Post-Exam Eye Report

Project Owner
Empowering patients and ODs through a post-exam report after a comprehensive eye exam
Product Designer
UX Research & Design, Visual & Interaction Design
Figma, Adobe Illustrator, Adobe Photoshop
The prototype mockup cover image
VSP Vision Internship

Over the summer of 2021, I worked as a Design Innovation (UX/UI Design) Intern at VSP Vision. My team is Global Innovation Center and I was working on pitching a new innovation opportunity with other 2 interns for internal use. My project specifically was to help diabetic/pre-diabetic patients learn more about their eye health. During the course of three months, I designed an end-to-end post-eye exam experience, which has been added into the innovation pipeline. The project further transited to focus on comprehensive eye exam for all patients, and this details would be sealed due to confidentiality. If you are interested in learning more about this project, feel free to contact me.

Note: VSP Vision is a vision care health insurance company and is the largest vision insurance company in the United States.

ROLE
Design Innovation (UX/UI Design) Intern
DATE
June 2 - August 28, 2021
METHODS & TOOL
Survey, Stakeholder Interview, Market Research,  Storyboard, Figma, User Testing
PRACTICES
Design System, Design Tools, Product Thinking, Interaction Design, Visual Design
Pre-pipeline Period
Pipeline Period
June 2021 - August 2021
October 2021 - January 2022
February 2022 - July 2022
Phase 1: Internship
Create the MVP of post diabetic eye exam report for diabetic/ pre-diabetic patients and learn about their eye health
Phase 2: Patient Research
Assess the impact on diabetic/ pre-diabetic patients and evaluate the 3 information delivery pathways
Phase 3: Optometry Intake
Consult and Test with 14 optometrists to plan how to scale the project and implement in the practice
  • Discovery
  • Survey
  • Patient & Doctor Interviews
  • Secondary Market Research
  • Product Creation
  • Prototyping
  • Iteration
  • Research Plan
  • Prototype Iteration
  • User Testing with 18 Patients
  • 3 User Scenarios
  • Project Pivot
  • Prototype Iteration
  • User Testing with ODs
  • Design System
The Problem
The perceived value of an eye exam from a patient’s perspective is diminished by the fact that they often leave appointments without a comprehensive view of the state of their eye health and how it has changed over time.
The problem with current patient journey is that the education is limited to 5-10 minutes at the end of an eye exam. ODs typically explain diagnosis and treatment verbally, take home materials are rarely provided. Moreover, there is a lack of patient-facing comprehensive view of their exam and patients do not receive a post-exam report.
The current patient journey of having an eye exam
The ProblemResearch InsightsIdeationTesting FeedbackReflection
Go back button
Market Research
Project focus on diabetes
Considering the short timeline, we'd focus on Diabetes to filter the project scope. Among all the eye diseases, we further decided to concentrate on the Diabetic Retinopathy prevention.
Note: Diabetic Retinopathy is an eye condition that can cause vision loss and blindness in people who have diabetes. It is the manifestation of diabetes in the eye, which are the spots of blood you can see in the image below.
The statistics of diabetics and pre-diabetics
34.2 M
People with diabetes (10.5%of the US population) - 21.4% are undiagnosed (7.3 million)
Diabetes
is the leading cause of new cases of blindness among adults aged 18-64
88 M
people aged 18 or older (34.5% of US population) have prediabetes
11.4%
of patients with diabetes with reported vision disability
Source: CDC, 2018
The retinal image of diabetic retinopathy
1 out of 3
patients with diabetes don’t receive an annual eye exam
2 in 5 
Americans with diabetes have some stage of Diabetic Retinopathy
7.7M to 14M
Prevalence of Diabetic Retinopathy in 2010 vs. 2050
Project Overview & Objectives
Identify opportunities to improve the OD/PT relationship by educating diabetic patients of the impact of diabetes on vision health through a personalized post-appointment report.
Analyze companies that can aid in the content and delivery of a post-appointment report.
Determine the most effective types of content in informing and education pre-diabetic and diabetic patients.
Create a working prototype that can be graded on usability and value added to the patient experience.
The Insight

Our insights are grouped after talking to 4 optometrists and 6 patients (1 Type I Diabetics, 3 Type II Diabetic patients, and 2 Pre-diabetic patients). Some of them are experiencing the eye diseases or seeing their family member experienced that.

The image of OD insights

Doctors would like to educate patients systemically

ODs are not the key contact in diabetes education 

Doctors typically provide the minimum amount of education that is requested by a patient

Challenges in educating the diabetic patient

  • Diabetesis a systemic condition
  • ODs want to educate patients on the link between holistic and ocular health
  • Co-management with PCP affects how much ODs feel the need to educate
  • ODs do not feel trained enough to do so (Dr. Chan)
  • Most doctors have 5-10 minutes to educate patients; they feel that this is enough
  • Visual tools are the most effective 
  • DR is often asymptomatic
  • Need to get patient to change lifestyle
The image of patient insights

Patients often are motivated by something tangible or emotional

Patients are the drive to the Dr/Patient relationship.

Patients view health from a consumer mindset

Patient motivation to bring about change is what drives action

  • Visuals are the most effective (photos of bleeding)
  • Often a bystander effect for many when it comes to statistics ("it won't happen to me")
  • The more patients are aware about their own health, the better conversation they initiate with the doctor
  • There is a wide range in patient responsibility; those who care will turn to Google but are unsure of reliability of sources
  • Patients want to be told what to do by the doctor. They rely on their doctor for specific suggestions when adopting a new method or tool
  • Patients often do not remember what they are told during an exam.
  • Degree of severity of condition does not correlate to action (irrespective of level of diabetes and DR)
Problem Re-statement
How might a post-exam report increase patient awareness of diabetes-associated eye disorders?
The prototype mockup of post-eye exam report

A digitalized platform (for mobile or computer) with links to educational content (including videos) to empower patients in being key players in caring for their health.

Features include:

  • Visualize the eye exam report•Explain the eye terms
  • Include images and videos to help patients understand the educational content
  • Provide tips
  • Utilize patient-centric and strength-based language

Based on the literature review on what best practices on patient education, we concluded 4 main directions which we would include in the prototype.

Language Style

  • Neutral language, patient-centric, strengths based, imparts hope (Dickinson et al.,2017)
  • Average 1-point A1c lowering when patients were taught to reframe self-blame using more neutral, fact-based messages

Patient Perception

  • Patients with pre-diabetes have lower understanding of disease and chronicity
  • Patient's understanding of the condition, perception of control, perception of chronic nature of disease (threat) affects glycemic control (Ledfordet al., 2019)

Storytelling with Risk

  • To influence behavior change, patients need to be able to understand risk and interpret information accordingly 
    (Vassy et al.,2013)

Technology

  • ‍Using technology to deliver and increase frequency of intervention to patients (Powellet al., 2021)
  • Text messaging, tele-monitoring, mobile application helps to overcome therapeutic inertia
Preliminary prototype testing
In our preliminary prototype testing with 3 optometrists and 3 diabetic patients (1 Type 1; 2 pre-diabetics), we had 83% of satisfaction rate from the participants.
The image of prototype testing result
Phase 2: Prototype Testing with Patients

After this internship project moved to the pipeline, I partnered with Market Insight Team to conduct prototype testings with 3 types of diabetic patients. Initially, I conducted a market search on how people assess the data and information, and defined 3 most accessible methods to add into the prototype. I solely created 3 prototypes with different pathways. In the testings, we intentionally have 3 different orders to test the prototypes with patients and get direct feedback.

ROLE
Interaction Designer
DATE
October 2021 - January 2022
METHODS & TOOL
Survey, Stakeholder Interview, Market Research, Figma, User Testing Platform
PRACTICES
Design Tools, Product Thinking, Interaction Design, Visual Design
The blurred image of phase 2
The image is blurred because of NDA
Phase 3: User Scenario Testing with Doctors

Following this, I was to lead the project alongside a team consisting of 1 design lead, 1 senior visual designer, and 1 research principal. The whole process took a ton of research, exploration, prototyping and testing. Beyond this, I also created a lots of presentation decks and spoke with different teams across the enterprise to see if there was a partnership opportunity to pilot the project. Last but not least, our goal of this stage is to consult and test prototypes with optometrists. In order to better understand the practice settings, we talked with doctors who are practice owner, and who are not VSP doctors to balance the feedback.

ROLE
Project Owner & Interaction Designer
DATE
February 2022 - July 2022
METHODS & TOOL
Stakeholder Interview, Storyboard, Figma
PRACTICES
Design System, Design Tools, Interaction Design, Visual Design
The blurred image of phase 3
The image is blurred because of NDA
Reflection
Lessons I learned from this internship group project
TAKEAWAYS 1
🤝🏻 Collaboration solves complex problems
This internship group is formed by me from design background, Phoebe from optometry school, Liam from Business Analytics. In the beginning, I felt very challenging because I haven’t worked with someone who are not familiar with the design process and design methods, and I know little about the optometry and insurance industry. However, we taught, learned, and benefited from each other by sharing our expertises. I also see how an open conversation help us better communicate, further engage the group relationship.
TAKEAWAYS 2
👄 There is nothing to lose when you speak up
As an introvert, I am always hesitant to talk about my ideas, opinions, and requests. However, I got to know my ideas can be validated, my opinions can be valued, and my requests can be approved during this internship. I started with my 1:1 with mentor through addressing what I want to learn and work during  the internship, and she helped with arranging some other 1:1 sessions with other colleagues who are also introverts. I further tried to raised my hand and shared my thoughts during the group meetings.
Comments
See how my internship mentor and cohorts said about me
The image of quote
Evident in the thorough, intern cohort presentation where she executed on the innovation process of discovery, research, prototyping, testing and evaluation. Also evident in the contribution she made for our sustainable program including: providing sustainable packaging competitive landscape which included research, synthesis, key insight and presenting slides with GIC director, collaborated with Design team during 5-day design sprint and sketched new sustainable packaging solutions, and, provided eyewear specific landscape of packaging and highlighting key insights. Finally, not only was Nicole producing results, she also championed the innovation process and helped teach this approach to others.
 — Caroline Lu, Design Lead at GIC of VSP Vision
The image of quote
It was an absolute pleasure to work with Nicole. She was hardworking and instrumental with the design and prototype development. During group meetings & doctor and patient interviews, she was very personable and engaging.
— Phoebe Tai, Optometry Intern at GIC of VSP Vision
The image of quote
Demonstrated her leadership capabilities by leading us through design thinking exercises and utilizing tools such as Miro Board to distill our insights from user interviews. She is a great team player and a solid asset to any team.
— Liam Brothers, Business Analytics Intern at GIC of VSP Vision
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Made with tears and a couple cups of bubble milk tea. Ⓒ2023 by Nicole Liu 💛