interactive education background

Patient education: birth of a feature

Motivating Indian diabetes patients to make a healthy choice in their lives is a tough nut to crack, but a bit of knowledge never hurt anyone.

Patients

Diabetes is a chronic disease that confronts people who suffer from it every day. Luckily, there are a lot of things patients can do to successfully manage their disease. Besides taking medication on time, most of these things involve changing daily habits or adopting new daily behaviors.

Relying on a mobile app to change behavior is quite a task. We believed a good first step to changing behavior is knowing which habits are healthy, and what behavior is likely to cause trouble.

Doctors in India

Doctors in India see hundreds of patients every day, and spend 5 to 10 minutes on average with a patient. Just enough to assess their current situation, do a quick check, and update medication. They lack the time to do any thorough form of patient education. Doctors also tend to have 2 or 3 jobs, in order to make an adequate income.

Doctor and patient
A doctor spends 5 to 10 minutes on average with a patient

Support staff

Nurses, dietists and other support staff spend a little more time but the patient volume is simply overwhelming, especially because most patients come to the practice around the same time in the morning.

mumbai clinic dietist
Dietist in Mumbai clinic

From the patient side there is a clear need for education, but the practices simply do not have the resources to deliver.

The pilot

Before investing a lot of resources in building anything, we wanted to see how many patients would respond and keep responding if we sent them educational content about their diet. A healthy diet is one of the most effective ways for diabetics to control their blood sugar levels. It’s also something that happens (at least) three times a day, so there are lots of opportunities to improve throughout the day.

pilot brainstorm
Brainstorming the pilot content
whatsapp pilot
Example of a question asked to a patient

Two weeks of testing yielded the following wisdom:

Version 1

The first version we released was pretty bareboned; it didn't have pictures, but because the pilot results were good we wanted to get something out as soon as possible and decided text-based education was OK for the first version. Similarly, we settled on a frequency of three questions per week, instead of one per day. This would give us some extra time to write more content.

flowchart
Exploring the logic of automated messages with a flowchart

I built an early prototype, to play around with timing and automated responses.

To make it easier for patients and less error prone for us, we went with A B C D buttons instead of patients having to type their answers.

education as part of chat
Should the new feature be a second thread within the existing Chat feature? Should users reply with text or use buttons?
whatsapp pilot
Exploring buttons instead of replying with text

Version 2

In version 2 we:

flowchart
V2, now with pictures

Unsurprisingly, after these changes, we saw improved retention and more intensive use of the feature. Good news!

Version 3

In the third version we added sound effects and animations to make the experience even more engaging.

Version 4

For the 4th version we upped the frequency to three questions per day. We also added the ability to enter data like blood sugar, medication intake, weight, etc. Finally, we added the ability to set daily reminders based on patients' answers to a specific set of questions.