Current System – Void Diary
In the current system, all those with bladder problems must use something called a “Void Log”. The patient must enter all of the their fluid intake, out put, leakage and whether or not they have urgency. They must continuously fill out the log throughout the day and often must continue to log for four or more days.
However, the current system is only a pencil and paper model. The patient must carry around a physical Voiding Log and writing utensil and add entries at least every hour. This system not only excludes those with other disabilities, but it greatly impacts quality of life for those where incontinence is their only disability.
- Those with arthritis
- Those with arthritis who cannot physically take out a folder and write entries every hour due to joint pain
- Those with visual impairments or blindness
- Cannot read the current Voiding Log headings and thus cannot write into it
Quality of Life Impact:
- Unnecessary social embarrassment taking out a “Voiding Log” every hour and recording entries
- Business Lunches
- PTA Meetings
- Additional activity limits
- Must take significantly sized breaks every hour
- Takes a solid minute to physically get out log and add an entry using pencil and paper
- Must be able to carry a pencil and paper log everywhere
- Swimming pool
- Must be able to physically write entries at location
- Movie theater
- Must take significantly sized breaks every hour
We decided to focus on the disability we perceived as having the most stigma: incontinence. We never hear about “breaking news” in the latest helpful technology for those with urinary problems. However, 30% of those over the age of 65 and over 16% of the general population suffer from Overactive Bladder
One of our team members recently went to a urologist’s office. The instructions were to use a “voiding diary” to record all fluid intake and output; however several other clinics also require urgency and leakage. The only method of recording available was a pen and paper table. This is not only extremely inconvenient and embarrassing, but it excludes persons with visual impairments and writing difficulties.
For instance, imagine going out to lunch with your coworkers and suddenly whipping out a voiding diary and recording the water you’ve been drinking. Or imagine having arthritis where taking out the journal and writing is painful each time. What about those who are blind and cannot read the diary at all?
Why are we using methods from the 1600’s when there is 21st century technology that could make following doctors orders accessible to all?
System Design Documentation
Voiding logs require input at least every hour, no matter where you are or what you’re doing. We decided to use a wearable because they can be discreetly worn and used 24/7 without much inconvenience to the user. Our large screened wearable is also more accessible to those with physical impairments that could prevent them from writing. Pressing a button or rotating a scroll wheel is significantly less joint movement than pulling out a journal and writing.
We will also offer the Watch Log as both an Apple Watch app and an Android Wear Smart Watch app. This allows individuals who already have wearables to use our Watch Log without having to buy and wear a new piece of hardware. In addition, our Watch Log will will work with any blue tooth earpiece so the blind and visually impaired can listen to the Watch Log options instead of having to read them on a screen.
2. Sketching / Modeling
The wearable intends to replace a watch. It’s main purpose is to be a void-capturing system, but will also serve as a watch. This protects the user from any kind of stigmatism by disguising the system as a regular everyday product.
It consists of 2 buttons on each side (left and right), a touchscreen display, and speakers. The buttons will be used to choose input options (refer to Figure 1A) which will be displayed on the screen. E.g. for the “Fluid Type” input field, pressing the right button will change the highlighted option from “Water” to “Coffee”, and pressing the left button again will change it back to “Water.”
Tapping the touchscreen confirms the answer and takes the user to the next question. Double tapping the touchscreen will take the user back to the previous question. To terminate and exit, the user can press both the left and the right buttons together.
When the accessibility setting is turned on:
Upon arriving on a question, the label is dictated. Then, the highlighted answer will be dictated both initially and upon change.
“Please choose the type of fluid. The answer selected is water”*USER PRESSES RIGHT BUTTON*
“Coffee”*USER PRESSES RIGHT BUTTON*
“Juice”*USER PRESSES LEFT BUTTON*
Tapping on the touchscreen to confirm the answer will also notify the user through dictation before moving on to the next question.
Our prototyping began by looking at existing watches as a base for our physical prototype. One of us had a watch that closely resembled the design sketches.
Creating a physical prototype was very helpful to understand the dimensions of the product. We played the role of the user in two ways. First, we simulated visual impairment by having one of our members remove their glasses and try to view the screen. We quickly realized that we needed to increase the watch face size significantly.
Next, we simulated motor/visual impairment by trying to feel for the buttons on the side of the watch with our eyes closed. This led us to a larger button design that juts out from the side of the watch face.
From what I understand about designing for inclusion is that you may be focusing on including certain groups of people, but overall your design should be universal, in that even people without a disability will want your product. Our watchlog follows that in some sense. It’s not necessarily something everyone would want to buy, based on its purpose. But it could be something people will buy for style (depending on the price), like they do with glasses nowadays. We tried to make it something you wouldn’t be embarrassed to wear and something you may even enjoy wearing. Originally we thought of just something that would go around your wrist that looks just like a bracelet. That way it was more subtle than a physical log. But as we brainstormed more, we thought of adding a watch face to the bracelet. This would make it gender neutral and universal. Everyone wears watches. This also made it more functional than just a log of your bladder. Now, it’ll tell time so if you don’t want to tell people it’s real purpose, you don’t have to lie. It is a watch. It just does more than that.
From this project, I understood how important it is to research and empathize with the people you are designing for. To the best of your ability, you need to be able to experience what they experience in order to understand how to include them in the best possible way. We may not have been able to do this with the time constraint, but we had a group member that had someone close to her that experienced this. So from her close companion’s experience, we were able to understand some of what made the original system so bad. From there we designed our system. There may still be assumptions we made but I think as a group, but we understand what we would’ve done differently had we had enough time.
Initially, our project didn’t quite fit what the assignment asked for. The system we analyzed (voiding logs) was made for people with disabilities; it wasn’t the best example of design exclusion. However, we quickly realized that this system wasn’t created with much empathy for the patient. In addition to that, if a patient has multiple disabilities (which is likely with the average user, who is elderly) they will be excluded from the system altogether.
What we arrived on was an interesting solution to a potentially embarrassing problem. We tried our best to do experience prototyping and empathized with our users. What if someone asks you what’s on your wrist? Well, you might not want to say, but you also might not want to lie to others. This solution gives you an easy, honest response: “it’s a watch.”
Overall, I found this to be the most applied pressure project. While our design wasn’t too focused on the hardware, we learned by making physical prototypes and trying it out. The opportunity to market this product by designing a logo and 3D model was also enjoyable to me.
I love product and UI/UX design, and what I really strived in the WatchLog was to merge accessibility, minimalism, and aesthetics. When I first started sketching ideas, I didn’t envision it being used by certain groups of users; for example, I didn’t incorporate the experience of a blind user. So when I thought about using my initial sketch with my eyes closed, I knew I had to start over. After a few trials I sketched a bracelet style WatchLog inspired by FitBit, but with 2 buttons on each side, a touchscreen display, and a dictation feature (to include my previously excluded range of users). After we collectively discussed about our targeted audience, we concluded that the screen was too small for elderly users. This led to the big, round display with comfortably-legible fonts and a smooth user flow.
What I learned from this project is that as a designer it is crucial to empathize and step into the user’s shoes. It is very easy to design for one ideal user!
Someone very close to me had a bladder problem and had to visit the urologist. The urologist told them they needed to keep a pencil and paper voiding diary for several days, which negatively impacted their quality of life. They were embarrassed to take out the “Voiding Log” in class and avoided going to social events because they didn’t want to take out and record in a “Voiding Log” while hanging out with friends. Even taking out the log was extremely inconvenient sometimes, like when they were working out. With the voiding log, those with bladder disabilities are excluded from social situations if they want to keep their condition discreet. They are also excluded from any event where they cannot do pencil paper recording every hour. I brought up to the team that this issue is real and we should be able to use technology to solve it.