Prototyping government policy in personalised healthcare
This research informed the "Predictive Prevention" programme, which was actioned by the UK Health Security Agency, Public Health England, the NHS and more.
The government wanted to understand how they could better use data to support people in making health lifestyle choices. We conducted a 6-week sprint to understand how we could create data enabled services that target people on an individual basis to take control of their own health. In particular, improving: sleep, diet and exercise.
I was the Service Designer working alongside a User Researcher during this project. Together we planned: the research plan, including how to target multiple demographics. We decided to create a pragmatic 6-week plan including time for prototyping and feedback. We managed multiple stakeholders within the organisation, communicating with people regularly through show and tells.
We started starting with interviewing health professionals, future of health experts and staff from within Public Health England’s Digital department. This was to understand which healthcare issues are most pressing, and how technology is starting to address those issues. From this we learned about how data-enabled health services could work, and what the potential limitations could be. For example: citizens need to retain autonomy over their own data. They need to have a clear exchange of value; if people are giving their data they need to get effective services that they want in return. The sense of trust and of ethical data-use was at the heart of our approach. These insights informed how we engaged with citizens, and what prototypes we generated.
Our team of two carried out research with citizen’s all over the country to understand how comfortable they would feel with the government using their data to influence their health. We
We developed prototypes to use as prompts, so that people had something tangible they could respond to. This allowed for citizen-informed design. The government needed examples to show to citizens to get feedback and inform the policy.
We developed personas to understand people’s strengths, and their health challenges. We also understood their technology literacy, and their general trust in health professionals. Understanding these factors helped us to understand how comfortable people would be sharing more health data with the government. It also helped us understand how we could support people’s health. *All the names in the personas have been changed.*
We developed 5 prompts that demonstrated ways in which health data could be used to make personalised health products. We used these to get feedback from people on how they felt about health data being used to support their wellbeing.
The shareable patient record allows you to share your phone data with health professionals, and allows data to be shared easily between a GP and a counsellor. During initial research the issue of interoperability of patient records was highlighted, showing how tricky it can be to share health information when multiple GPs and hospitals often have different record systems.
The idea has mixed reactions from members of the public: “I wouldn’t use this because I’ve got kids and I don’t want the GP to know this much about me. I don’t like the amount of info that the government have about you already and I don’t trust the GP.” Ami, 34
Whereas Graham, a retired firefighter at 61, had a different reaction, with a higher level of trust in the government and health services: “If something monitors you properly and then prompts you to go to the GP if there’s something wrong with you that they can maybe help you with. I think it’s a great idea.” The younger members of the public we spoke to had less trust in health professionals than older people.
This concept questioned what level of autonomy people would feel comfortable with. Your devices would be shut off when it was time to sleep, in order to encourage better sleep habits.
Most people were uncomfortable with this idea, Alyssa, 23: “A complete shutdown? It’s worse than my mum telling me! I think I’m quite happy with what apple does when it just mutes all my incoming calls. I’ve noticed it has delayed me picking up my phone. I’m happy about that, that’s enough for me.” Some level of devices changing at night was acceptable to people, but completely shutting off wasn’t.
“It would be good, but it would be annoying. If you’re writing something and then it shuts off. But it could be a blessing. I keep scrolling on FB when I’m in bed. I’ve seen all of these posts and this stuff before, but I keep scrolling.” Ami, 34
It offers to create a personalised physical activity and diet plan for you, based on your genetic makeup. We used this concept to explore the themes of trust, in giving their genetic information, and value, in whether they would see value in this.
Some participants had already shared their data with health services: “I’ve recently shared my DNA with ancestry. It said I’ve got all these cousins around the world.” Sheila, 69 Whereas others felt: “My genes are a bit precious to me.” Erika, 22. The value of a personalised diet and exercise plan was unclear to some: “I’m not sure about my DNA being sent off to various places. What would they be doing with that information? I’d only share it if there was a problem, not if they just wanted to test me for no reason.” Ami, 34
You’re doing your food shopping online. At check out, there’s a Healthify button, which offers you a healthier, cheaper version of your basket. This concept was popular, with people seeing they gave a small amount of data, just their supermarket shop information, for something that was convenient for them: “For someone to prompt you for a healthier option that’s really useful.” Graham, 61.
From the research carried out during this 6 week sprint, we’ve come up with 6 draft principles for how we should proceed to design data enabled health services:
Service Design: Charlotte Fountaine
User Researcher: Callum Bates
This was a research project that informed the government’s strategy on data use and digital health technology.
