Patient-centric system for migraine sufferers
Problem Statement
Scenario

The problem is that the recall of symptoms in between communications with the doctor are often inaccurate. THE SCENARIO DESCRIBES TYPICAL INTERACTIONS FROM SYMPTOM TO MEDICATION AND SUBSEQUENT COMMUNICATION. The problem with this is that the information needed to treat migraines effectively is dependent on what the patient remembers, which results in inaccurate accounts of what actually happened.
Design Challenge
How can I enhance the quality of patient-doctor communication and enable tracking migraine patients’ health in-between recurring appointments more accurately?
Research Questions
- What are the patients’ pain points in terms of interactions with care providers?
- What are existing design solutions for migraine patients?
- How do doctors typically keep a record of patient’s case for recurring appointments?
- What are gaps in the care provider’s’ existing case management system for recording information between appointments?
Goal
Develop a patient centric system to support tracking of relevant information between appointments. Alleviating the the patients’ burden to have to remember this information by tracking doctor specified items with precision, and hence resulting in better treatment outcomes.
Design Precedents
- Migraine Monitor : The Good: Allows you to access the support of your doctor (Headache Navigator). Easy-to-read reports can be shared with others, such as family, friends or your doctor. Get daily information that helps get your headaches under control, such as news, tips, and inspirations. Designed by neurologists in concert with Health Monitor’s 30+ years of patient education expertise.
The Bad: This is an online service. The organisation assigns a doctor, independent insurance plans. Color contrast. Link: https://migrainemonitor.com/

- Curelator N1-Headache App: The good: Makes it easy to log your headaches and other migraine symptoms, medication use, and to track each day a (customizable) range of factors (moods, weather, diet, etc.) that may affect the occurrence of headaches/migraines. The app is customizable to suit the things you’d like to track.
The Bad: Tracking is in the application and the feedback and suggestions are on the website version.
Links: https://vimeo.com/176162198

- Migraine Buddy: The Good: The app is easy to use, even when you have a headache and has the most tracking features, Goes above and beyond by providing many features and allows users to connect with other users, Can track migraine duration, positioning, medication, relief, symptoms, affected activities, etc, This app has the most features by far. It lets you track everything. Where exactly the pain is located, triggers, sleep timer, amount of stress, etc.
The Bad: There really is not a bad associated with this app. It tracks everything. If I had to say, it would be that there are a lot of fields to fill in, which can be overwhelming with a headache. The positives of this app can also be a negative. It offers a lot of features, but it might be too much for some. Hard if you don’t like changing screens during periods of pain. Reports based on goal rather than overall data. The colors on the page are brutal during a migraine

- Migraine Coach:
- The Good: Migraine Coach is helpful because it has a lot of features and it also helps prevent future migraines. It gave descriptions and identified the kind of headaches and migraines
- The Bad: The flashy colors and fonts are too small, poor readability

- iMigraine: The Good:
- Easy to use and can help you track when you have a headache.
- Helps sufferers track migraine frequency, severity, duration, positioning, medication effects and timing all on one screen. Provides informative reports
- Great visuals and easy to use
The Bad:
- It deletes migraines and doesn’t have enough tracking information to make it useful
- It would have been nice to track concurrent physical side effects

- Migraine eDiary: The Good:
- Migraine eDiary is simple and allows its users to record their migraines
- Users can stay on the same screen and can record various components of their migraine
- Helps sufferers track migraine frequency, duration, triggers, medication timing, certain symptoms
- Provides reports based on personal data.
The Bad:
- This app does not offer as much other apps
- When recording a migraine, it is harder to log the start time and end time
- Doesn’t track positioning (area of head affected) and requires too much flipping between screens
- Complex to use and tiny fonts
- It had a lot of screens to toggle back and forth

Competition Analysis
Feature Audit

Usability Scorecard

Digging into users’ needs
User Interviews
Demographic Questionnaire
Demographic Survey link: https://forms.gle/Uxb4VAi4Ss4CD2WY6

Discussion Guide for Migraine Patients
- What is the frequency of your migraines? How often do they occur?
- What type of care are you receiving?
-
What types of things do you need to do and what not to do between appointments?
- What type of information do you need to keep a note of between appointments?
- What type of questions are asked by your doctor about symptoms during your recurring appointment?
- What challenges do you face when communicating with your doctor about how you have been feeling between appointments?
- What types of things you think would improve doctor-patient communications?
Discussion Guide for Doctors
- What type of information do you keep track of the patient’s health in-between appointments?
- What are some of the conversations you had with patients where you felt that the information regarding the symptoms is not accurate?
- How does the current reporting system of tracking symptoms in-between appointments work?
- What are some of the gaps it has, according to you?
- What types of things you think would improve doctor-patient communications?
- What are some of the things that are critical to take care of for migraine patients?
- All participants track their symptoms through mobile notes after the migraine attack is over.
- They communicate with the doctors with emails in-between appointments. The email is sent twice a week or sometimes once a month.
- At each recurring appointment, the doctor completes a standard form to append to a patient’s case to document patient symptoms between appointments. The details are given by the patient verbally.
- All participants either assume that their tracking method is correct or feel it is not that important to be accurate.
Factors Informing Design
Themes
- Tracking methods
- Memory
- Nature of tracking
- Triggers
- Alerts
- Reports
- Prescriptions
- Minimal interaction design/Microinteractions
1. Tracking Methods
All participants track their symptoms through mobile notes or using pen-paper after the migraine attack is over. These notes are then shared with the doctor during appointment. These notes often give away inaccurate and incomplete data.

Design Requirement: There should be more detailed tracking features leading to accurate data such as Severity tracking, Severity duration, frequency of attacks, medicine dosage, previous medicines, migraine triggers, eye number change, sunlight exposure, acidity, type of food intake, blurred vision, sleep schedule, weakness/energy loss, Attack timing, etc.
2. Memory
“ I cannot remember the name of the precaution medicine prescribed to me. ”
“I sometimes forget what the doctor advised to do.”
Design Requirement: Features like the app reminds when is time to buy medicines as they are about to get over. The app should also remind the users of medicines to be taken.
3. Tracking Nature
“Different people get migraine cause if different reasons. So it would depend from people to people.”
Design Requirement: To focus on giving users personalized experiences. The things that the doctor asks to follow should be recorded thus enabling the app to track only necessary factors relevant to the patient and send reminders/alerts to the user accordingly.
4. Triggers
“My mind does not work when I am going through the pain.”
Participants usually do not understand how to take care of themselves in different situations when they get a migraine attack. Eg: Travelling, Hectic work schedule, during family functions.
Design Requirement: If a migraine attack is triggered in the above situations, the app should be able to guide the users on how the users can take care of themselves. Tells what they should be doing in order to get relief.
5. Alerts
Factors like lack of sleep, empty stomach, oily/spicy food, over exposure to screens or sunlight affect migraines. Patients usually do not realise when this is happening to them but regret not taking care of these factors after the migraine attack is triggered.
Design Requirement: Send alerts to the patient when screen time exceeds certain limit or regarding very sunny weather conditions. Enable users to track sleep and diet. Alert users when they have not tracked sleep or taken less sleep.
6. Reports
At each recurring appointment, the doctor completes a standard form to append to a patient’s case to document patient symptoms between appointments. The details are given by the patient verbally.
Participants communicate with the doctors with emails in-between appointments or on call.
Design Requirement: Enabling the app to save what the users have tracked in a repository. The users should be able to download the reports in the form of .pdf to email the doctor before the appointment. This saves time and also provides accurate information to the doctor.
7. Prescriptions
“I sometimes forget what the doctor advised to do.”
It is necessary to keep a track of the previous prescriptions. Also what the doctor has advised to do.
Design Requirement: The app should enable users to scan the prescriptions. This will help users refer back to their previous medications.
8. Minimal Interaction Design / Microinteractions
“I just feel like lying down and not do anything.”
“Sometimes the pain is just too much to handle. My head and eyes tired after the attack.”
“It takes about 1 – 2 days to recover completely.”
Design Requirement: The interactions that are required for the patients to do in order to track the symptoms should be as quick, simple and minimal as possible. The lesser the screen time, the better.
Concept Map
I created the concept map to give me a vision of what data needs to be considered when designing the MigCare patient centric system. The concept map helped me to organize my findings and integrate them with the design requirements for the project. This map is a result of my research findings through user interviews and factors informing my design.

User Flows
Once I had an overall understanding of the product, I started working on the user flows. I used Lucidchart to develop the user flows. It was an iterative process as I shared them with my Capstone advisor and received feedback from my classmates and the Professor.
List of Tasks
- Create a Profile/Sign Up
- Customize tracking dashboard
- Track migraine trigger time
- Track migraine severity
- Track severity duration
- Know the frequency of migraine attacks
- Track sleep schedule
- Track medical dosage
- Track eating schedule
- Track type of food
- Track acidity
- Track location of migraine trigger
- Track activity is done when migraine triggered
- Access prescription repository
- Access migraine tracking reports
- Send reports to the personal doctor
- Scan prescriptions/reports


Sketches
Sketches proved to be a turning point in the design process. They enabled me to start thinking about layout and how interactions could be more simplified resulting in a user-friendly interface. A design review was conducted to make further improvements.

Wireframes
After revising my sketches and making some changes, I used Sketch to create the wireframes. These wireframes convey the structure of each screen, the content, the actions and behaviors the user might expect from each button. It is a foundation of the what the structure and layout will be.

Low-Fidelity Walkthrough
This walkthrough was done with 3 participants who are designers to gain their insights on the low-fidelity wireframes.
Participant 1: UX Designer, No awareness about migraine
Participant 2: Product Designer, Does not have migraine, but has a family member suffering from migraine
Participant 3: UX designer, Migraine sufferer
Usability Test
Test Plan
Participant Consent Form
Task Scenarios
Prototype for Task 1: https://xd.adobe.com/view/f47bc98e-7643-4cfe-4cce-a55dc661892b-824a/
2. Record a migraine attack
You are starting to see that a migraine is coming. Use the app to capture that your migraine.
Prototype for Task 2: https://xd.adobe.com/view/a33ca2bc-95b4-4d2f-6459-0b6badbcbda6-d50d/
3. Capture your symptoms
You just recovered from a mild migraine which started while you were cooking in your kitchen. You need to capture your symptoms faced during the migraine. You have not slept well for the past couple of days. You were experiencing pain as if something was hitting the right side of your head and eye, weakness and sometimes your vision was a little blurry. You took the recommended medicine by the doctor but still had to miss work that day.
Prototype for Task 3: https://xd.adobe.com/view/d0bc85a7-6971-4473-7250-4aa2fe4fb195-a68d/
Prototype



























