According to Renalis Health, “Pelvic health disorders are insidious and expensive, affecting one in three people in the U.S. with costs exceeding $100 billion per year.”
These disorders are often emotionally fraught and complex. They are a progressive problem to solve for patients and equally challenging to treat for healthcare providers. Often, pelvic health patients must follow a comprehensive plan to manage their symptoms and improve their overall state of being, but many are unable to succeed.
Knowing how difficult this can be for patients and providers, Renalis wanted to build a tool that focuses and supports the patient on this journey.
To date, they've had success with a conversational agent (sometimes referred to as a chatbot), CeCe Lite, which provided people with a five-day experience of interaction and education.
When they came to us, the next step for Renalis was to do a proof of concept study for a full-digital therapeutic for Overactive Bladder and submit those results to the FDA. In this study, participants will fill out validated surveys through the CeCe conversational agent, as well as keep a bladder diary (tracking fluids in and fluids out) for three days.
After the initial diary tracking participants will receive ongoing behavioral therapy consisting of behavior modification, fluid management education and urge suppression for 7 ½ weeks. They will also engage in exercises to increase their pelvic health.
Missy Lavender, Founder, CEO
Renalis sought help from Table XI in two ways: to develop, in the short term, what was needed to facilitate the FDA study and, more broadly, to understand what the opportunities are to better serve this population beyond the immediate constraints of the study.
Our goal was to reimagine a better patient experience while increasing physician and care team capacity through the power of digital product innovation.
Throughout our research and discovery process, we tested many different ways to add diary entries. The final product resulted in a mix of representative iconography and specific numeric inputs to ensure accurate and complete information.
Renalis came to us with a strong understanding of the data that physicians needed to collect from their patients but desired a greater understanding of the patient’s needs, goals and priorities.
For people experiencing pelvic health disorders, the symptoms can be intensely embarrassing, and many are reluctant to identify and investigate their issues.
The opportunity to capture adequate patient data and inform better avenues of treatment and education will come from an upcoming proof-of-concept study Renalis’ research partner, University Hospitals will lead.
The study will require participants to keep a bladder diary (tracking fluids in and fluids out) for three days. At the end of those three days, participants receive ongoing virtual behavioral therapy consisting of education and exercises to practice. There are two subsequent diaries at the four-week mark and eight-week mark, to show patients how and where they have improved over the course of the study.
Table XI’s integrated team worked to answer the following questions through a series of workshops and prototyping:
With the norms changing in work collaboration during the pandemic, we utilized digital whiteboard tools, like Mural, to create a collaborative co-working space for the team and client.
Table XI’s multi-disciplinary team of strategists, designers and developers guided Renalis stakeholders and patients through an established double diamond process to deliver innovative solutions. This integrated team, imperative to the project’s success, provided the different perspectives required to effectively deliver an end-product that mattered.
The crux of the double diamond approach is the concept of divergent and convergent thinking. Being able to go broad but then narrow based on informed decisions allows us to understand the total scope, while also prioritizing the right problems to solve. This approach leads to more creative and innovative solutions that meet business and user needs.
Before you can define a solution, you must back up to understand that you are solving for the right problem.
Our four steps of Research, Map, Ideate, and Define provide a rich foundation for us to kick off all of our projects. Over the course of two days, we led Renalis through a series of collaborative sessions to gather insights and ideate potential solutions. That was followed by prototyping a mobile product that we then validated through patient interviews.
Throughout our process we were able to explore ways on how best to:
After our initial workshop, we developed an interactive prototype to test with our target users: women who experience symptoms like needing to urinate multiple times throughout the day, having leaks during the day or night and/or intense urges to urinate.
When testing with users initially, we represented liquids using icons. However, because of the specificity needed in measurements, we found users actually preferred having a combination of iconography and numeric entry.
Empathy is the most important factor to build during this research phase and will ultimately impact how valuable a product is after its release.
This user research unveiled common themes and insights that provided a consistent roadmap for design to follow, like interface simplification and language use that is sensitive to the emotional aspects of the symptoms and gender-inclusive to trans and nonbinary folks with OAB.
In tandem with our research and design phase was a technical discovery to better understand HIPAA constraints, optimal technology for the conversation agent and how to unify that agent with a diary-driven experience.
Feedback we heard in user testing supported our hypothesis that diagnosis and treatment must meet a user where they are to ensure adoption and success of treatment.
Through our research and discovery process, we determined that an app that focuses on engaging patients in a trustworthy and flexible format would lead to stronger adherence to a voiding diary. That outcome, while meeting user needs, would also support Renalis’ business needs in validating their product in their first official study.