zbeardUXportfolio816

Zachary Beard
UX, UI, and Product Design

Dynamic Haptic Robotic Training Simulator
Penn State University College of Engineering, 2016
Central Venous Catheter (CVC) insertion is a process designed to give clinicians convenient access to parts of
a patient’s venous anatomy. Typically, this is done by piercing a large diameter vein –typically in the neck or
inner thigh– with a heavy syringe and running a line through it into the vein. The process was pioneered in
Germany in the 1930s and perfected by doctors in the U.S. in the 40s and 50s.
Like many surgical procedures, aspiring doctors are trained using the “see one, do one, teach one” model.
Simply, this requires the trainee to observe a mentor or instructor performing the procedure, then demon-
strating their own ability and their understanding of key knowledge. This has worked well, however the es-
tablished mentor/trainee model used in medical education is rapidly becoming unfeasible due to the in-
creased demands on instructors’ time.

The DHRT simulator is an effort to reduce workload on the instructor by allowing the student to practice
the procedure on their own and get useful feedback on their performance. By adapting an off-the-shelf
haptic feedback device, the device simulates the process of inserting a needle through flesh and puncturing
a vein. Our team’s task was to design a digital interface that took the data generated by the tool and
turned it into information that could be understood by a surgical resident or student.
We talked to clinicians and nurses to gain a thorough under-
standing of the ins and outs (get it?) of CVC line insertion,
conducted research into what sort of VR trainers already ex-
isted in this space. A previous study generated several hours’
worth of video that had to be viewed and transcribed. Once
that was done, content analysis techniques allowed us to find
common themes in what sort of feedback live trainers gave
students, as well as common trouble areas where students
made mistakes. Knowing these gave the team a starting point
for interface development, and paper prototypes were tested
and evaluated by the stakeholders for layout and content.

Using a combination of whiteboard sketching and paper prototypes, the team was able to quickly gener-
ate, evaluate, and discard a wide range of ideas for both the overall workflow and specific interface ele-
ments. In addition to the screen and haptic feedback generated by the device, the team experimented
with audio cues but they were deemed to be too distracting to the user.
Final iterations of the paper prototypes were presented to classmates and stakeholders to get outside opin-
ions on what worked and what didn’t. These sessions were recorded and analyzed, playing a major role in
the creation of both final paper and initial digital prototypes. Among the key findings from these testing ses-
sions were that the users would not want to navigate to a lower level of the interface to get key feedback on
their performance. While it was okay to have in-depth feedback on a certain metric be on another screen,
the users wanted a high-level view of how they performed all at once. This led to the creation of a
“dashboard” view with each metric being presented as a screen element that could be opened for further
information.

Once a thorough concept was developed on paper, we moved to the computer. The current iteration of
the device was set up to run through MATLAB, and the team was forced to develop the interface compo-
nents using MATLAB’s GUI function. This resulted in an interface that was necessarily simple, with very
little graphical embellishment.
After some iteration, we tested the interface with the device, allowing the physicians and nurses to run
through a training session and get feedback on their performance. Their feedback yielded further insights,
and we were able to again refine the interface before the final handoff. While I was active in all parts of the
project, I took the lead in communicating with the client through both weekly emails and milestone presen-
tations.
The project was very well received, winning our team the “Best Graduate Design” in the College of Engineer-
ing’s 2016 Showcase event in April 2016. The prototype we created is being used as the framework for a ful-
ly functional interface which is being used in upcoming clinical trials.

Mobile Applications for Community Paramedicine
Penn State University Master’s Project, 2014-2016
MS students are given the choice of authoring and defending a traditional Master’s thesis or a ‘project’ op-
tion to write a paper suitable for publication in a scientific journal. I decided on the latter, and leveraged
my previous experience in medical device design to explore how mobile devices may be better utilized in
the field of community paramedicine (CPM). CPM is a new field where EMS personnel conduct home fol-
low up and preventative care visits as part of their non-emergency workload. These visits are aimed at
addressing endemic or chronic issues before they become critical and necessitate a trip to the hospital.
Half of the finished paper is a review of related literature from CPM, home healthcare, and mobile technolo-
gy use in emergency medicine. The other component of the work is a series of field interviews with para-
medics, getting their opinions on mobile technology and how it might be better utilized. Part of these inter-
views took the form of the evaluation of mockup application interfaces on an iPhone. While not the focus of
the project, these followed a design process based on my initial research from paper to low-fi digital proto-
typing and were mainly used to focus the interviews and inspire the participants to provide forthright feed-
back.

Two different mockups were created that reflected different needs I uncovered during my initial research.
The first is a fall risk assessment app that walks the paramedic through the process of checking a patient’s
house for slip and fall hazards. While essentially an interactive checklist, it provides the user with conver-
sational prompts to engage the patient and explain why each step is important and what corrective action
can be taken. Intended to be comprehensive, the app would provide metrics for both interior and exterior
environments, as well as a physical assessment of the patients themselves.
Upon completion of the checklist, the app would generate a “score” for the patient’s risk of falling, and
recommend possible interventions to lower it.
Checklists are a well established and well researched paradigm in medicine, and allow both clinicians and
EMTs to navigate complex tasks efficiently and safely. It was thought that presenting this elaborate
checklist as a screen-by-screen process would be complete without overwhelming the user.

The second mockup is a case management app. Currently, CPMs use patient care reports that were de-
signed for EMS visits, highlighting one of the primary differences between the two services. EMS reports
are designed around a single encounter or incident, usually documenting care delivered by medics at the
scene and then on the way to the hospital. Community paramedics must document a more long-term rela-
tionship with the patient, and current recording methods, both paper and digital, have not met that need.
This mockup was generally more well received than the fall assessment checklist, as while fall assessment
is not a task common to all CPM programs, paperwork is. Many healthcare systems, and the ambulance
and fire companies in the towns they serve, are moving to electronic health records to ensure both conti-
nuity of care and proper billing of the patient or insurer. However, medics in the field still often use pen
and paper to complete a report, later transcribing it into the computer at the end of a shift.

It was very interesting to approach this design project as an academic exercise, as having the time to
properly research a topic is not common in an industrial setting. Equipping myself with a through under-
standing of not only the issues faced by EMTs and paramedics but also a familiarity with their specialized
terminology and procedural knowledge helped me make an educated “best guess” at an interface before I
went into the field.
While the initial instinct for the UX researcher may be to go directly to the user and learn as much as possi-
ble from them, I discovered that –especially in medical fields– the user’s time is very limited and very ex-
pensive if you take them away from their work. Conducting a through review of scientific literature in and
around the field of CPM gave me a great breadth of knowledge that allowed me to closely target my users
and not waste their time when I finally put a prototype in front of them.
As people with a great deal to think about besides their mobile phones, the paramedics and EMTs I talked
to didn’t have much to say on the finer points of mobile apps for emergency medicine. Shifting the conver-
sation to problems with their current communications technology and procedures got the ball rolling, how-
ever, and it soon became apparent that despite their initial attitudes, most paramedics (and the world at
large, probably) are receptive to new technology if it makes their lives easier.
Additionally I rediscovered that, while I stressed to them that the application was strictly hypothetical, in-
volving the users in the design process made them stakeholders invested in the development process.
After a single brainstorming session the members of one CPM company wanted to know when the app
would be on the market, and made themselves available for further feedback over email.

Certegra© Imaging System Interface
Bright Innovation, 2012
MedRad, an affiliate of Bayer AG, is an international radiological imaging company. They are involved in all
parts of the imaging process, and their devices for measuring and administering proper quantities of contrast
dye are among the most innovative on the market. In addition to the production and delivery of the radioac-
tive dye, they also produce software tools to view and manage the imagery generated by the process. As in-
volved as they are in all points of an imaging technician’s workflow, they wanted to develop a centralized
“dashboard” system for the various components of their system.
They asked our consultancy, Bright Innovation, to help them
develop an interface for their upcoming Certegra suite of soft-
ware. The Certegra platform was envisioned as a central hub
for managing patient records, imaging tasks, and whatever
Medrad software components were installed on the system,
with the eventual goal being reducing the number of comput-
ers in the imaging suite.
We were tasked with gaining an understanding of the imaging
process from the viewpoint of various stakeholders such as the
patient, facility manager, and technician. This was done
through a combination of interviews and observation over a
period of several weeks.
During this process we learned about the time constraints in-
volved in medical imaging once the dye is administered, and
how important proper dose management is for patients who
must have multiple imaging procedures. These drove our de-
signs to focus on efficient access to the most important infor-
mation. Keeping things at a high level allows technicians to do
their jobs and not get bogged down in unnecessary details.

A key finding was that the technicians in the suites were so proficient at both their tasks and communicating
with each other that they were able to anticipate the next steps in the process and begin working on their
portion of the job before the last task had been accomplished. This improved patient throughput and
demonstrated the value of engaging a team of workers rather than attempting to design for a single user. In
the central image below, the “apps” in the suite are shown in pink. While there is some overlap, they are
meant to serve as individual milestones in the imaging process.
The project team constructed both paper and digital mockups for the interface and solicited feedback from
users in focus group sessions. Concurrent with these focus groups, the team began generating art assets for
use in the interface which followed styles specified by the client. Feedback was gained on these as well, and
minor tweaks and adjustments were made that allowed for its eventual transformation into a touch-screen
system.

In addition to field research and assisting with the wireframing, I was responsible for most of the art develop-
ment and the creation of specification sheets to direct the developer in implementing the designs. This in-
cluded both mock screens to show the “look and feel” as well as pixel-specific directions for image placement
and layout.

In addition to the “look and feel” and layout specifications, I developed construction guidelines for icons and
toolbars that reflected the design preferences of the client. These enabled the overseas developer to recon-
struct the art assets in their own workflow before implementation in the software.

As Bright Innovation’s first standalone interface design project, this was an educational experience, both in
terms of client communication and learning new tools and methods. The level of detail requested by the
third party developer was frustrating to meet at times but resulted in clean and comprehensive documenta-
tion both for them and future developers for the Certegra interface.

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