UX Case Study: Modernizing prosthetic fitting for adaptive athletes
A deep dive into one student group’s Client Project for General Assembly in San Francisco
“I’ve been a prosthetist for over 30 years, and you’ve just shown me the value of rethinking my workflow… these are forms I want to fill out.”
— Michael Nunnery, Hand:Made Prosthetist
For anyone unfamiliar with General Assembly’s User Experience Design courses, a little background info: the full-time immersive bootcamp is designed to jumpstart students’ career changes into the field of UX. Group projects are a core component of the program, aiming to simulate real world design sprints that students might be faced with in future professional roles. During the capstone client project, student groups are paired with real clients who have applied to participate in the program.
In late 2019, my cohort began their client projects. Our group was assigned to Hand:Made, an Autodesk BUILD resident startup crafting durable upper-limb prosthetics for adaptive athletes who’ve experienced limb loss.
The Project
Duration & Type:
- 3 weeks
- 4-Person Team
Tools:
- Sketch, inVision, Illustrator, Google Forms
- Paper, pen, marker, whiteboarding
The Problem
Every amputee is unique — their residual limb is unique, and so is the life they lived pre-injury.
This makes designing the fit of a prosthetic device very complicated, but also important: discomfort due to poor fit accounts for most cases of prosthetic rejection.
Hand:Made’s new measurement system for socket design helped to solve this issue, but they were only able to fit new clients who could travel to their facilities. What if they could have reliable, highly accurate measurements recorded remotely?
The Solution
Our research revealed that it’s pretty hard to find two prosthetists that take measurements in the same way, and that neither prosthetists nor amputees could imagine a “miracle solution” to a long, laborious process. Even the prosthetists and designers at Hand:Made couldn’t picture the solution they were hoping we’d create.
So our team envisioned a communication hub that would train prosthetists in Hand:Made’s proprietary measurement system, transmit reliable data, and include the patients in the process of designing their own gear.
My Role
Project Management:
- Laid the foundation for a collaborative working environment to help each individual’s strengths shine
- Mediated conflicts, redistributed tasks as needed, and maintained morale
- Wrote daily agendas for EOD deliverables
- Managed or delegated all communication with client, interviewees, and usability testing participants
User Research and Data Synthesis:
- Conducted interviews and usability testing
- Synthesized and distilled research data into actionable findings
Visual Design:
- Synthesized our divergent ideation on dashboard concepts and contributed to process infographic design and illustration
- Designed the most complex screens — the orthotic form workflow
The Process
The nature of this project’s complexity made it clear that we needed to focus on diving deep into research before any design ideation at all, as our product would be a first-of-it’s-kind service for a very particular, niche group of users.
But we also wanted to leave enough design time to craft top-notch deliverables, so we organized our process into three distinct phases each with three of their own key stages:
The “research” phase was comprised of gathering and synthesizing data, and then strategizing based on our findings.
Once we moved into the “create” phase, testing was paramount. Making adjustments in response to that testing, and then testing again, guided our progress throughout the remaining sprint time — a cyclical process of ideating, testing, and refining on our work repetitively until we hit deadline.
The third, oft-overlooked phase was presenting our work. It was important to us that we put just as much care into communicating the reasoning behind our design decisions — to encourage stakeholder buy-in — as was put into the design work itself. We defined the stages of this phase as “tell,” “show,” and “imagine.”
1. Research
Gather
This project’s topic was so detailed, and so complex, that the “gather” phase of our research had its own sub-sections: Subject Matter Research, Comparative Analysis, Survey Questionnaires, User Interviews, and Field Research.
Additionally, it turns out that professional prosthetists are pretty hard to get a hold of. While we waited for responses to our interview requests, we dove into those other forms of research:
Subject Matter Research
We strove to understand the processes and challenges of prosthetic fitting, and what 3-D printing and scanning was bringing to the industry, on a deep level by doing subject matter research.
Comparative Analysis
Though the service we were designing didn’t exist yet, there were definitely other companies dealing in the communication and organization of biometric data.
We compared the workflows of three companies (Invisalign, Warby Parker, and LimbForge) against the workflow of Hand:Made, and illustrated our findings in a comparative features chart.
Survey Questionnaires
At the same time, we looked for more users to interview by turning to Instagram. We searched and posted via hashtags such as #adaptiveathlete hoping to find athletic amputees willing to participate in a survey questionnaire.
Participants responses were a great start in understanding the relationship amputees have with their devices, and with the experiences they have while being fit for one:
What would you change about the process of finding and fitting the right prosthetic device?
“I don’t know how to change a lengthy & tedious process. The casting, test socket, trial, refit, wear it. It’s as good as it gets but I always have problems. I’m not sure how to create a miracle.”
“I had a really good experience being fit with [prosthetics company].”
“I’m not sure how it could be different.”
User Interviews
A week and a half later, we had accumulated some excellent data. But we still hadn’t been able to talk to any actual prosthetists.
Finally, interview requests started getting responses… with enthusiasm. We were able to set up a number of interviews with some people doing incredible work in the field, and they were excited to hear about our work as well.
Here are some takeaways from two of our key interviews:
Key Takeaways:
- Designing sockets remotely is very difficult; all fitting is left to local clinics and LimbForge only provides technology and training
- Sometimes “lost function” is social and emotional — feeling “whole,” being perceived as “normal,” having confidence for self-expression, etc.
Key Takeaways:
- Prosthetists have an empathic connection with patients — one particularly felt during measuring and fitting; it’s a step they’re reluctant to relinquish to technology
- Unless — if new technology could make this step quicker and more painless for the patient, it would be welcome. Like UX designers, prosthetists are all about their user’s experience.
Field Research
We also attended a presentation of student work on Upper Limb Prosthesis Design at the Jacobs Institute for Design Innovation at the College of Engineering, UC Berkeley, where we observed and inquired with the students, participants, and attendees.
By networking at the event we were able to meet Joshua Unterman, an orthotics and prosthetics development technician at UCSF.
Speaking with him gave us valuable information on how orthometry forms are used in the industry, and about their limitations.
We used this information to compare orthometry forms from other prosthetics manufacturers against the forms Hand:Made is currently using internally.
Synthesize
Once our depth and breadth of research gave us a firm enough understanding of our subject matter we synthesized our key findings into the creation of our personas, whose particular joys, needs, and pain points would guide the design of our product.
While “Ben” (the adaptive athlete) and his experience as end-customer was important to us, we labeled him as our special case persona. We decided on “Greg” (representing a Hand:Made manufacturer) as our secondary persona.
“Gina Reyes, CPO” became our primary persona, as guiding the prosthetist’s measurement taking process was the keystone of our project brief.
The prosthetists Hand:Made will be working with remotely need to learn Hand:Made’s proprietary measurement system, and errors in their workflow could throw off the socket fit entirely.
To identify which parts of Gina’s current workflow could be improved, we made a User Journey Map.
Our research made it clear that prosthetists have a strong bond with their patients that is particularly expressed in the process of measuring them for socket design and fit. Our product would take over some aspects of that process, so we wanted to make sure our design preserved Gina’s “joy points” while improving upon her “pain points.”
Strategize
With all our synthesized research data in hand, it was time for us to sift through and pull out the key points that would guide our design.
We used methods such as MOSCOW (Must have, Should have, Could have, Will have) and Feature Prioritization Charts to craft our Solution Statement and define our Minimum Viable Product.
2.Create
Ideate & Test
Before we began ideating on the interface of our product, we wanted to test Hand:Made’s orthotic workflow itself.
Were the right questions being asked? Were they being asked clearly? Were there any questions missing? Could prosthetists unfamiliar with Hand:Made’s measurement system follow the instructions without confusion? Was there anything else we had overlooked?
To get these questions answered, we built out Hand:Made’s workflow in a Google Form, and tested it with prosthetists that had participated in user interviews.
Feedback from these usability testing sessions informed our prototype revisions, particularly in rewording verbiage to prompt more accurately for precise measurement data.
Refine (& repeat)
At this point, we finally had enough data to begin work on the user interface design. From whiteboarding our initial concepts, to paper sketching and rapid prototyping, to wireframing in Sketch, we brought the product to life one step at a time.
With each iteration we continued to conduct usability tests with prosthetists, and we brought in designers and developers for their feedback as well.
3.Present
Tell
Once our deadline arrived, it wasn’t just a matter of handing something pretty over to our client. We wanted to ensure that they understood our process — how our design decisions were rooted in research and validated by testing — so we crafted a presentation rich with infographics and specific data points to aid us in telling the story of our product.
Show
After the “tell,” it was time to show. We walked our (very ecstatic) client through prototypes of the patient database, communication portal, and virtual orthotic form.
Check out an excerpt of the prototype here.
Imagine
What we were able to create in three weeks exceeded the expectations of our client, but it left out an important part of our vision. While the 3D-mark-up portion of our product’s virtual orthotic form had patient feedback ability built-in, we envisioned something larger.
What if there were a portal login for patients themselves, so that they could participate actively — as a collaborator — in designing their gear? Our team would have loved to explore those ideas further with additional time.
Instead, each of us went on to start our professional UX careers at companies across the Bay Area. If anyone reading this is thinking about a switch to UX and has questions about my personal journey to find it, feel free to get in touch at miahariel.xyz :)
Want to learn more?
If you’d like to become an expert in UX Design, Design Thinking, UI Design, or another related design topic, then consider to take an online UX course from the Interaction Design Foundation. For example, Design Thinking, Become a UX Designer from Scratch, Conducting Usability Testing or User Research — Methods and Best Practices. Good luck on your learning journey!
Credits: Course instructors were the brilliant Imani Beauford and Shalom Ormsby. Comparative Features Analysis by team-member Kris de la Cruz. Comparative Workflow Diagrams by team-member Austin McIntosh. Macbook Mockup by Rubens Franco. Humaaans by Pablo Stanley, remixed by me. All other graphic content by yours truly.
On the day this project was completed, my father passed away unexpectedly. I’d like to take this space to acknowledge the visionary odd-ball, craftsman, and inventor who taught me that the limit of what’s possible is defined by the limit of your imagination. I love you dad — you live in everything I create.
