From the outset, it has been Team Doc Ready‘s goal and passion to involve young people throughout the co-design process, so that the product developed reflects their needs and wants, as well as helping to build a sense of ownership. To date, we’ve shared lots about the design process, but we thought it was about time that we shone a spotlight on the important part young people have been playing since the beginning of Doc Ready’s life and even before this during the Innovation Labs process. So without further ado, let us hand you over to the stars of the show, the young people involved in developing Doc Ready:
“My involvement in Doc Ready began with the interviewing process to choose who would be designing the tool (by which I mean the app/website). The interview process was an enjoyable experience: the ideas put forward were all innovative, and we had some trouble deciding on which to go with. We decided on Enabled by Design in partnership with Social Spider, FutureGov, and Neontribe. Doc Ready will be made available firstly to young people in Brighton and Hove as a pilot, and will enable people to get the most out of their GP appointments – quite how this will work we are still unsure, but there have been a multitude of ideas, but the main one is simply to use the tool to keep a diary of symptoms and reminders, and then be able to take this with you to the GP or send it in ahead of your appointment. It is a tool which will hopefully help young people feel more at ease and more empowered with their GPs and their health in general.
In April this year, some people from Enabled by Design, FutureGov, Neontribe and Social Spider came down to Brighton to get the views of Right Here volunteers on what Doc Ready should be like. The day was thought-provoking and energised, and a whole load of fun too. We used workshops, exercises and discussions to really hone in on what we believe are the primary features that should be included in Doc Ready – though we were all still aware there was some way to go.
Being involved in Doc Ready has been, and will continue to be, extremely rewarding. A piece of research by the Mental Health Promotion Team at Right Here into how young people feel when visiting their GPs showed there was much room for improvement and a need for something to level the playing field. Hopefully Doc Ready will begin this process.”
“I have been involved in the ideas workshop, as well as the paper prototyping exercise. Both were very well executed and allowed everyone involved to contribute meaningful ideas and perspectives to the project; it’s been fun.
My favourite parts of the process have been the paper prototyping, using a character profile to channel ideas and having opportunity to chat with the design and development teams.
Adopting the profile of a person who would benefit from using Doc Ready, we discussed and brainstormed issues and challenges that might inhibit this person from using Doc Ready based on their personal circumstances; hurdles. By attempting to see through the eyes of another person (real or otherwise) we managed to depersonalize the process and get some great ideas. In our groups we then, in turn, presented our findings to each other and discussed Doc Ready further.
The paper prototyping was a stroke of genius. I had enthusiastic expectations for the concept when it was explained to me, but the exercise was even better than I had anticipated. Having something malleable to work with in a group catalysed the creative flow. Whereas in the ideas workshop we were steered with questions and comments, often it became difficult to understand how verbal descriptions of ideas could be realised, likewise to try to precisely explain visual or functional concepts in the realms of spoken language; I found myself wondering “what do you mean by that?” and “how can I explain this idea better?” regularly. My experience with paper prototyping was quite the contrary, super-fast (though taken at a comfortable pace, we were hardly working with a quad-core processor, haha) and easy to understand. It’s enjoyable to physically cut pages in half, add and remove buttons and functions, use sticky notes to comment on sections and offer ideas for new pages.”
These are the views of two of the young people who have been working with the Doc Ready team and there are many more, so we’d just like to say a very big thank you to each and every young person involved, as well as the team at Right Here who have been a great support throughout the project. Without all of you, Doc Ready really wouldn’t have been possible, so thank you!
We’re busy building the first version of Doc Ready and we’d like to invite you to the following survey to have your say on the design.
Our mission is to make something awesome that supports young people to feel more confident about their GP appointments and we’d love to hear from you…
Over the month of April we traveled across Brighton & Hove getting young people involved in the design of Doc Ready. We ran workshops with the volunteers from Right Here Brighton, Allsorts Youth Project and Mind Me Up Group. The workshops saw young people come together with the designers of Doc Ready to co-design the product by exploring:
- What do our potential users really want?
- Is what we are building solving the problems of the potential users?
The workshops main goal was to build up a picture of potential uses and wants the young people had for Doc Ready. It aimed to challenge assumptions, existing services, mindsets and current solutions. We used a simple card activity to stimulate discussion and highlight areas of importance with the use of Doc Ready and the content it should contain. We asked groups to put themselves in the shoes of fictional users to allow conversations to be steered away from personal desires and allow groups to work towards the same goal.
As the activity progressed the cards built up a visual representation of potential uses of Doc Ready. The outcomes provided valuable insights into desired features and content to be developed. This has proved to us how valuable it is to design with people who represent potential users, while challenging any assumptions we had entering the project and helping to outline:
- How potential users envisage using Doc Ready and why?
- What content they want to access?
- How and what medium they envisage using it on?
- What information they would like to take in and away from a GP appointment?
The insights and ideas from these workshops informed the design of the prototypes used in the paper prototyping workshop we ran in April. (You can find out more about the process used on the day by reading our previous blog What is Paper Prototyping?). We gave the young people at the session free reign to adapt, add and delete features in the Doc Ready application to better meet the needs and wants of fictional potential users. We prompted them to consider:
- How would the user navigate the product?
- Which features will achieve their users’ goals best? What works well / what doesn’t?
- How often would each feature be used?
- How much time does it take to access each different feature?
- How would the user prioritise the features on the paper prototype?
The outcomes of the workshop were then evaluated by the Doc Ready design team to prioritise the importance of features to be developed for an initial version. These features have now been consolidated into a single design known as the minimum viable product, a stripped back version of the Doc Ready application that satisfies the most important user goals. By building the minimum viable product we can involve users in testing to gather feedback at the earliest possible time, then develop the application further. User engagement is extremely important to the Doc Ready team as we are building a service with people for people.
Next week we’ll be talking about those all important workshop outcomes and the functionality being developed for the initial version of Doc Ready. Watch this space for news of the user testing workshops of the first digital version of Doc Ready coming soon. If you have any questions or comments about the process so far, please don’t hesitate to get in touch!
Who better to explain paper prototyping than Neontribe (user experience designers, programmers and Doc Ready partner), who are currently working with the paper prototypes developed through our recent workshop to build the very first digital version of Doc Ready. Take it away Neontribe:
Paper prototyping uses a hand-drawn vision of how an interface might work as the starting point for rapid improvement. It’s the best method we’ve found for co-designing digital products.
We take these prototypes out to meet the sort of people who’ll actually use the finished products. One of us plays the part of “the computer”, the person helping us test imagines our paper prototype is a real digital tool. Their finger is the mouse: when they click, we reflect that click in the prototype. Maybe they’ve clicked on a navigation element, and we’ll add an overlay to the prototype to reflect this. Maybe they’ve clicked on a “next” button, and we’ll move them on one stage in a process we’re developing.
At every stage, we stress that it’s the paper artefact we are testing, not them. Any difficulties they find using the interface are our fault as designers, not theirs. There’s much cutting and sticking during this process as their thoughts and ideas can change the look and feel of the prototype right there and then.
We believe a key advantage of paper prototyping is that people feel more relaxed about challenging the design. It does not have a polished look, it’s clearly not finished, so it is obviously mutable. We have found that the personification of the computer by a real person who consistently acts in a self-deprecating fashion, reassures the person helping us test the prototype. It helps make it clear that we are there to listen to them, and that we’ll listen to their feedback.
In our experience, time spent on prototyping is very cost effective. It’s far quicker than building a test interface with code and rapid change is very easy.
FutureGov’s designers had already run a series of workshops to explore the people who’d use Doc Ready and the situations they’d be in. That done, they built a series of paper prototypes as strong starting points for improvement.
On a gloriously sunny afternoon in a Brighton Hotel, a group of very willing volunteers got together into small groups. Each of these groups was given a fictitious persona to check, and the start of a user journey to imagine. Then, with the assistance of a facilitator, they used a paper prototype to follow that journey through.
The afternoon created some great discussion points, some really useful feedback and challenged us with some interesting points of view and some searching questions. All this helped to change the way these prototypes worked as the afternoon unfolded.
People’s opinions turned into activity and often their feedback was added to their prototype right there and then. It’s paramount, and very satisfying for them, to see they are having such a direct influence on the future of the product. After all, these test groups will be our first voice to the rest of the world when Doc Ready goes live.
It’s also quite an entertaining afternoon, especially when “the computer” slows down or errors. Everything is catered for during a paper prototyping session!!
Following on from that, the groups then took it in turn to present their version of Doc Ready to each other prompting more interesting debate.
As designers, we do not simply do as our testing groups say. For one thing, each of them took their prototype in a different direction. What we do do is guarantee to listen, and use what’s been said as a springboard for the next stage of the project. That’s when we’ll develop a digital prototype, a minimal viable product, ready for review at the end of the first sprint.
We’ll get some new faces in to challenge our work with fresh eyes and experiences, and we’ll invite the young people we worked with back to see what they think. They’ll get the opportunity to see how their valid and valuable input on that sunny day in Brighton has grown into digital form.
Next week we’ll be sharing more about the user engagement work we’ve done so far, including the paper prototyping workshop already mentioned, so see you then.
Just how do you go about working with young people to come up with the idea for an application and then make sure it works? Mark Brown explains:
As you’ll probably already know, Doc Ready is an application to help young people aged 16-25 to get ready to visit a GP about their mental health or wellbeing. It’s being developed by a partnership between FutureGov, Enabled by Design, Neontribe and me for Social Spider.
But do you know how Doc Ready came about and how we got to the stage we’re at now? From the beginning young people’s participation, knowledge, enthusiasm and ideas have been a big part of the process that eventually created the conditions for Doc Ready’s development.
In the days before Doc Ready
The story of my involvement and of the process that would eventually create Doc Ready begins back in 2011 at an initial meeting of the great and good organised by Right Here, Comic Relief and Nominet Trust that asked the question: can young people with mental health difficulties even be involved in a hack day or an innovation lab?
At the time there were objections raised that it was all a bit macho, all a bit full-on, that the process of innovating and designing just wasn’t right for young people with experience of mental health difficulties. When those with concerns voiced them, it seemed people were picturing the process of idea and application development as being a bit like Alan Partridge’s definition of brainstorming: “an American business technique where ideas are graded according to how loudly they’re shouted out”.
Despite those reservations the consensus was that it was something worth taking forwards, so Right Here, Comic Relief and Nominet Trust did just that.
What followed were two Innovation Labs where young people, tech people and mental health people came together to try to come up with ideas for tech/app solutions to some of the challenges young people face around their mental health and wellbeing.
The first of these labs used a technique that we have also used in the development of Doc Ready – people creating and using persona as a way of exploring and designing ideas.
Working from an initial stimulus – in the case of Innovation Labs and Doc Ready photographs of people – groups worked together to invent an entire story for the person in the photograph. Questions included: who this person was; what their life was like; and what challenges they might have around their mental health or wellbeing. By the end of that activity we had a variety of ‘fictional’ people or persona, all of whom had mental health or wellbeing needs or wishes. The rest of the day was taken trying to think of solutions to the kinds of challenges that the people we’d made up might have about their mental health. (I wrote about this first day here: http://www.oneinfourmag.org/index.php/on-spending-a-saturday-innovating/)
Persona work like this has two benefits; it shifts discussion into a safer space for those taking part by taking the discussion away from directly speaking about their own challenges and difficulties and it also moves the debate from ‘what I want’ to ‘what would be useful for another person’ This turns the activity from something about coming up with solutions to problems you experience to using what you know and your creativity to work out solutions to problems arising from the story of someone else.
The result of the first Innovation Lab was a large number of ideas for applications that addressed a number of different challenges for young people around their mental health.
Doc Ready comes into focus
It was at the second Innovation Labs that Doc Ready really took shape. At the second lab, those attending chose which idea they most liked the sound of and were invited to get on with turning the idea into a project that would be pitched for funding at the end of the day. One of the ideas that came out of the first Innovation Labs day was ‘See it My Way’; an idea for an application for GPs that would translate what young people wanted to say into language that GPs could understand.
The motivation behind this idea was the feeling that young people were often dissatisfied with their interactions with GPs and felt that GPs just didn’t understand what they were on about.
In the process of developing the idea of ‘Try to See it My Way’ our small group worked out that the actual problem we were looking at was that there was something that wasn’t quite working in the interactions between GPs and young people when it came to talking about mental health.
Correctly framing the problem that the application was to solve was in part due to the involvement of Rob Trounce from Right Here Brighton and Hove. Right Here Brighton and Hove do lots of work around GPs, mental health, wellbeing and young people and making that experience work better (I’ve written about their work here: http://www.right-here.org.uk/home/assets/pdf/brighton-and-hove-case-study). Rob’s input made the group rethink the actual challenges or difficulties around young people and GPs. Also in the group as facilitator was Rupert of Neon Tribe (now involved in building Doc Ready) who brought his experience of development which really pushed the idea in the direction of what might be possible. Me and two other people made up the group.
During the process of thinking through the problem, the idea went through a pivot moment where it made a sharp change of direction. What was the pivot? ‘Try to See it My Way’ became the idea for Doc Ready when we realised that another tool for GPs wasn’t going to go anywhere, especially not a complicated translation tool to change young people’s language into medical language. Where was the point of leverage for change? We couldn’t hope to control the behaviour or practice of GPs with an application but what we could do was somehow aid the ways the young person as patient entered into the GP/patient relationship. We switched the direction of the application around: ‘what if the application was to help young people work out what it was they wanted to say to their GP before they went,’ we asked, ‘and then help them to say it in ways that would make it easier for the GP to find the correct support or treatment for them?’ It was at that pivot point that the idea for Doc Ready came into being.
At the end of the second Innovation Labs day I pitched the idea for Doc Ready and it was one of the eight ideas that were chosen by Comic Relief, Right Here and Nominet to form a portfolio of funded projects.
When our partnership was successful in our bid to develop Doc Ready, the objective was to get to the point of having something to test as quickly as possible.
Diving into the research process involved speaking to GPs, mental health folks and young people to get a strong sense of what should and shouldn’t feature in the application. Receiving notification that we’d been successful in our bid to develop Doc Ready fired the starting pistol on the sprint towards having a version of the application we could actually test with people.
Our idea throughout the project has been to involve young people in meaningful ways in the development of Doc Ready. It’s young people who will be the end users of the application. Saturday 20th April was the first time we had something we could actually get people to mess around with. Working again with Rob of Right Here Brighton and Hove, as we have throughout the development, we managed to get about 20 young people to give up the first really sunny Saturday afternoon in months to help us work out how Doc Ready should work.
To co-design Doc Ready we used the same tools as were used in the Innovation Labs process, including persona, but with one very nifty addition: paper prototyping, where we got people to test different prototypes of Doc Ready. Instead of these prototypes being made of bits of code that appeared as graphics on a screen, they were made from paper, pens, blue-tac and tape.
To start the session we split into groups and got to know our persona, working out how, when and why they would use Doc Ready. Once we’d done that we unleashed the paper prototypes in all of their pen and paper glory.
The idea behind paper prototyping is really simple: create a prototype of the way an application or website will work (screens, buttons, navigation, graphics, pop-ups, functions) then get people to try to use it as if it were really on a digital device. A facilitator pretends to be the computer processing all of the commands, so if someone presses a button the facilitator ‘brings up’ the relevant function or screen.
When we were prototyping Doc Ready we brought pens, paper and addition buttons, sliders, back buttons etcetera and said ‘let’s see if this works. If we think it could work better, lets add, subtract or rearrange to make it work better’. We used three different prototypes and three different persona. Each prototype ended up being altered and tweaked with bits taken away, bits moved around and new bits stuck down with Blu-tac.
By the end of the prototyping session we had a really good idea of what seemed to work, what really didn’t work and what needed to be thought about more.
The next stage is to go back to people with an early technical prototype as quickly as possible to check whether we’ve taken the right insights away from the prototyping and research stages. That time round people will play with an actual ‘on the screen’ version of Doc Ready to see if it still ‘works’ for them.
Prototyping, invigorating and involving
While the obvious measure of whether the Doc Ready development process is successful will be the final application, there’s something really invigorating about developing in such a hands-on way.
Rather than just asking ‘do you like the look of that?’ we’ve been able to involve people in hacking the idea about in a real way before the process of the actual technical build begins. Paper prototypes are used to build something quickly so that people can play with them as soon as possible, allowing them to give feedback, input and be involved throughout the design process. These can be a great source of ideas, guidance and knowledge and can be a real eye-opener compared to more ponderous ‘consultation-based’ forms of involvement.
There’s no point in spending years developing something only to find out that it isn’t right or doesn’t work for the people for whom it is intended to work. It’s better, cheaper and more efficient to involve people throughout the process in ways they can make a difference and to find out early and quickly if you’re getting stuff wrong.
I’ve been having a blast.
Mark Brown is development director of Social Spider and editor of One in Four magazine http://oneinfourmag.org. Mark experiences mental health difficulties himself and was, once, young. He is writing the content for Doc Ready.
Over the past few weeks, the Doc Ready team has been carrying out a wide range of research in the build-up to running a co-design workshop to develop the idea further. This session will be run in Brighton on Saturday 20th April, so if you’re a young person or mental health professional and would like to get involved by joining us please register here.
Doc Ready is a product that will facilitate positive and useful conversations between a young person and their GP during mental health consultations. We already have a good understanding of the need from the young person’s perspective, but it’s also essential that we understand what’s important for the doctor, to have the most efficient and helpful consultation possible. We’ve been conducting interviews and using questionnaires to ask GPs about their ‘best practice’ guidelines for mental health consultations; what questions they need to ask and why they ask them; what happens at the end of an appointment and what problems they often encounter before, during and at the end of their time with a young person. We’ve also been asking about their feelings about the Doc Ready product in general.
Here are some of our key findings to date:
1. There was a unanimous response to the information which is essential to gain during a consultation.
- Mental symptoms – thoughts, hallucinations etc.
- Physical symptoms – appetite, sleep etc.
- Emotional state – moods, manias etc.
- Duration of episode (how long have you been feeling like this?)
- Psycho-social context of the patients life (events which might have triggered episode)
- Lifestyle factors – alcohol, drugs, stress etc.
- Risk presented to safety – self-harming, suicidal, any other parties at risk.
- Medical history – physical, mental, emotional. Is there a family history of mental illness?
- Impact on ability to function/ day-to-day life
2. There was less concern from GPs about…
- The young person’s feelings about what they wanted to happen next
- How the young person engaged and responded throughout the appointment
- Did the young person feel they would benefit from working with a therapist or counsellor?
We feel that it’s part of Doc Ready’s job to place emphasis on the importance of these issues, to help young people to have a voice and feel empowered.
3. Embarrassment and lack of information were common problems doctors found young people faced before coming to their first consultation:
They spoke about “the fear of the unknown”. Self-diagnosis using the internet or the advice of peers was also a big concern. Our content must serve the users’ need to reassure and inform and avoid putting labels to experiences.
4. Some questions the doctors ask can be confusing or illicit unhelpful responses:
“Perception of what it is to be depressed, compared to the doctors’ definition is often quite different” said one GP. Another said, “[young people] often lack the confidence and vocabulary to describe accurately what is happening to them”
5. Most GPs were very receptive to idea of a checklist:
Three-quarters responded very positively to the idea of a young person bringing a list of their concerns to their appointment with them. Some, however, had concerns that the list shouldn’t be too long or complex as it could distract from the natural conversation during the consultation and take a long time. Another concern that was raised was that some GPs might be a “bit put-out” by a young person “trying to tell them how to do their job”.
6. Things doctors thought should be recorded after the initial consultation (in order of priority):
Follow-up appointment details; prescription details; emergency numbers; info about therapy; lifestyle advice resources; self-help advice resources.
7. Preferred methods of recording this information:
Hand-written notes; printed literature; mobile phone app all had equal highest votes, but none were unanimous. This is going to be one of the most important decisions we make in the design of Doc Ready, so we really need to consider how we can provide the best user experience possible while keeping the product simple and relevant.
All of these insights, as well as our work with young people, will prove to be invaluable to the design process of the Doc Ready toolkit. Our research is ongoing, and we’re planning to speak to more mental health professionals and GPs over the next few weeks.
Are you a GP or work in mental health and would like to help by contributing to our research? If so, we’d love to hear your thoughts and you can share these by filling out our questionnaire here. Thank you!
We’ll be keeping you posted on more Doc Ready developments in the coming weeks, so watch this space…
Come and design a tool to help young people get more out of mental health related GP visits!
We’d like to invite you to a workshop on Saturday 20th April, 1pm – 4.30pm at The Jury’s Inn Hotel, 101 Stroudley Road, Brighton, East Sussex, BN1 4DJ to design and develop Doc Ready, a digital tool to help young people get the most out of their mental health related GP visits (see the invitation at the bottom of this post for more details).
Our mission is to make something awesome that supports young people to feel more confident about their GP appointments by helping them to: know what to expect from a GP visit, get ready for it and make a note of what happened at the end.
We’ve had lots of conversations with young people to find out what they want and now we need the help of both young people (aged 16 – 25) and mental health professionals (including GPs) to design the tool itself.
This will be a fun and interactive session, where you get to tell us what you think! We can’t build a tool that meets your needs without your involvement so please do register for the event at http://docreadydesignworkshop.eventbrite.com. Spaces are limited so make sure you book quickly!
You can find out more about Doc Ready in the following places:
Back in March, the Doc Ready team were invited to visit Comic Relief HQ in London for the Innovation Labs Grants Startup Day. Not only did it give us the chance to find out about more practical things such as what the Innovation Labs grants process actually involves, but it also gave us a nice opportunity to meet some of the other projects too.
We thoroughly enjoyed our day out and you can watch a short video of Mark Brown, editor of One in Four magazine which is produced by Social Spider a Doc Ready partner, being interviewed at the event about Doc Ready and its potential challenges here:
“How might we help young people make the most of mental health related GP visits?”
We were lucky enough to be joined by some of the Right Here volunteers to help start the user-led process. So, armed with sharpies and blank storyboards together we mapped out a GP consultation through the eyes of fictional personas. The insights painted a holistic picture of the service from a young persons perspective by looking at the process before, during and after a consultation. Amid the mess of chocolates, paper and suspect background music we had begun the project!
This was the first of a series of codesign workshops that will run over the next month or so. Here the findings from this initial activity will be explored further with the help of the young people from Brighton and Hove.
Thanks to the Right Here volunteers that joined us and we hope to see you again soon, along with many others!
Stay tuned to the blog for updates on the project and how to get involved…