Para-Stroke
Para-Stroke is a theoretical solution to identify stroke symptoms in a near-future scenario where technology has advanced in battery life, machine learning and detection algorithms. Para-Stroke would run on existing ambulance Mobile Data Terminals (MDTs) to augment data paramedics receive, directly from potential stroke suffers, with the ability to forward the information on the EDs. This was created for a masters-level health design subject.
Challenge
Treatment seeking is delayed as patients do not recognise the symptoms of stroke, and/or do not appreciate stroke is a medical emergency. The gold standard treatment for ischaemic stroke is a drug called tissue plasminogen activator (tPA), which acts to dissolve the clot and restore blood flow to the affected area.
This drug can only be administered within 4.5 hours of stroke onset, after which time it loses effectiveness and risks begin to outweigh benefits of administration as the risk of haemorrhagic conversion increases, significantly worsening prognosis.
Despite this time pressure, only 39% of patients arrive at hospital within 4.5 hours of symptom onset, with pre-hospital delays remaining a key challenge. Further, time of onset of symptoms is often unknown as the patient is unable to report when they were last well, with significant implications for the types of treatment they will be eligible to receive.
UX process
The design process for the Para-Stroke solution encompassed the following steps:
1. Documenting the current flow of events when a stroke occurs from experts
2. Identifying users in this process and interviewing them
3. Creating Personas based on interviews
4. Documenting current user workflows
5. Identifying pain points and opportunities
6. Identifying user stories to express requirements
7. Documenting design assumptions
8. Creating low-fidelity wireframes and the system design.
Outputs
From this process the following personas were identified:
Michael the Paramedic
Jean the Potential Stroke Sufferer (PSS)
Ellie the ER intern
Bruce the Stoke Consultant, and
Louise the ER Triage Nurse.
The carousel below presents the outputs in a rich picture.
Results
From the current process the following pain points were been identified:
Michael only gets information that the 000 operator receives. Often this is only address, age, sex and the presenting problem (i.e. stroke)
Information received does not consistently include anything else
Michael may not know when the patient was ‘last well’ therefore there is insufficient information about time onset to radio to ED for quick decision making regarding treatment
All information is radioed to ED thusly may be inaccurate and cannot be retrieved to confirm.
In response to the pain points, opportunities were identified:
If the potential stroke sufferer is prompted to call an ambulance, all additional information can be logged and made available to Michael
Time-stamped log of symptoms detected and prior behaviour could assist doctors in determining time of stroke onset.
Based on Michael’s needs, user stories were created.
Michael needs to receive additional information about the potential stroke sufferer so that he can target his questioning to rule out other causes for stroke-like symptom
Michael needs additional information to be obvious so that he can quickly assess the patient
Michael needs to send information to the ED so that they can quickly get the PSS treatment.
Low-Fidelity prototype
Para-Stroke is integrated into the existing MDTs. Existing information regarding the address, patient gender, age and symptoms are included.
The MDTs provide route information to the ambulance on where they are and where they are going.
When the pickup address for the patient matches the address of a record, Para-Stroke prompts paramedics that there is extra information available.
Selections have being designed to have specific affordances so Michael knows how they can be used: radio buttons were selected for gender as only one may be selected and checkboxes for symptoms logged as PSS can record multiple systems.
All of these fields are updatable if they are incorrect or if new symptoms have presented.
This screen enables the paramedic to go back to the map view by clicking <Back - providing a simple exit for the user if they mistakenly came to this screen, enabling user control and freedom
If yes is selected for drugs or alcohol, the paramedic must enter a free text description relating to this. They cannot proceed without providing this information; Para-Stroke will not enable them to do so, acting as error prevention.
When the paramedic selects ‘Send to ED’, a message displays that the report has been sent to the ED that they are en route to.
This adheres to Jakob Neilson’s usability heuristic visibility of system status by providing feedback; Michael is told that the system did something, sending the report to the ED, rather than leaving him to wonder regarding the system responsiveness.
Clicking OK automatically takes the user back to the map view, now showing the ED and the route to the ED.
This screen displays that the report was sent to the ED and they can view this report if necessary. The system presents the report status enabling at a glance assessment that the report was submitted so, with everything else going on, Michael doesn’t need to recall whether he sent the report - he can easy recognise that he did.