PREDICTION CALCULATORS, CLALIT

https://www.clalit.co.il/he/info/services/Pages/Predict_Calculator.aspx

General

This project involved a collaboration of the Department of Online Medicine, The Research Institute and various consultant physicians – all are part of Clalit Health Services – Israel’s leading health institute. The main goal was to motivate patients to adopt a healthy lifestyle by engaging them with preventative medicine. 4 types of calculators were presented at first stage – Stroke, Colon Cancer, Kidney failure and Osteoporosis. In future stage there will be added more calculators, among them for Heart Attack and Diabetes.

Milestones

(Or: And then came the patients… and the doctors)

What seemed like a great idea for us – showing the patients their higher/lower chance of having a stroke by changing the parameters they have control over – turned out to be only partially solved.

Look at this screen:
We thought it contained all the information needed. All parameters for the algorithm the users can play with, the chances shown clearly, and a reference to an article providing a treatment suggestion.

But then came the focus group. And the real faces told us another story. We had 2 groups, men and women, 10 participants in each, with the idea behind it to make them feel comfortable to talk about their health, body condition or any intimate thought, fear and idea they have. Naturally as one grow older the chances for carrying a disease increases, and so our youngest participants were at their late 40’s. Here are the main concerns brought up in the focus group:

No one knew what their own BMI was.

The expectation for an optional treatment offered according to the results turned out to be diverse. Some expected to be offered a workshop or a course, some expected to be offered an appointment with the doctor, some wanted reading material such as relevant articles and some just wanted to know what would be the best treatment or medicine they should take.

The saddening gender and generation differences: The women were hesitant using the scales, playing around with the parameters and therefor coming up with conclusion about what future steps they should take. We tend to believe this is due to the technology challenges of the older generations, and the fact women were less revealed and motivated by society to dare and explore what’s considered as technological. Men were suspicious regarding who are the agents behind the scenes, why should they believe the results, and very keen to cooperate if this feature will turn out reliable.

(us? we’re here just for snacks)

Conclusions

BMI factor was changed to Weight. The patients medical file already contains the parameters needed to calculate it – gender, age and height. So the algorithm will do it for them.

A few treatment options will be offered. This means we can’t gather all the information in one popup window. The page format will have to change. A list of recommendations, customized to the patient according to his own medical condition and parameters, will be displayed following the results section.
To earn credibility, we will use the logo and a collaboration indication of the Research institute.They have developed the algorithm based on the big data of millions of patients and using this unique opportunity they came up with statistics no other health organization in Israel holds.

There will be more clarity about the “decision making” process of the calculator. The patients will be notified there are over 20 parameters included in the algorithm, which increase reliability and engagement.

The look and feel of the calculators has to change. The round scale of the results is actually inaccurate. It should show a range of 0 to maximum and not a circle. In addition, the design was based on the old website and we were working on a new one, so better to go forward and worst case to combine the new look of calculators in the old website.

But then came the doctors

It turns out doctors have their disagreements on what is the higher limit of a normal blood pressure. They all agreed that a systolic pressure of under 120 is normal and over 140 is high. But what about in between them? Same for the diastolic – up to 80 is normal, above 90 is high.

Some of them were not willing to consider a blood pressure of 130/85 as high and didn’t want patients knocking on their door because they have this in-between blood pressure. So we couldn’t use this type up scale:

This was the opportunity to offer a design solution. What if we use gradient as a range between normal and high blood pressure?

Also they wanted to make sure patients understand this is a tool they can use to hopefully save future appointments. Legal department had its say as well:
And then there was peace for all.