Setting Patient Expectations in Digital Health Products
In the previous article, I summarized psychology research breaking down different types of patients’ expectations and discussed why it’s important to align patients’ expectations with the product offering.
To align expectations, it’s crucial to understand patients/users, map out the user journey, gain an understanding of their expectations, and balance them with business requirements. If, by stating the intended outcome of the product, the logical conclusion is that very few patients will want to spend time on it, the answer is not to then avoid telling them the outcome. This is the perfect opportunity to reevaluate business requirements to determine what additional value could be provided for the user.
Recently, I freelanced for a startup hoping to streamline optometry visits by allowing patients to complete portions of the vision field exam from the comfort of their own home. Through the process of working with the team and synthesizing findings from a usability test I led, many of the improvements we ultimately implemented were related to setting better patient expectations from the get-go. Here are the key points that were surfaced and how we addressed them, packaged into the 5 W’s.
As a rule of thumb, we should always aim for transparent communication and education about the product, with as much information surfaced at the beginning as possible.
What?
What does this product do? What will users need in order to use it and be successful?
In the case of the startup, the beginning of the user flow clearly stated that it is an at-home vision test. However, in the middle of the flow, there were some household items that were needed to calibrate the device before beginning the actual exam. One of the major findings from the usability test was that participants felt unprepared and caught off guard when they suddenly realize they needed a plastic card to proceed. As a result, we decided to implement two extra set-up screens at the beginning, outlining what items patients would need, and what settings should be on their devices (eg volume turned up).
Who?
Does this product require anyone other than the direct patient to be present to use? Is a helper needed?
Luckily the startup’s product was intended for independent use and no issues were uncovered in this regard. However, it’s worth pointing out that in health tech, it is of the utmost importance that the product is accessible. Users may have mobility issues or vision impairments and there should be accommodations that allow a patient to elegantly complete tasks on their own.
When?
When should they use the product? How much time will it take to reach the immediate end result?
Another issue we encountered during the usability test was that as participants were completing the exam, they would grow frustrated after some time had passed if they weren’t finished yet. At the end of the study, I asked about their expectations of how long the process would take going in and found that those who grew annoyed during the test had begun thinking it would take less time. We side-stepped future annoyances by providing a clear estimate of the duration of the test before users would begin the test, so that if it is longer than their schedule allows, users will be able to make an informed decision about whether or not to take it now.
Where?
Where should patients use this product? Do they have to move to a different location in order to successfully complete the task?
There were some technological restraints with the at-home vision test. One of which was that best results occurred if the user’s glasses weren’t obstructing their pupils (ie they didn’t have reflections of light in them). Therefore, as part of the setup process, we encouraged glasses wearers to move away from any direct sources of light that may cause reflections in their glasses.
Last and most important, why?
Why should the patient use this product? what is the value they’ll get at the end?
Even if the value may seem obvious, it’s best to explicitly state it as not all users may realize it on their own before starting. Calling back to Laferton’s concept of patients’ expectations, this directly addresses their behavior/treatment outcome belief.
On a more granular level, why does the product do what it does? For example, why does a user need to input certain personal information?
The at-home vision test had a strong value proposition on its starting page so in usability tests, participants were able to immediately understand the benefits of using the product, and know what to expect at the end. However, there was one step of the setup process that resulted in a large degree of apprehension. The product asked for a credit card in order to callibrate the user’s screen size (using the standard plastic card size to measure how large the screen is). However, before getting to further instructions, many users stopped in their tracks and were reluctant to even continue reading. This was because as soon as they saw ‘credit card’, they expected to be required to pay to continue and were thus unwilling to continue. From a task-completion perspective, it made sense to ask for a credit card considering the universality of its size. This was a difference we needed to reconcile — so, as part of setup, we included a reason as to why they needed a plastic card and included more options other than just a credit card to make it abundantly clear that it wasn’t a payment method that was needed but a standard item most people would have.
Although these changes are still a work in progress and as such we have no metrics as of yet. Keeping in mind the degree of related issues uncovered in research, we are confident that providing all of this information upfront in a clear and concise way will ultimately allow patients to feel better prepared and set them up for successfully completing the exam.
Ultimately any digital health product is but a means to an end for patients — the end being any goals they have about their health. There must be a tangible and compelling reason for a patient to spend time on a product rather than doing literally anything else. In this case, patients use this startup’s product to cut down on the duration of optometry visits and to complete required exams with full control and from the comfort of their own home. Making sure this value is clear and decreasing barriers to completion helps align patient expectations with the product offering, increasing overall engagement, adherence and satisfaction.
