Team SAT

Week 12-14: PREPARE, TRAVEL & APPROACH USERS

With a new field trip around the corner time was pressing. We scheduled various research activities for the upcoming trip. The second stay in Nigeria is divided into three stages: 1.Initial usability testing, 2.Reflect on designs & redesign, 3.Evaluation redesigns with user.

Our goals for testing are:
Obtaining recommendations for the service scenario, application and device
Getting insights in the requirements dealing the various stakeholders, such as: HMO's, Physicians and Patients.

Meeting those goals we created a research plan and build prototypes for both the app and the blood pressure device. For app-prototyping we use proto.io, an browser based tool that enables to run clickable prototypes on smart-phones.

Week 6&7: 19 INTERVIEWS, 8 OBSERVATIONS, 2 CO-CREATIONS

For this two weeks, Tobias and Masako have soaked into the Nigerian context for the research for creating a better blood pressure control service in Nigeria. We visited 3 hospitals and 2 medical outreaches, interviewed with 6 doctors, 6 patients, 2 advisers, 1 nurse, 1 insurance company, and conducted 2 co-creation sessions. It was a quite hard schedule, but we surely grasped the current barriers and potentials for better healthcare. At the same time, Tine, Doenja, and Lenneart have created the first trial of the design concept based on the information from the field research in Delft.

HOSPITAL VISITS
It was a precious opportunity to stay in some hospitals in Lagos for a while and observed interactions between doctors and patients directly. We looked at a lot of barriers to the hypertension treatment in a public hospital, such as language barrier, lack of knowledge, fear of awareness of chronic diseases, and too busy doctors. On the other hand, in a private hospital, because doctors can have more time to talk with patients, the interaction was quite different.
In the interviews with doctors, we understand doctors’ great efforts to empower patients to comply with and take the initiative to treatment. For example, one doctor gives patients clear pictures, so they understand the seriousness. Another doctor told us that patients’ satisfaction during a physician meeting affects their dedication of self-treatment afterward.

PATIENT VISITS
With the introduction from Ibrahim’s mother, we were able to interview with 6 patients and conduct 1 concretion session with 3 patients. Through these activities, we have been emphasized with patients’ values and emotion towards hypertension. The most patients see the importance of patient-doctor relationship including clear information, quality of advice and diagnosis. Also, one patient told us in the co-cretion session that after the self-measurement in the home, she feels fear and unconfident if the result is not good because the blood pressure device just tells the reality rather than what she should do for improving the reality. To empower patients to initiate treatment, they need more connection to information, doctors in the best timing.

INSURANCE COMPANY VISITS
We visited the insurance company, “AXA Mansard,” and discussed our current ideas and the trend of health care in Nigeria. Their concerns were people’s unawareness on health care. Currently, only 7% of population join the health insurance and most of the contracts are for a big companies or organizations. But they start offering smaller health care package plan so that low-income group can reach the benefit. Also, the interesting thing is that they also offer the internet blood pressure monitoring service which connects patients and doctors remotely. We could have confident that our service direction is matched with the Nigerian context.

Week 3: GENERATE RESEARCH QUESTIONS FOR THE INITIAL FIELD RESEARCH

The team SAT is in the goal setting phase where we are exploring what opportunities are underlying around hypertension in Nigeria. We have been collecting information and learning things from three areas; current Nigerian context, market, and technology. In this week, with our current understanding from papers, websites, statistics data, and interview with some Nigerians, we identified what we would like to see, who we would like to meet in the first field research.

CLOUD HEALTHCARE IN THE WORLD AND NIGERIA
Currently, healthcare service providers start making use of cloud/mobile. At the same time, cloud/mobile service providers (e.g. Amazon, IBM, Nokia) start healthcare service via the cloud. For example, patients can be informed by doctors with a text message on their mobile phone. Research suggests that these services are a good way of getting patients involved in their treatment. In Nigeria, although many people have mobile phones (some people have more than one mobile), power outages frequently occur. Therefore, most hospitals do not rely on the online medical record system (They store patient's medical history with papers). But how about cloud? If all the data is in servers outside of Nigeria and each device works with inside batteries, the cloud medical service should work despite constant power downs. We will see this interesting IT environment of Nigeria carefully.

PERSONAS
With the current information we have got, we generated the three personas. One is a 35-year-old guy, a hand‐to‐mouth existence, working as a hawker on a street, obesity, and smoker. He found his hypertension but has not visited a clinic and has not started treatment. Another is an elderly woman living in a rural area. She needs helps of her family when coming to a hospital. She is aware of her hypertension and trying periodical clinic visits and self-treatment, but difficult to do so. Last is a pregnant woman living in an urban area working as a researcher. She visits a hospital once a week and tries to cure hypertension herself for her baby, but her blood pressure has not still controlled well. We are going to refine the personas during the field research.

PATIENTS, PHYSICIANS, and DATA JOURNEY
We have communicated with Ibrahim, a doctor and activist in Nigeria collaborating with us, to get to know current activities and values of patients, physicians regarding Hypertension. With the current understanding, we have visualized the journey map. Although the information is still not enough and the map is unsophisticated, we could see what we would like to understand more, who we would like to meet in the first field research. These will be connected our research questions and the field research plan. We are going to refine the journey map during the field research.

NEXT WEEK
With the coach, JC, we are going to fix the research plan. We will be busy to make research tools such as interview sheets, observation sheets, generative session tools. At the same time, the interview with Dutch doctors dealing with hypertension will be conducted to know the general barriers of patients against controlling high blood pressure. In addition, technology research and context research will continue.