FLOURISH
Overview
Flourish is an iOS app that streamlines the process of finding providers specifically in the field of women’s health. The platform was developed to create community among those searching for quality care and to improve communication between women and their doctors.
Role(s): UX/UI Designer, UX Researcher, Mobile App Developer
Duration: 10 months
Tools: Figma, AdobeXD, Adobe Illustrator, SwiftUI, Xcode, Notion
The Challenge
Eighteen minutes.
That’s how long the average primary care exam lasts. It’s the amount of time you might have to get the most out of an appointment with a doctor you may see only once a year. This brief window is one of many contributing factors to medical gaslighting — the moment a doctor diminishes your concerns without explanation.
Women are among several groups who experience this at higher rates and many are sharing their accounts to draw attention to the problem. It is particularly concerning in relation to women’s health where there is a growing maternal mortality rate and delayed diagnoses for common reproductive health conditions.
This lack of communication between women and their doctors leads them to seek out better answers to their questions. But when they’re in need of a second opinion, where should they start? Flourish streamlines the process of finding a new doctor by putting all of the tools they need to do research in one place.
With the emergence of FemTech, women are embracing new ways to maintain their physical and mental well-being and one of the best ways to do this is to stay informed. With Flourish, they can read and write detailed reviews on a range of medical providers in order to find the ones who put communication with their patients first. Being ignored by a doctor is painful enough. The process of finding a new one shouldn’t be.
A frustrating disconnect
Women are experiencing a disconnect with doctors regarding their reproductive health. As a result, they are in search of more providers who are dedicated to their physical and mental well-being, who are easily accessible, and offer a positive environment to voice their medical concerns.
In the U.S. this problem is reflected in the maternal mortality rate — a rate that, according to the CDC, is the highest among developed countries. In 2020, over 800 women died from maternal related causes, an increase from over 700 deaths in 2019. The CDC defines maternal mortality as “the death of a woman from pregnancy-related causes during pregnancy or within 42 days of pregnancy.”
In response, the CDC’s Division of Reproductive Health created the Hear Her campaign to “raise awareness of urgent maternal warning signs during and after pregnancy and improve communication between patients and their healthcare providers.”
The campaign reinforces the importance of listening and taking immediate action when a woman expresses concerns. Responding quickly can lower pregnancy-related deaths caused by easily preventable issues.
Women also face a number of reproductive issues outside of maternal mortality. Within the U.S., over 26 million women have uterine fibroids with over 15 million who experience symptoms. Endometriosis affects 6.5 million women and 5 million women suffer from polycystic ovary syndrome (PCOS). While menopause is a natural stage of reproductive aging, its onset has been associated with the development of Alzheimer’s.
Unfortunately, there are spaces where women feel they aren’t taken seriously when it comes to their overall reproductive health. In cases of medical gaslighting, providers dismiss their concerns and could potentially overlook symptoms caused by medical conditions like the ones above. When this happens, frustration sets in and it’s common to seek a second opinion from another provider. But it can be overwhelming to look for other options without recommendations.
Research, development and design
A digital solution
In the space of apps that offer reviews for a variety of businesses or services, women’s health is but a small subcategory among thousands of search options. Flourish is a mobile app that allows women to research providers that range from OB/GYNs to midwives to therapists specializing in postpartum care.
Market research
Flourish has strong potential as an app due to FemTech’s growth in the last few years. In 2019 FemTech reached $820.6 million in global revenue and earned $592 million in venture capital funds (New York Times). A Forbes list of 52 FemTech startups show there are several areas these apps can focus on. As of now, the most popular are targeted toward period tracking and fertility but there are other areas of women’s health that could be highlighted.
When researching competitors, I initially looked at apps like Clue (period tracking) and She’s Well (fertility subscription) because they also fell into the FemTech category. While those were both great for understanding why women would use apps to manage their reproductive health, they didn’t help me understand how people research providers.
I took a step back and thought about an app that everyone uses to get quick and insightful reviews on just about anything: Yelp. Yelp also has reviews for doctors, but they weren’t as extensive as their reviews for restaurants and other businesses. When I looked for apps with only medical reviews, ZocDoc was the most popular. Although it did include reviews for providers in women’s health, it wasn’t focused on that area exclusively. Flourish combines elements of both, with an exclusive search for providers in women’s healthcare setting it apart.
User research
I interviewed three women and surveyed 19 on their personal experiences with medical gaslighting and reproductive health. During interviews, they shared past negative experiences with doctors:
At the end of these interviews, I organized these and other compelling quotes and found themes related to how these women would like doctors to communicate with them along with how they would like the process of researching a doctor to be. Based on this I built a survey with Google Forms. From the 19 surveys completed, I learned:
- 17 out of 19 women used online reviews to find a doctor
- 13 out of 19 women said the process of finding a new doctor was difficult
- 16 out of 19 women said privacy had an impact on how technology use
- 18 out of 19 women agreed that finding a new doctor through recommendations was valuable
Surveys also included an open-ended question on the qualities users valued when looking for a new doctor. These influenced the areas I chose to include for 5-star ratings focused on communication, patience, wait time and bedside manner.
Personas
Based on this research, Lori and Christine emerged as personas:
Development
Features
After collecting data and insights from user research, I focused on developing these features based on user needs.
- Provider Search: Using Google search to find information on a doctor is useful, but it requires tapping into multiple resources across the internet to look for reviews, ratings and insurance options. The Flourish app puts all of these resources in one place
- Reviews: Users can take reviews a step further by including their experiences with providers in the areas of communication, patience, bedside manner and wait time. This insight helps users research doctors more effectively.
- Favorites: Having a place to store favorites helps users keep track of preferred providers through a list that’s easy to access and edit.
- Insurance: Storing insurance provides a way to always have information on the go. It also lets users know which providers in the app are in or out of network.
- Privacy Policy: Based on the Flourish survey, users valued app privacy which has also become a concern for women after the 2022 Supreme Court decision to overturn Roe v. Wade. The ruling created concerns about cycle-tracking apps collecting sensitive information that could potentially be incriminating for those considering abortion.
Alpha
In this phase I mapped out the app’s information architecture and built a bottom navigation bar that takes users to the app’s main search page, personal profile settings and favorite providers. While this was only the Alpha phase, I wanted to lay the groundwork for three of the most important parts of the app: a functional search bar, provider detail page and and page to store favorites.
- The provider detail page contains information on ratings, address and background. It also allows users to read and leave reviews.
- The search bar allows users to manually search for providers by name, specialty and location. This is done through applying in SwiftUI’s searchable modifier
- The favorites page stores user’s favorite providers through use of a like button that either adds or removes a provider from the page.
While building the features, I created a design system to define appearance, content and tone. This includes guidelines on the logo, typography, color palette, imagery, UI components and pattern library.
Flourish has a clean, clear and simple design. The use of white space and cool colors give it a calming aesthetic. A combination logo features the word “flourish” and signature flower symbol in place of the letter “o.” The flower symbol represents fertility. The word flourish means to grow and develop vigorously as the result of being in a “favorable environment, ” which is what the app is intended to be for women seeking quality care.
Beta
My focus during this phase was to expand the database of over 40 providers and build subpages that branched off of the main navigation. The initial plan was to pull my data for each provider from an API, but I could not find one with the range of specialists I was looking for. I eventually built a JSON file with entries containing details for each provider seen in the app.
On the landing page, I included the option to search by specialty in one click, so I spent this phase organizing providers by their field on separate pages. From the profile tab, I added pages for insurance information, user preferences and a privacy policy.
This was also an important phase for perfecting my code to have a functional search bar and to have favorites populate on the favorites page. The most challenging part was getting the search bar to filter for name, location and speciality all at once. In this phase, I could only get the search bar to filter just one of those categories and not all of them simultaneously.
Usability Testing
Goals
Testing began at the end of the Beta phase to see how well Flourish allowed users to:
- Optimize search results for users through a filtered search bar
- Create a research environment that informs and doesn’t overwhelm
- Offer a way to keep track of preferred providers
Participants
Participants were 5 women aged 30 to 60 living in the metro-Atlanta area who spend an average of 37 hours a week using apps. They have all used an app to maintain their general or reproductive health and believe in the importance of app privacy.
Testing was done through a combination of quantitative and qualitative testing methods guided by a User Experience Research Plan.
Testing Methods
Quantitative Testing:
Users completed 11 tasks that were read out from a task table script. Seven were measured based on pass/fail success rate and four were measured for time on task. After completing these tasks, testing participants completed a System Usability Scale questionnaire.
The above average score of 68 on the SUS shows it was effective, efficient and easy to use.
The average 89% pass/fail rate shows the app performed well, but still needed improvements.
The 26 second average time on task rate shows the app was easy to navigate and users accomplished tasks quickly.
Qualitative Testing
Flourish is designed to be calm and clear in its appearance and content so understanding participants’ emotional response to the app was important. I asked each participant to select five words from Microsoft’s Product Reaction Cards to describe how they felt about the app and their experience. Below is a word cloud of selected reaction cards and quotes from users who chose them. Words in bold were selected twice or more.
“Inviting because of just the interface. From the font, to the layout, to the colors to the spacing…it’s not noisy.”
“Comprehensive because I think it covers a good amount of what we look for as consumers.”
“Clean, because there’s not a lot of unnecessary clutter. It gives you what you need for what you’re looking to do.”
“Organized because everything’s right in your face. There are literally only 4 clicks to get to anything.”
Changes
Testing revealed several changes that needed to be made for version 1.0
- Search Bar: I spent most of the Alpha and Beta phases trying to get the search bar to generate detailed search results. I started with a search bar that could only filter doctors by name. The problem persisted during user testing as I watched some participants adapt to a faulty search bar by relying on a category search instead. Others flat out told me the search bar wasn’t working. Either way, getting it to work was a priority. By the end of user testing, I found the code I needed to add options to search by location, practice and keywords.
- Doctor Detail Page: Several participants mentioned most apps they use also include in-network insurance and whether a doctor is accepting new patients. These sections were added to create a more comprehensive detail page.
- Anonymous reviews: During testing, only 2 out of 5 participants successfully adjusted their settings to have anonymous reviews. This option was initially only in the preferences section under the profile menu item. I decided to add the option to the review page as well. In addition to this, I improved the separation between the “write a review” and “rate their care” sections of the review page.