Designing digital therapy tools: Reflecting on Industrial Design Honours

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This year i’m beginning a new chapter of my design journey within the academic realm, commencing a PhD, in order to collaborate with the healthcare industry to provide digital designs for wellbeing. This project was born from the ideas, efforts and practice-based experiences of my honour’s project last year.

Increasingly, facilities and health professionals are wanting and recognising not only the need for patient-centred experiences and value based care, but also the potential engagements which immersive technologies can support. Last year, as part of a design research team we collaborated with Bendigo Health with the intention of driving human-centred design outcomes.

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In the early weeks of semester, a design research team was established to begin the process of collecting research and developing comprehension for the field of interest: non-pharmacological opportunities in healthcare and multi-sensory therapy. Multi-sensory therapy is a well documented approach, which was made famous by two dutch therapists through the Snoezelen. A person is placed in a soothing and stimulating environment, provided with sensory stimuli such as bubble tubes, projectors and olfactory dispensers. Much of this technique hasn’t changed in nearly 50 years.

A multi-sensory room

With insight into both the existing and developing state of multi-sensory therapy, we started to engage stakeholders. We collaborated with the psychiatric ward staff at the country Victoria Bendigo Health Hospital as part of the project. Through the research, staff were hoping to better leverage the existing multi-sensory stimulation rooms within the wards, made available to elderly patients, suffering from dementia disorders. These rooms were small spaces, containing lounge chairs, wall-mounted textures and an assortment of playful games for use. Patients had to request access and be monitored throughout, often being provided stimuli by a care professional. Said workers wanted to enhance and leverage the rooms more so, but had issues providing relevant and useful games and tools.

Occupational Therapy Staff @ Bendigo Health

This proposition fitted into a greater context of ageing which has been a focal aspect of Australia’s future population outlook. The number of Australians over 85 years old is projected to more than double by 2066, requiring more care services, as well as the problems associated with it, as dementia is expected to soon become the leading cause of death for the country.

Within this futuristic scope, there was consideration for how future generations might cope and manage not only dementia, but mental health care in a broader context. As determined by the Australian Black Dog Research Institute, 75% of mental health problems emerge before the age of 25 years, suggesting that the development of tools which help reduce and improve the wellbeing of younger patients can be beneficial both short and long-term. With this in mind, along with discussing this potential direction with the staff at the hospital, I begin exploring the young adult specific ward, Y-PARC.

YPARC Facility @ Bendigo Health

At Bendigo Health’s Youth Prevention and Recovery Care Service, the 10 bed facility enables younger patients either moving into a more permanent stay at the hospital itself, or returning to the local community. Staff provide sessions where skills and tools are taught that can be utilised to improve their stay. These programs and the therapeutic techniques (art therapy, magic sand and mediation) enabled a context in which my project could work towards practical introduction.

Initial consultations with the relevant staff involved sharing opportunities and potential intervention methods, as well as exploring the existing environments and tools available for use. With these documented, and insights gained from the occupational therapy staff at Bendigo Health, we began framing the issue, exploring methods and mediums in which we could engage with patients. This was undertaken through co-design methods such as user feedback, observation analysis and stakeholder engagement. Reflective artifacts were created such as patient & staff journey mapping, further exploring the modes and motivations with persona creation.

User Experience Synthesis tools

Based on the target audience for the project being young adults, an approach involving emerging technologies, particularly those enabling stimulation and personification was identified. My own exposure to digital technologies like virtual reality, and it’s increasing relevance as an emotive tool, provided a potential medium for exploration. Other interactive technologies and systems, such as projection mapping and tactile interfaces were investigated, however the improved flexibility, mobility and cost-effectiveness of new VR Headsets such as the Oculus Go unit won out in comparisons. As a developer platform, Oculus had a well developed library of resources to suit the directions that might be taken, as well as enabling developers using the Unity 5 game engine. This medium was supported by research and precedents within Healthcare, leveraging the virtual realm to support patient care.

Patient Therapy tool — DREAM3D (Phoria & Murdoch Children's Research Institute)

Due to staff’s interest in creating more relevant and contextual experiences for patients to explore, particularly due to the country background of the patients, I wanted to explore VR mediums that would resonate best with users. Initial 360 degree videos were investigated and tested, recording a library of relevant environments and action. However in testing these through a VR Headset, the lack of depth and interaction reduced the video content’s capacity for immersion. While stereoscopic & depth sensing is improving, it didn’t suit the content needs. Instead, we determined that computer-generated content would provide the best level of immersion, interaction and adaptability.

360 Degree Footage

With a clearer medium and format now found, I took to discovering precedents and concepts within the Virtual Reality and Gaming industries. In particular, I engaged with a local Melbourne company, LiminalVR, who were establishing a VR platform for games which enabled experience that could improve wellbeing in daily life. Through partnering with them, I was able to leverage extensive psychometric data and research that had been undertaken by the Psychology Team at LiminalVR. Through then reviewing games and experiences through this framework of colour, action and shape, I was able to identify both Campo Santo’s Firewatch and Ustwo’s VR game Land’s End. These games enabled immersion through flooding the screen with deep hues and using interactive content that was intuitive and engaging.

Campo Santo’s Firewatch and Ustwo’s Land’s End

Looking to cater to a wider range of skills and ability, experiences were developed around a central theme of water in nature, with varying levels of interactivity. These levels catered well to 3 separate story lines, which were expanded on through storyboard scenes, which enabled a workflow of asset creation, environment design and adding mechanics to the experiences.

A workflow of storyboarding, asset design and modelling, interactive development

This approach enabled a more applicable method of testing and screening for user ability. Having developed the experience to a point of effective efficacy, further user testing was necessary. Designed to take place over an hour session, 3 occupational therapists and 3 ‘patients’ partners (of the target demographic) were inducted into the Aperture application and documentation, informed of the goals and objectives, then provided with both equipment and protocol.

The Occupational Therapist would set up the Oculus Go headset and support patients to complete the prescribed activity, providing feedback through the feedback forms provided and observational summaries.

User Testing

The sessions were observed and support by a Project Operator (i.e. Design Student Facilitator) to resolve potential technical issues, observe the interactions and interview the participants after concluding the session. With Occupational Therapists delivering the therapy tool to patients, the exercise was able to uncover many important aspects that could be refined and built upon:

  • The arrangement of the Virtual Reality experience within a more progressive and storied format, rather than having them at as individual, separate journeys
  • Further integration of the controller during the experiences was also highlighted for refinement to enable Patient immersion.
  • Therapists recommended the inclusion of some form of monitor to review the patients experience and gauge interaction.

These result provided evidence for both the potential applications for VR tools in contributing to patient treatments, alongside the need for more refined, interactive and integrated digital journeys to undertake. As with any emerging technology being explored and tested with a Healthcare context, conservative steps and testing are required to support both patient concerns as well as finding the best methods for healthcare professional uptake.

As a developing design practitioner, the ability to engage and take on projects within the healthcare context has been an incredible opportunity. Through not only working through different frameworks and methods of design, but also crafting my on process an skills throughout the project. Through collaboration I gained insight into the role and need for design research, leading to my pursuing further study.

Bendigo Health’s continued use and support for the project, along with other healthcare institutions looking to add experience and sensory treatment opportunities, has seen the project develop into a long-term initiative to grow the psychiatric wards’ digital capabilities, alongside the teaching and re-tooling of staff working in these roles.

Within this broader context, my intention is to explore opportunities for further collaboration which concerns designing digital health, as this space provides us with not only the means to support individual stories, but begin to craft, control and add value and meaning to them.

Jacob Sheahan

Industrial Designer, RMIT PhD Candidate, jacobsheahan.com

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