Our guest this week on Moving Digital Health was Carmen Branje, Director of Product Design for Maple, Canada’s leading online medical care platform, providing virtual access to reputable, Canadian-licensed healthcare providers.
Listen to this podcast episode to hear Carmen discuss with Reuben Hall, CEO of MindSea Development, the challenges of designing for critical digital health services.
“One of our biggest problems is, and this is domain specific now, is not everything can be done through virtual care. And sometimes it’s hard to explain that to someone, especially when you don’t have a doctor in person. The clinics are hard to access and you’re trying to access care. And then a provider doing their best and what they should be doing… Which is saying, I’m sorry, this isn’t appropriate.” Carmen Branje
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Read Transcript:
Reuben:
Welcome to the MindSea podcast series Moving Digital Health. Our guest today is Carmen Branje, Director of Product Design at Maple, a virtual care platform widely adopted across Canada. Thanks for joining us today, Carmen.
Carmen:
Thanks, thanks for inviting me.
Reuben:
To start off, could you tell us a bit about your background?
Carmen:
Sure thing, sure thing. How much time do you have? Cause I could talk your ear off. We’ll do the short version?
Reuben:
We’ll start with the short version and we’ll dive in from there.
Carmen:
So, well, we’ll go way back. So I was a computer geek since I was a little kid. Since I was 12, I would spend hours and hours and hours on my 386. And so that was kind of the beginning of my intro, my journey. So I studied computer science. And I really liked that, but I met a researcher at Ryerson. Her name was, it’s now called Toronto Metropolitan University. It was Ryerson when I went.
Carmen:
Um, I met a professor there. She was a research professor and she did lots of research around accessibility. So providing access to multimedia, to people who are blind and deaf, or who have mobility issues. And so I sort of took a, a 45 degree turn and I didn’t abandon coding or programming, but really added on a research part where, so I joined this research lab and I really started, you know, joined research projects as a developer, as a, you know, later I became more of a designer. And so I did a number of degrees there, including a PhD in industrial engineering. During that, for my PhD, what we did was, I extended a project we were working on that involved vibro-tactile interfaces. So what we were trying to do is convey sound effects and music, right? Stuff, sound that’s not typically conveyed through closed captioning. We’re trying to convey that through vibration. So what did is I took that interface and I created, well, I took that display and then I created an interface to control the display. So basically a keyboard that you would play music that you feel. So that’s what I did in my PhD. And so that was, I stayed in academia for about 10 years. I did teaching, I did research, because I got to work on projects like that. There’s not a lot of like vibrating chair projects going around in industry. So, but eventually I kind of, I felt I ran my, I ran through the course of academia. And so I kind of went into the private sector. So I joined up. with a few banks early on in my career and I did UX design for banking apps. Then I joined a small company and we worked on coaching software. So I did that for a number of years. Then I joined up with Loblaw Digital and I worked on their Shopper Struck Mobile app and a few other products at Loblaw. And then I left Loblaw and came to Maple. So that’s where I am now. So Maple is a, it’s a scale up. So we’re about 130 the last time I checked. And so what we do is we provide, we connect patients with doctors through our telemedicine platform, right? So if you have, let’s say, I, so I use Maple all the time. My use case is usually I have young children, I have a two year old, she gets pink eye, right? Or she gets an ear infection and. So we could like book off time for work, find a doctor, which that’s hard enough on its own. But then, so assuming you have a doctor, you have to get to the doctor, you have to go into this room with other sick people, you have to wait there only for the doctor to see you for five minutes and say, oh, that’s pink eye, here’s your prescription, and then you’re out the door, right? So that’s what we do really good right now. And we’re trying to expand and sort of… satisfy those other use cases for maybe when it’s not an acute problem like that, that could be solved that quickly. But that’s where I am now, so I lead a small team and we’re trying our very best to improve health care in Canada through our own little way.
Reuben:
Okay, interesting. I noticed you also had some teaching experience on your background. So have you kind of done that in parallel with your work in the private sector?
Carmen:
Yep, both. So I did, I was towards the end of my PhD, I, I was a professor at Centennial College in Toronto. I’m not sure if you know that, that there for about two years. And so I was a full, I was full-time prof there. I taught a lot. I also did a bunch of really exciting applied research projects. So in Ontario colleges, they really, there’s a lot of funding available for connecting industry and academia and students, right? and they have this kind of trivecta and they say, okay, all of you get together, here’s some funding, make something cool. And we actually did. So one of the projects that I worked on at Centennial was called Magnus Mode. And the viewers should, you should look that up if you’re interested because so what it is, it’s a tool that’s geared towards older folks with autism because there’s plenty of, well, not plenty, but there’s more… tools and assistance for younger people with autism. But once they turn 18 and they want to be a little more independent, this is what with that. This is the type of person that this app would help. So it uses sort of sort of like a card collecting paradigm where you collect cards for how to do laundry or how to use the ATM and things like that. So that was that actually became a like a successful viable product that’s out in the real world now and Um, you know, a lot of times these academic partnerships, they kind of fizzle out, but this one was really great and I’m really proud to have worked on it. And, and then in terms of teaching, I still, I like to do teaching on the side. Um, I used, I was teaching a certificate at York that actually I designed the course and stuff, but it does get busy when, when you have a full-time gig and even just one course that can add 10 hours to your week, you know, and then.
Reuben:
Yeah.
Carmen:
So I’ve kind of stopped the teaching for a while and started to do more stuff like this You know still kind of communicating and talking but less so in like a formal academic setting
Reuben:
Okay, great. Well, I’m glad you could spend some time with us.
Carmen:
Great, yeah.
Reuben:
Getting back to Maple, there’s a lot of different virtual health platforms on the market. Have they all kind of aligned on a similar feature set and user experience or is there anything that really, sets Maple apart from the others?
Carmen:
Um, I think initially, so the success for maple initially, right, was the, this acute problem set, right? So if you have like a, uh, a urinary tract infection or like pink eye or something that lends itself to virtual care is relatively simple to solve, um, that’s where maple really excelled and during COVID. that we were just right in the right space to help with that, right? Because suddenly all the…
Reuben:
Maple was already established in the market and just kind of, I’m assuming just kind of boomed from there?
Carmen:
Right, exactly. And so that’s where that’s what we’re good at really good at now. But like I said, we’re trying to expand. And we’re trying to look at like more holistic approaches, like how can we how can we help people that have a longer term problem, right? Or how can we, how can we help you before you’re sick? Right, so that it doesn’t even get to that point. So that’s kind of where what we’re strong at and where we’re trying to work towards, I think a lot of the virtual care companies have sort of… they’ve sort of focused on that acute problem, right? I think where they’re focusing on that, they’re doubling down on that. Whereas I think we’re trying to expand a little bit and we know what we’re good at. We’re gonna keep doing that. But I think like one of our primary goals or our values is we wanna improve healthcare, right? And so… You know, I can see how from a business perspective, like dealing with those acute problems really quickly, that works from a business perspective. But we also, we’re a medical provider, right? We provide medical care. And so there’s sort of, there’s a little bit more that we should be doing, right? So if we’re gonna, if we just, we don’t just wanna make a fast buck, we wanna improve healthcare. So that’s why I think we’re focusing on these other issues, right, that are maybe a little more expensive or like. not quite as profitable to look at, but still something that needs to be solved for. And I think maybe that’s where Maple stands ou
Reuben:
Yeah, and I think that’s been some of the criticism of virtual care as well, is, you know, losing that continuity where people come in, they get their appointment, maybe they get their prescription, but then they see a different doctor every time. And there’s there’s an argument that, you know, that’s not the best way to provide care.
Carmen:
It’s not, it’s not. And we definitely, we have conversations about that stuff all the time. And how can we better, how can we improve virtual healthcare so that it’s closer to everything that in-person can.
Reuben:
Yeah, so I’m interested in both the UX process at Maple. What does the team look like? How do you conduct UX research? Maybe we could talk a little bit about that.
Carmen:
Yeah, sure. So Maple is still very much in a scale up situation. So a lot of times UX decisions are made out of inevitability, not inevitable, but practicality, right? But when, often we are, we try and be a data based design group as much as possible, right? Anytime we approach an initiative, we want to start there. Right. So for example, um, a while back and this was, you know, and different projects have different flavors of let’s call it UX maturity. Right. You know, some projects might be just like, Hey, we need to get this copy change in because this partner really needs it. Or there’s a, there’s a regulation we have to meet. So let’s, we just have to do this. Okay. That’s kind of one type of project, but then there’s other types where we’re like, okay, we want to improve conversion. Right. Okay, great. Let’s let’s look at that. So for example, like, product and design will get together on that and say, Okay, we want to improve conversion, where should we look? What’s our first move? Right? So first thing is we look at in the analytics, right? What, like, what are our current users doing? Where are they dropping off? Where are they getting stuck? Right? Another thing we have in terms of analytics is session replays, right? That can help.
Reuben:
Okay.
Carmen:
So the flows kind of show you the aggregate of where everyone is moving around and where, okay, you know, we’re losing 50% of our people who enter the flow. We’re losing 50% here and 50% there. But then the session replays, I can go in and say, oh, look, this person is moving over here and clicking and then going back and then going forward and then going back again. I’m like, they’re clearly confused, right? So that’s a good first step. right, is to take a look at the data analytics. Then another step we might take. So let’s say we’ve done this on a different project where we were finding, we knew people were getting confused over a flow, right? So that part of it, we knew what the problem was, but now, like I said, we needed to understand why. So in that sense, we decided to do an experiment with user testing, right? Where we would… we put together a prototype of the existing design, and we would have people just go through the flow and we wouldn’t really tell them what we’re up to. We would just say, hey, go through this flow, get to the end, right? And then at the end, we would have sort of a pop quiz. That’s like, okay, so you just did a thing, tell me how much did that thing cost, right. How long did you commit to? Right? And then we can see, so then I look, I look at, okay, look, out of the 30 people that we ran through this, 15% got it correct. Oh, that seems like a problem. Okay, so then we do another design, we do what we think would improve it, we run the experiment again, right? And then we see, oh, 60% of them are answering it correct now.
Reuben:
Yeah.
Carmen:
So right now we have some real data that says, okay, we’re on to something here, right? And then, then we feel confident enough then to spend the money on development. Right. Because for me to do a prototype or one of the designers on the team to do a prototype and Figma takes a day, right. Versus weeks, weeks for devs. Right. So.
Reuben:
Yeah, I’m preaching this all the time, you know, make the changes before writing the code because it’s just didn’t save so much time.
Carmen:
Yeah, it’s like a dollar spent on design saves you a hundred, even a thousand dollars on the development end.
Reuben:
Yeah.
Carmen:
So those are some of our approaches. I think we’ve pretty much done the full gamut of say like UXR. I think we’ve done, because what I was describing was more stuff on the validation side, maybe not so much on the discovery side, but we do things. For example, like open ended interviews, right? Where, you know, we’ll talk to, we’ll talk to users. And we don’t have a solution. We don’t have a prototype in hand. We don’t have any designs, right? We just want to talk to you about your situation. Right? What’s your problem?
What are your problems? What are your pain points? What are your tasks like, you know, things like that, just learning about without being without rushing to solution, right? And then gaining insight from that. and then approaching it with a solution. Oh, based on this problem that we’re seeing in these interviews, I think we should do this initiative. So that’s sort of another, that’s sort of on the other side to that versus validation on one hand, where we have a solution and we’re testing it versus like, I don’t even know what the problem is. And we’re just sort of figuring things out. And so we do all that to varying degrees.
Reuben:
And so when you’re doing the validation testing with users like testing a prototype, are you able to get actual Maple users or are these more kind of, you know, anonymous user groups that might not be people that are actually on the platform already?
Carmen:
Depends. So, one thing I keep in mind with the consumer facing app is it has to work with everybody. Right? Like we have target markets, and we have groups of people that we’re like trying to sell to, or like we’re trying to focus on marketing messaging to but a form a form has to be usable by everybody by a person who’s blind, right? By the 92 year old by 12 year old, everybody has to use it. So, unless there’s a real particular thing that’s particular to Maple users, then I don’t really care. And so I’ll just go to like usertesting.com and I’ll get any human being, right? I just need a human, right? Especially if it’s just usability testing or, because I have no, like any random Canadian could enter our registration flow at any time, right?
Reuben:
Yeah, you have such a broad user base.
Carmen:
Exactly. Now on the other side of this, now, so we have a consumer facing side, but we also have a provider facing side. Now that, now I can’t just ask random people on the street, do you think this sick note UI is like, is good or whatever? Right? So that doesn’t, in that case, it’s much more important that I get the particular user type that I need. Right.
Reuben:
Yeah, exactly.
Carmen:
So in that case, I would need provide, or maybe not even maple providers, but I need a doctor at the very least. Right. And then so and then there’s other kind of middle ground. So maybe like, so we do B2B and B2C, right. And the B2B flavors a little bit different. You know, so it may be in that sense, especially actually, you know, because with B2B, here’s the big difference is the person buying it. is not the person using it. Right.
So two completely different groups. Two different people, right? Or there’s now there’s two groups involved. So again, the person using it on the end, there that’s like, that could be anybody. So again, I have to make sure it works for like the boundary cases, right? But now if I’m talking about the buyer, like let’s somebody in HR or whatever that buys it for a company, that person, they have very particular, problems, goals, tasks, all of that. So in that sense, if we, that I would wanna talk to the actual person, right? So in that sense, it’s a spectrum from, I need to talk to this particular person, right? Otherwise I don’t wanna talk to anyone. Or on the other end, it’s, I need to see the human that is breathing, right? And so we, and we work all in between.
Reuben:
Okay, yeah, it makes totally sense, depending on who the user is, what they’re trying to do with the platform and that defines who you’re talking to.
Carmen:
Yeah, absolutely.
Reuben:
And so, you know, aside from getting access to, you know, those people sometimes, like, you know, doctors, for example, to, you know, to get feedback and, you know, what are some of the challenges with doing that research in a healthcare setting specifically?
Carmen:
Yeah, one of the biggest challenges is privacy. Because we have to be extra, extra double, licked it, sticked it, stamped it, dutiful for around privacy, right? Like even our employees, if we look in the database, we can’t see any, it’s all encrypted, right? You need special permission to access stuff.
Reuben:
Yeah.
Carmen:
And so for example, even when I did, if I do experiments, Or let’s say, for example, on our session replay, we have to blank out everything.
Reuben:
is that done? Does that get, is there like software that, you know, redacts sensitive information before you can see it on the replay or?
Carmen:
Yeah, so most of them do that. So we use one called Datadog and it’s just a configuration setting. There’s other ones called Full Story. Another one we looked at was called, I forget, like Hot something. But it’s data masking and it’s quite, I think it’s a common requirement because when we were talking to these other groups, they were like, yeah, we can do that. But I mean, but that’s a challenge then, because now I’m looking at replays with black bars over all the text. And a lot of times I can infer what’s going on, but it makes it harder. Or like another, you know, like, you know, let’s say I wanted to do a survey around like medical problems. Like I can’t normally, you know, if I was gonna, you know, when I did research around media and entertainment, Right? And I, and I wanted to know about what shows you watch or whatever. Right? I would just ask you, there’s no like ethical considerations there, like, you know, serious ones, but now I’m asking you about medical stuff. And so you have to have all, all these checks and balances in place and they add a system to, to respect people’s privacy. And it just makes everything a little harder when you’re dealing with that level of privacy.
Reuben:
Right. And then what about on the actual like designing solutions for healthcare? Do you find that much different than other industries?
Carmen:
Uh, no, not really. Cause we were talking just a little bit before we started, but I, I’ve noticed in my career that as a designer, the, when you change domains, like say from fi I was in finance and then I was in, I dunno, like coaching, I don’t know if there’s a larger group for that, but then I’m now I was in retail and now I’m in medical, but the patterns of say designing UI or experiences are very similar. Right? And like human beings don’t change, right? If we’re gonna implement Gestalt features, right? We’re grouping and all that stuff. Like whether you’re grouping things for a banking app or grouping things for a health app, it doesn’t matter. It’s the same human. And so there are different requirements or like, let’s say, you know, I will say one extra thing is there’s tons of rules and regulations, but you’re working with a PM. Right? You’re not just out there solo. And the PM provides a lot of that. Like here’s the regulation that we’re trying to meet. Right? The PM has a great deal of domain specific expertise. And then the designer’s expertise is, okay, given that requirement, I know I’m the expert on the human. So I’m gonna create a solution that will meet that requirement. And so you do need to be familiar over the last two years. I’ve become more familiar with the particulars of designing in the medical field, but if there are any designers watching this I wouldn’t I haven’t found much problem jumping between Domains.
Reuben:
Yeah, and one of the first steps of any project is understanding the constraints that you’re working within. So really as a designer, you’re just in a different set of constraints and you’re used to those moving from project to project anyway, right?
Carmen:
Exactly. Their constraints come from all sorts. So constraint could be domain specific, or it could be just project specific. So no matter what, you have to go out and figure the constraints out. So yeah, I think it’s just like the domain is just another different part of your project that you’re working on.
Reuben:
Yeah, we found that a lot too with the apps we’re designing for. And just that kind of added layer of empathy, especially from the patient side, really thinking through the different mindsets that people might be coming into when dealing with medical software. They could be in a very distressed state, which makes it hard to compute and parse information that might be a lot easier for someone who’s just looking for banking information.
Carmen:
Yeah, it’s true. You know, it’s funny, if you look at our ratings, like 95% of our ratings are five star, but any rating that isn’t five is a one. And that’s because one of our biggest problems is, and this is domain specific now, is not everything can be done through virtual care. And sometimes it’s hard to explain that to someone, especially when I’ve been in this situation. You don’t have a doctor in person, right? The clinics are hard to access and you’re trying to access care. And then, you know, a provider doing their best and what they should be doing, right? Which is saying, I’m sorry, this isn’t appropriate, right? I’ve had that happen to me and it feels bad, like really bad, really bad, right? And so I get it why they’re saying, you know, one star, right? Even though when people do… get access, they love the service and it’s so great. So, and that’s what, that’s the kind of stuff we have to keep in mind. And you’re absolutely right about it. The emotions are primed, right? You got a sick kid or you’ve been sick or you’re in pain. Right? So.
Reuben:
Yeah, and people come in with the expectation that I’m gonna get this prescription filled or I’m gonna be able to solve this problem and I don’t have to go to the emergency room. And then like you said, there just are hard limitations that you have to live with and it’s not gonna suit everyone. So people are gonna go away being. not having their needs met. And they’re gonna be disappointed in that. And it’s not about the software or the service Maple is providing, it’s just that it didn’t fit their use case or expectations.
Carmen:
Yeah, because we’re kind of competing with the clinics, right? Because that’s people’s mental model. That’s what they’re working off of, right? And
Reuben:
Yeah.
Carmen:
so when you go to a clinic, they don’t ever say, Oh, I can’t help you. Right. They’ll, they may not be able to help you, but they’ll talk to you, right? You’ll, the doctor will talk to you. Um, but sometimes we just, it’s just the nature of virtual care. Right. Um, so yeah, that’s, that’s been a challenge is that that. people can be quite emotional around those types of things. And then the other part too, as I’ll mention is, speaking about emotion, is people really get emotional over private versus public healthcare. So
Reuben:
brave.
Carmen:
like you can do OHIP covered visits through Maple,
Reuben:
Mm-hmm.
Carmen:
but you can also, you can do private visits, right? And so a lot of people, there’s a lot of really high emotions around that. uh like very high level politicians have been bringing this up and people kind of follow along they’re like yeah this is terrible this we should be doing this and so that that’s another aspect too there’s a whole politics thing that if you’re not in this domain you may not really realize until you’re in it.
Reuben:
Yeah, I think we’ll just kind of dig into that a little bit more. I know there’s, you know, in Canada, every province is a little bit different in terms of how they handle that balance of public and private. And I know there’s been different, you know, virtual care billings, regulations changing. You know, do you see those impacts firsthand, whether it’s from the patient’s feedback or in other ways?
Carmen:
Absolutely, absolutely. So the Ontario government recently, so they announced last year that they were going to change the how much they would pay for virtual care OHIP and
Reuben:
Yeah,
Carmen:
they were
Reuben:
and in a big way too, right?
Carmen:
quite a bit, quite a bit. So they announced it and said we’re doing this in November. So that directly affected me like over that time we were we were rushing like oh we got to deal with So, but then it was delayed, right? So they made us rush for no reason. It was delayed, but we still, we ended up doing what we needed to do for that. But absolutely that kind of stuff affects us.
Reuben:
So has that, you mentioned it was delayed, has that taken effect now or no?
Carmen:
Yeah, I believe it has gone into effect now.
Reuben:
Okay.
Carmen:
Don’t quote me on that one. I haven’t, I haven’t.
Reuben:
Fair enough, fair enough.
Carmen:
Yeah. But yeah, that was certainly last year around the end of the year, that was top of mind for us. Is, you know, we have to figure out how to deal with that. So.
Reuben:
Yeah, because you know, Maple exists within this kind of, you know, to fill a gap within the healthcare system, right? And as you mentioned, the you know, the politics and regulations around that are shifting and that can have a massive impact on how you deliver your service.
Carmen:
Absolutely, absolutely. You know, and when they reduce the funding like that, like so, especially when they’re reducing something that is available to people, and then what they offer in person. Like, so I don’t have a doctor right at the moment. I’m lucky, I’m healthy, I haven’t really, I searched for a while, but I gave up. But it’s one thing to have a strong public system. but it’s another thing to not have that and then also not support the other thing that’s trying to fill in those gaps.
Reuben:
Mm-hmm.
Carmen:
I mean, you can’t have it both ways. Like, you’re not providing it, we’re trying, but you’re not letting us either. So that can be frustrating, when you have all these solutions, technological solutions ready to go, but you can’t because the funding isn’t, it’s not going to where it needs to be going.
Reuben:
Yeah. So getting back to the user experience of the Maple platform,
Carmen:
Thank you.
Reuben:
what are some of the improvements you’ve been able to make over the years?
Carmen:
Um, so I can talk about, uh, you know, I’ll tell you about two. So actually I mentioned one already was, um, was the conversion improvement. I really, cause that, that project that we worked on as a team, it was really an example of, of high UX maturity, right? Where are you, you start with the problem. You investigate, you come up with a solution and you implement the solution. Right. So many places I’ve worked at. Are. solution-based, right? They start in solution, always, right? And they live there. And then you end up just checking boxes, right? So that was a great… So because remember, Maple started as just a… Basically, the model was a virtual clinic on your phone, right? So you have a UTI, you need a prescription, you get a doctor one-off, and then you’re done, right? But then as we started growing, we started offering more specialties. Right? Dermatology, endocrinology, right? Do you know how long the wait time is for a dermatologist in Nova Scotia? I was interviewing people. It’s like two
Reuben:
Uh,
Carmen:
years.
Reuben:
wow. Yeah.
Carmen:
It’s two years, right? Or more. I think the person I talked to had been waiting for two years. And so they used maple because they couldn’t get one otherwise. So, you know, we’re adding Derm, we’re adding… also, we have we have about 2020 or 30 specialties now. So the design when I this was when I first came about two years ago, so the design was still very much unicentric to just GPS. Right. And so we were, you know, the whole team was like, something’s up here. Let’s let’s take a look at this. We can do better. Right. So again, we looked at the data. We did a little bit of user testing with the solutions that we usually came up with. And again, we did pretty simple, wasn’t like, it wasn’t super original or anything, but again, we just had a big list of specialties. So we, you know, we created some categories, we added in a little search filter thing. We added like a feature section. And then another place we saw the big drop-off was in our scheduler, like when, cause you could pick either. on demand, so see a doctor right now, or you can book for later. And what we found was when for the booking flow, there’s a big drop off when you pick the time. And I said, Oh, okay, that’s interesting. So I looked at the design and the design was like your typical calendar view.
Reuben:
Yeah.
Carmen:
Right? You know, like outlook or whatever. I was looking, I’m thinking, Hmm. Okay. So I, then I looked in the data again and I said, okay, what tell me like how often are people booking like one, two, three, four, five days out, right? Because normally if you have a, you wanna see a GP, you wanna see him not in three weeks, but in like two days. So
Reuben:
Yeah.
Carmen:
I looked at the data and it’s like hugely skewed to like two or three, right? It was like 80% do it with one day and then another the last 20, you know? And so there was very few people booking beyond six days in advance, or even I think there was, the absolute outlier was 10 days. So
Reuben:
Yeah.
Carmen:
I said, okay, so we have a calendar centric view that’s very much favors like picking way in the future. I said, no, let’s do a view that’s more like this, here’s tomorrow, here’s the next day, and here’s the next day, here’s what’s available. And then you could go to the next day. And if you really, and then we still kept the old view in if you really wanna look like a month in advance, right?
Reuben:
Yeah.
Carmen:
We did all that and we saw a really good bump. You know, we did an A-B test with that. And I told the design team, I said, I think we paid for our salaries with this project alone.
Reuben:
Ha ha
Carmen:
There was a projection done, like we just did an experiment, right? But they said, okay, if we apply this to the whole population, we should see this much improvement in revenue. And over the year, I said, that’s our salary. So right there, I was really happy with that.
Reuben:
Nice. Break
Carmen:
Another
Reuben:
open
Carmen:
one. Exactly.
Reuben:
the champagne bottles right there.
Carmen:
Exactly, right? It’s always, I always feel good when my work is valuable, right? Because then I get
Reuben:
Yeah,
Carmen:
a little worried
Reuben:
yeah,
Carmen:
like,
Reuben:
adding
Carmen:
uh-oh.
Reuben:
value.
Carmen:
Right, right. So another interesting one was we had a, this was interesting because there were two users and their needs were conflicting, right? So what do you do in that case? So you can imagine as a doctor, so this is about sick notes, right? So why do you need, people typically need a sick note because… their employer or their school or some authority figure is saying, I need you to prove that you were sick, right?
Reuben:
Yeah,
Carmen:
Okay,
Reuben:
some
Carmen:
so
Reuben:
requirements.
Carmen:
you go off, yeah, you go off to the doctor and you get a note that says, Ruben was sick on this day. He had a cold, he can return on this day. Okay, that’s what the user wants. Now the doctor, especially doctors in Quebec, is what I found out, is they are worried about saying things that can’t be proven, right?
Reuben:
Right.
Carmen:
saying things that they can’t substantiate.
Reuben:
Mm-hmm.
Carmen:
Right, so they’re really worried about being too specific. So they wanted the message to be something like, Ruben said he was sick.
Reuben:
Yeah,
Carmen:
Right, but
Reuben:
yeah,
Carmen:
that’s not.
Reuben:
because virtually, virtually I could say anything and the doctor would be like, okay, I’m gonna have to take your word for it.
Carmen:
Yes, especially virtually because even in person, like I can, what are you going to do? I say, Oh, I have a, I have a severe stomach pain. What are you going to do? Say no. Right. So, okay. So, so there’s this conflict, right? Where there’s this tension. So how do we, how do we do, you know, how we got us solve both? Cause we can’t just put the note, you know, what the user wants and then upset our providers and vice versa. Right. So our solution was to. because the old solution was based on a canned message. So you press a button and then the message kind of drops in and then it had the Rubin said he was sick, right? So let’s change the paradigm a little bit. Let’s use the message the users want, but make it super easy for the provider to edit it, right? And so that’s this balance, right? So now, I want the provider to see exactly what they’re sending out. Right, because that’s satisfying. They don’t wanna say anything that they didn’t know they were saying. Like the old design, they couldn’t really see the content very easily. So I said, okay, we’re gonna put the content right upfront, make it more about customizing a message, right? And then we’re gonna see how that goes. And so far we got good, I haven’t, we actually haven’t looked into the user feedback quite yet. That’s something I’m looking to do this quarter. but we
Reuben:
Yeah.
Carmen:
did get some preliminary feedback from the providers. Oh, it’s so much easier now. So that’s kind of two interesting cases, I think, that were quite different from each other. And it goes to show you every initiative you approach almost is completely different. There’s no boilerplate solution you can bring to any of these problems.
Reuben:
Yeah, definitely. So along those lines, was there anything really unexpected that you ever uncovered during doing some of that research that either patients or clinicians were doing something that was completely like non-intuitive from a designer’s point of view?
Carmen:
Mmm. Nothing’s coming to mind in terms of unintuitive. I’m sure there was some, but I can’t, it’s not, nothing’s coming to mind right away. Probably something will jump in my brain as we continue talking, but.
Reuben:
Yeah, fair enough. I know, I just know that sometimes there is those aha moments that, you know, as a team, you put all the effort into, you know, putting together these prototypes and doing the user testing sessions. And sometimes it feels like, oh, they’re validating what I already knew to be true because of, you know, user experience best practices, right? Because of, you know, grouping information, hierarchy properly. you know, stepping them through it. And sometimes the results are, you know, as expected. And then there’s just those times where you test something and you’re like, oh, wow, that was completely not how I thought that people were gonna use this. And it can be really, really eye-opening.
Carmen:
Yeah, I always enjoy those. That’s my favorite type of research and science result is when it overturns your intuition. Because that’s
Reuben:
Yes,
Carmen:
kind of
Reuben:
exactly.
Carmen:
the point in science, right? Is to double check your intuition and make sure your brain, which is not really great at sifting through information, is not doing one of its faults. Yeah, you’re biased, you’re quick to judge, all those things that humans are terrible at. Science is supposed to overcome that. So I love when it does. But yeah, I can’t think of a lot of this stuff. I’d say mostly it comes out, it doesn’t overturn your intuition. I’ve been doing this for a while now. There’s only so many patterns and you kind of catch on after a while and you’re like, I don’t think this is gonna work. Or I think they’re getting confused over this. And usually more often than not, I’m on the right track at least.
Reuben:
Mm-hmm. And as you mentioned before, it goes back to the, humans don’t change. They’re still humans, whether you’re
Carmen:
Exactly.
Reuben:
taking them through for booking a doctor’s appointment or getting financial advice, right? There’s ways to book appointments and ways to take people through that exercise.
Carmen:
Yep, yep, absolutely.
Reuben:
Cool, so you mentioned before how you’re looking at expanding maple into different areas, talked about preventative care and that sort of thing. Yeah, is there anything more specific you can go into depth there or is that still kind
Carmen:
Yeah,
Reuben:
of behind the curtains?
Carmen:
I think it’s probably shouldn’t. It’s largely behind. It’s still a work in progress. And
Reuben:
Fair enough, yeah.
Carmen:
yeah, but generally, you know, I think that’s where the fertile ground is now. That’s where the pioneers need to go, right? I think it’s the whole, this model that we are at now, it’s established, right? And I think… you know, if you want to grow in this industry, I think that’s where you need to look, you know, because there’s plenty of conditions and stuff that even in health, even in person health care, I don’t think does a great job, you know, of doing and so like an example of me like I was pretty overweight a while back, like kind of
Reuben:
Oh, yeah.
Carmen:
towards the end of my PhD, I didn’t I wasn’t doing a lot of physical activity, you know, and I think I had to do it kind of all on my own. right? And I think like something like that, I think there is there’s lots of junk out there. I think there’s real opportunity for like, you know, really medically supported, but long term support, right? That goes over months. Because right now, even if you want to see your family doctor, and you’re like, Doc, I’m interested, you know, I got a few extra pounds, I’m interested in losing some weight there, you’re gonna see them once a quarter, maybe.
Reuben:
Mm-hmm.
Carmen:
Right? And so how are they, you know, for weight loss, you kind of need to up, you need a coach that updates you like every day. And it’s like, okay, what’d you eat today? You know, oh, your weight went up a little bit. Okay, let’s double check your eating, blah, right, or what’s your fitness level like? I think
Reuben:
Yeah.
Carmen:
that kind of long-term stuff that’s like quasi mediated by the platform, but also the human medical professionals are also there kind of minding and tending it. I think that’s where the fertile agro, fertile.
Reuben:
Yeah, I think there’s a lot of potential for that, you know, kind of pocket health coach app that’s on your phone, right? It is all around, you know, staying healthy and, you know, being proactive and in the realm of preventative medicine. But it is, it kind of has to be. driven by the individual themselves to take that initiative, to really be engaged and follow the coach. But I think there’s a lot that can be delivered in a mobile app form in terms of programs, exercise, nutrition, and video content in a really curated, really customized way that’s… you know, personalized to that individual that could, you know, I think eventually someone’s gonna solve that and there’ll be some really cool services around it.
Carmen:
Yeah, you know, my professor at Toronto Metropolitan, they’re Deborah Fells, we talked recently and she’s working on research around severe chronic pain management. And
Reuben:
Mm-hmm.
Carmen:
they were looking at things like these video diaries and things like that where it’s a technology mediated process that’s long-term and it’s just, it’s not really possible with the current setup right now, which is like, you know, you have a doctor, you meet with them. Right? I think things like that, there’s so much potential for sort of an asynchronous approach to care, right? Because right now we’re still we have a lot of design inertia. So I’m not sure if you’re familiar with that. But I’ve noticed that it’s hard to like shift systems all the way. Right. Because you’re stuck in the old model. Right. Like cars used to be steered with a tiller. Right. Because both.
Reuben:
Yeah, yeah.
Carmen:
boats were, right? And then it took them a few years. They’re like, Oh, no, this wheel is a lot better. Right? So I think that we’re still in this mental model of the clinic, right, which is, I go to a place, I meet with a person, we’re,
Reuben:
Mm-hmm.
Carmen:
we’re synchronously communicating for five to 10 minutes, and then we part ways, right? And then we might do that again in like three months. But what about a more asynchronous model? Right? Because now we’re not limited before we were limited by the, you had to physically go see the person. We’re not limited by that anymore. And so it take, it’s going to take humanity a decade or two to realize that and be like, Oh, we don’t have to, like, we still have appointments and stuff on our app. Right? What if it worked more like, like you chat with someone over the course of a week or two. Right. And you know, and you would, Text your doctor or let’s, you know, mental health. Think of how much that would, how that would support mental health, right? You know, you could have, oh doc, I’m not feeling great today. And then there could be some interaction, right? Versus having to wait for that appointment or whatever. You know, there’s so much new possibility with all this technology mediated communication. I’m quite excited for the future.
Reuben:
Yeah, and I think that hybrid approach of digital tools that really help facilitate that communication and interaction, whether it’s sometimes asynchronously and sometimes on a video call or whatever, that hybrid between the doctors behind the scenes and the tools that allow them to help more people. uh in last time.
Carmen:
Yep, absolutely. I think there’s tremendous opportunity there and I don’t see the public system really embracing that at all.
Reuben:
Mm-hmm.
Carmen:
And that worries me because our system is not ideal and we got to be using all available resources to help deliver this medical care.
Reuben:
Exactly, it’s all hands on deck. So thank you so much for joining me on the podcast today, Carmen. It was
Carmen:
Yeah.
Reuben:
really great to speak with you. And thanks for everyone who is listening in as well. And if you enjoyed this conversation on Moving Digital Health, please go to movingdigitalhealth.com to subscribe to the MindSea Newsletter and be notified about future episodes.
Carmen:
It was great talking with you, Reuben. Thanks for inviting me.
Reuben:
Thank you.
