Shared Decision Making
Decision Making Aid for Depression Patients and Physicians
Our Client, the Mayo Clinic currently uses a series of physical cards enlisting various side effects such as weight, sleep, sexual issues, withdrawal symptoms. The physician after identifying the problem faced by the patient, uses these cards as an aid for himself as well as the patient to visually compare the various side effects of a medication and to decide which drug to take, based on the patient’s expectations from the drug. Using these physical cards to facilitate conversation, the patient, who is the expert of him/herself, and the physician, who is the expert of the medicine, make the decision on patient's medication together.
Although the cards have served the users well, Mayo Clinic came to us with the request of designing a digital version of the decision making aid cards, since the physical cards are difficult to update and they also want us to explore how the digital medium can further facilitate the decision making process.
Through online research and watching the videos the Mayo Clinic provided on the therapy sessions, we gained a deeper understanding for the depression patients and physicians, as well as the usage of the current system. Medically, there is no answer to which antidepressant is the best, it's important for the patient and the physician to make a shared decision and choose the medicine best for the patient.
The design should support both of the user groups: patients and physicians. The system should not only serve as a conversation tool for both parties when deciding the medication, but also as a reference for the physicians to remind them of the different medications.
Depression affects aspects of people’s daily lives that are very personal and sensitive, such as weight, sex, sleep. The design should be careful and sensitive when dealing with these issues, providing a safe and comfortable environment for the conversation.
Encourage Balanced Conversation
The system should encourages more discussion between the patient and the physician, rather than giving any party or the system the total authority in the decision making. We need pay attention to different factors that could affect the balance of the conversation: the environment, the physical form of the system, the way information is presented, the interaction model. It’s important to encourage the patient to provide input beyond what are available on the system. The system should help to enrich the conversations with trivial context information, such as previous experience with antidepressants, and decrease silence caused by interacting with the system.
Design Option 1: Preference Model
- Patients can communicate their preference, "ideal situation first" to the doctor first.
- Helps make trade-offs between different side-effects instead of optimizing the problem
- iPad makes it a more tangible, equal interaction than interacting with a desktop screen.
- Can be hard to follow one particular medicine across different side-effects
- Requires a lot of clicking to select their preference for each issues
- The medicine that fits patient's ideal situation may not exist
Design Option 2: Tracing Model
- Clear overview of different side effects of a certain drug
- Can compare between the side effects different drugs
- Showing the realistic options available for each side effect
- Procedural yet can easily undo selection, support conversation back and forth
- Optimization rather than conversation
- Showing all the coordinates can be visually overwhelming and distracting
- Can improve on the design of the topic selection. Icons are not easily recognizable