucose information was right after they made a check. To encourage this, we included the blood glucose values in the feed based on time posted. This allowed easy access after a check.

Building a Trusted Source

One of the glowing needs that arose as we started down the path of a social experience was the need to keep the trust of our users and define our platform as the source of truth for diabetes related content.

Crafting a Path to Trusted User Posting

We knew that fostering the trust we already had would take experimentation and a new level of understanding that we did not yet have about our members and artificially create expectations of how and why to use the platform. We create a series of phases (subject to change) that would help us understand how our users naturally interact with each other and allow us to nimbly support and shape these interactions.

Organizing into Channels

Independent of the content being posted, we knew that trustworthy content also has to be easy to find. Indexing toward surfacing relevant content over recalling past content, we started with a set of channels that we tested with our users to understand how

We used registration information to personalized the initial set of channels a member was opted into.

Creating a Space for Safe, Social Feedback

With a confidence that we had the trust of our members, we knew we needed to be intentional with how we allowed our users to interact to extend that trust to the relationships they would build on the platform.

Allowing Anonymity

Flow: Creating an Identity

The Livongo program is sold company by company and engagement can be high in the first 30 days. There is a high likelihood that members of the same company might interact with one another after an enrollment period.

Because of these real life connections and the sensitive nature of health information, we built a tool to allow members to create their own Livongo-specific identity, but biased them toward using their own photo and name.


Flow: Comments

At launch, comments were the main interaction members would have with each other. All comment threads were spokes off of the curated posts that were generated by our teams.

To keep conversations light, poignant and, most of all, controlled, we imposted a character limit with tracking to see how often it was reached. If personal identifiable health information was surfaced, we would alert the user and confirm that they were willing to publish this information.

Quizzes and Polls

Within the Livongo app, you can test your knowledge of baseline diabetes lifestyle choices and clinical information and see the trends of how others live with diabetes.

Incorrect Quiz Answer

Quizzes allow members to test their diabetes knowledge with questions that are generated by our clinical team. If you get a right answer, we give you more context on the question. If you get it wrong, we let you know why you might have chosen that answer and

Polls allow our members to see how others are living with diabetes.

A “Like” for Diabetes

At Livongo, we are always looking for opportunities of ways in which we can empower our members. Sometimes that means building a new feature, other times that means using the right language.

Like Interaction Exploration

Knowing that a key form of engagement on any social network is positive acknowledgement, we wanted to embrace this, but make sure it fit with our demographic. After working with our content team and talking with our users, we found that the “thumbs up” icon registered as unbiased and understandable. while “Helpful” as the label tailored itself to the content and subject matter.

Solving for the Ghost Town

Developing any social group takes a close eye, steady hand and unique understanding of the group you are building for. Because we controlled the platform and the community, we set ourselves up for success by increasing response times and building a platform that never seemed empty.

Leveraging Views

To encourage engagement, we operated on the assumption that if people saw that there was an audience, they would participate in the community. We launched with two primary statistics: Likes and Views. Likes required interaction and views were counted whenever a user scrolled over a piece of content.

Through user testing, we found that these lightweight statistics gave members just enough certainty that there were other people on the platform.

Rallying the Team

The best way to make sure that people feel heard and supported is to make sure that questions are responded to. We rallied a group of internal leaders to make sure that we cut the response time down for members who posted comments the first weeks after launch.

What I learned…

Through the process of iteration, collaboration with the team and ultimately, launch, there were a couple key take aways that I took from this project.

Ruthlessly Prioritize or Deal with the Consequences

For a team of 4 engineers, 1 designer and a PM, the scope of this project was massive. Implementation tradeoffs and design decisions were always impacted by time. If I had the opportunity to start from scratch, I would have established discrete information we wanted to learn from the MVP and drive all decisions to support those learning goals.

Stakeholder Involvement is Essential.

Engaging engineering and leadership at the right time is always an art. In this project, we had a very healthy, open dialog with engineering that allowed us to move quickly. Essential in any project!

Cater to your base and build from there.

The expectation of social interaction with other is not something we focus on as a key selling point of our program. Because of this, some members were happily surprised while others were confused. I think we could have done a better job through both sequencing and onboarding to help our members understand how this experience could fit into their life.

Applied Design Philosophy

Build for Speed & Learning

With a small development team, aggressive deadlines and a desire to learn fast, design decisions were influenced by their precieved impact and how fast we could ship them. To keep me honest, I constantly find myself asking the following questions.:

  • What is the MVP? Is there a way I can find an answer quicker? Can we inform this decision another way?
  • Why does this need to be different? Engineering can move faster when they are using off-the-shelf pieces and parts. What value will a unique interaction bring?
  • Will this stand the test of time? Think in timeless components. Always consider the long term benefit or implications of breaking from the norm.

Finding the edge between systems

No matter whether you are working on a designing a new component, user flow or conceptual model, the most complexity always exists wherever your problem space meets other systems that always exist. Deeply understanding these other systems reduces overhead in the long run.

Bias toward Accessibility

The vast majority of users on the Livongo platform are between the ages of 30 and 50. Because limited eye sight and mobility issues are commonly associated with diabetes, we wanted to make sure that we abided by all existing standards for accessibility and increase hit areas and font sizes where it was possible.

Design as a Generator

Decisions are best made when key stakeholders can see their implications. I believe that a key role of design is to articulate and visualize what people are thinking in a group. It fuels conversation, illuminates inconsistencies in how people view problems and powers a group toward consensus faster.