“You are strong if you turn your pain into something positive.”
Esther Göröcs & Anja Mück, UI & UX Designers at our Berlin office, share the story of our sideproject ‚PIA‘ — an app experiment for pain patients.
Mobile healthcare, fitness apps and body monitoring systems are unprecedented phenomena popping up all over the service landscape. In their 2015 digital consumer survey the business consultancy Accenture revealed that out of 24,000 respondents from 24 countries around 40 percent plan to either acquire a fitness or health wearable by 2020. As a full stack mobile agency we see this trend not only in changing consumer behavior but also in incoming client briefings. With markets apparently growing, beautifully designed interfaces are fighting for attention. Countless providers offer all conceivable mobile functionalities for collecting, measuring and monitoring vital parameters and behavioral data in order to ultimately get the most out of your body — and your lifestyle. However, rooted in the trends of quantified self and big data those products and services are mainly targeted to a very specific group of users: tech-savvy, young or middle-aged and presumably healthy fitness maximizers.
But what if shedding some extra pounds is not the case; what about people struggling for a normal state of wellbeing due to illness or pain — be it chronic, phased or temporary?
A question, that arose in our Berlin office when one of our colleagues, recently diagnosed with the so-called Restless Legs Syndrome (RLS), informed us about her medical condition and the undesired side effects of her medication, one of them is suddenly falling asleep — even at work. RLS is a neurological disorder described as the need to move one’s body to modulate or stop uncomfortable and even painful sensations in the limbs. A case like this in our close working environment made us wonder about the availability of apps that are specializing in health care rather than optimization. That was the moment when we started to dig deeper into the topic of pain treatment.
With 1 in 5 adults in Europe affected by chronic pain, a huge part of the society struggles for a life free of discomfort; no thought of maximization. Experts speak of chronic pain if patients are severely physically and psychologically impaired through pain perception for more than 3 to 5 months. A common phenomenon is the so-called pain memory where patients are getting more and more sensitive: former hurtless stimuli are increasingly perceived as pain. Trawling through the app store we found many apps that serve such pain patient use cases. Yet, their scopes are fairly limited as they mainly focus on an archival approach where users can document pain cycles, discomforts and patterns and by that allegedly risk to trigger the formation of a pain memory. In addition, taking a deeper look into design is an underwhelming task with only a few candidates as silver linings: interfaces are often formal, outdated and clinical, the UX often not very evident.
On average, people live with their chronic pain for up to 7 years. Nonetheless, for us as designers the discovery of an underdeveloped territory is a promising challenge that we embrace. This is how PIA was born.
Keeping it ‚quick and dirty‘
We wanted to create an app, that takes a different angle to this serious topic by turning the measurement of pain into something personal yet even comforting. True to the saying ‚a sorrow shared is a sorrow halved‘, we thought about both design and technology that might even absorb the user’s burden. That is where PIA’s name is coming from: pain input assistant. With Apple’s launch of the iPhone 6s and the 3D touch technology we found a hardware suiting this approach. Some research, draft interface explorations and a short brief to the developers later we had a first prototype ready to be challenged. But still, we had to dive deeper into pain treatment in order to come up with a concept that both patients and therapists would appreciate.
It was time to meet an expert to get a better understanding about common practices in pain therapy.
With some questions in mind and the prototype in our pocket we visited Dr. med. Jan-Peter Jansen, medical director and CEO of MVZ Schmerzzentrum Berlin and chair member of the Professional Association of Anaesthetists in Germany. The first insight for us was the fact that there are two sides to pain medicine: On the one hand there is a need for objectification provided by a validated questionnaire and highly sensitive medical equipment to measure the level of pain and impairment to the health of those affected. The reason for that lies in obligatory medical estimates regarding pension rights and occupational disability statuses. On the other hand and far more important of course is the actual treatment of pain. A very common approach is the so-called multimodal therapy; an integrative triangulation of medication as well as psycho- and physiotherapist treatment. The main goal is not only to ease physical pain but to teach patients how to deal with a pain disorder which — in most cases — can only be alleviated but not cured to total recovery. To do so, positivity is key.
“We want the therapy to change the patients’ viewpoint. We teach them not to see themselves as victims of pain but rather become actors that handle the pain confidently.”
— Dr. med. Jan-Peter Jansen
It’s not about trivializing the pain, it’s about dragging the patients out of the vicious circle they are in and connect the moment of pain to something positive and relieving — a basic strategy since classical conditioning. One key goal is to help patients to develop strategies of coping and a mindset of self help through mental strength. That is why pain physicians on the one side apply a very empathetic approach. On the other side they have to focus on the most pressing cases while managing to monitor all others in passing. Hence, medical care via the internet and postal forwarding of prescriptions are central tools to tackle the big amount of patients per doctor.
“We need the majority of our patients to treat themselves. Thus we are looking for something that allows us to monitor and remotely support those medically adjusted in order to have the proper time to care for those with pain peaks!”
— Dr. med. Jan-Peter Jansen
This is where PIA comes into play. Despite all efforts for standardization, the perception of pain stays subjective, which is why the doctor’s question ‚How do you feel today?‘ and his/her emotional support will never be replaced by a form. The smartphone though has already gained its status as a daily companion which is why we think that a mobile app can serve as a ‚pain pal‘: albeit sophisticated questionnaires, PIA is all about the immediate, intuitive and quick tracking of an undifferentiated pain event as emotional and subjective as that may be. According to Dr. Jansen its simplicity and everyday availability is the app’s very advantage compared to existing quantifying methods. By building on the 3D touch technology PIA offers users the possibility to translate the pain into pressure on the display relieving themselves in the very moment. Depending the intensity of pressure PIA gives direct visual feedback: The more pressure the bigger the colored cloud grows to represent the input. Users have the possibility to not only give the pain away and let it be absorbed by a device but also the option to externalize the pain event itself. In order to encourage a positive connotation while doing so, the user interface relies on a soft, light and foremost friendly design language. As physicians and patients need a tool to constantly monitor pain perception, a graph documents each input on a temporal basis providing insight in the therapy progress.
But still, there is homework to be done: Future steps are further conceptual, visual and technological elaboration of the prototype. With Dr. med. Jan-Peter Jansen we found a competent consultant and a possible pool of interview partners and testers. We are happy to keep you posted.
