IHME Local Burden of Disease


The Institute for Health Metrics and Evaluation (IHME) has an interactive visualization called the Local Burden of Disease Tool. Professionals are hesitant to use this tool because they don't initially understand what underlying data they are looking at.


A streamlined path from the LBD Tool to a new page displaying the source data that makes up the visualization, filterable by country and health indicator

Video Summary (2 Minutes)
Learn about
the problem
Design, test,



Institute for Health Metrics and Evaluation (IHME)


UX Researcher and designer. All 3 team members played this same role. I was also
Project Manager during the Design Phase, and Facilitated Usability Tests

Team of 3


  • 2 Focus Groups (1 with WGHA, 1 with the BMGF)

  • Interactive Wireframes

  • Whiteboard ideation

  • Affinity Analysis and Empathy maps

  • Personas

  • Journey Maps

  • Usability testing


  • Adobe XD & Illustrator

  • Sketch

  • QuickTime Screen Recording

  • HappyScribe


        January 2018, Ongoing (through June 2018)

        Watch Demo Video

        Learn about the problem

        The Institute for Health Metrics and Evaluation (IHME) is a research center that measures health problems around the world and creates visualizations of global health data that policymakers can use to inform decisions and target treatment.

        The Local Burden of Disease Tool helps users explore health trends at a very precise level (5-kilometer radius). It's a powerful interactive visualization, but it wasn't widely used by target users like global health organizations, directors at research foundations, students and policymakers. They wanted to increase uptake by helping the tool better support global health workers at the Washington Global Health Alliance (WGHA) and the BMGF (Bill and Melinda Gates Foundation)

        Local Burden of Disease Tool - Set to "Under 5 Mortality"

        Focus Groups

        We needed to know what professionals were looking for that they weren't getting from this tool. We asked how do potential users of this tool currently use health data in their work? During each of 2 focus groups, we had participants recall specific experiences they had using global health data in their work. We asked them to map out these experiences step-by-step, and then discuss these experiences as a group.

        We analyzed themes that came from these conversations, and used those to make Personas that captured 2 distinct types of users, and Journey Maps that helped us make sense of their process.


        As we grouped our findings (see visualizations below), we realized we were dealing with two types of people who each used health data in different ways; data as process, and data as output.

        Data Analysis
        Mapping the process of health data use

        We organized comments from the focus group in terms of where they fell in the process of using health data for some purpose. We were able to separate concepts into distinct stages of the data-use journey.

        Empathy Mapping




        Data as Process

        "Where do I make an intervention?"

        "I doubt the validity of this data, and [my client would have] questions about uncertainty interval"

        Compare two countries or districts to see if there has been a change

        Data as Output

        "How can I tell stories about how things are changing?"

        "Is the data a triangulation of sources?"

        Talk with a Minister of Health about piecing together a new data system

        "Think, Feel, Do" framework helped us unpack the underlying motivations behind the tangible worklflows they described (this chart is simplified to our chosen solution)

        Persona - Neil (Data as Output)
        Persona - Taylor (Data as Process)
        Journey Map - Data as Output
        Journey Map - Data as Process

        "As a global health professional, I need to..."


        We brainstormed a list of 12 design directions. We ideated within these directions, discussing how valuable various solutions would be in addressing the needs of our personas (see Analysis). IHME also helped us prioritize solutions based on their own business concerns. It was clear to us that validating source data was a key step in both our personas' workflows. This fit well within the scope of our project, and was high-priority for IHME.

        Brainstorm Ideas
        Chosen Direction
        Source Data Transparency

        The local burden of disease landing page (leftmost box) could link directly to information about the source data. A "source data" page would let global health workers find sources that would help them feel confident about using the tool in their work.

        Some directions we didn't pursue

        • Make the "story" behind the data more clear by framing the visualization as a narrative and showing connections between health indicators

        • Support comparing two regions side-by-side

        • Help users see value in the tool and interpret data (e.g. giving example questions that could be answered with the tool, framing output to make conclusions more clear)

        Design, Test, Iterate

        Design Goal
        We set out to make source data behind the LBD Visualization more transparent. We knew we needed to give users access to the sources behind visualizations, and we need to do it in a way that aligned with their process for using data.

        Design Process
        1. Individual Wireframes (my contribution)

        We individually created wireframes of the LBD landing page, a new "Source Data" page, and the map page. These helped us solidify the overall solution we wanted to propose to IHME.

        2. Group Critique and Iteration

        In critique sessions, we discussed how well our designs addressed the needs of our personas. Iterating individually gave us a breadth of ideas to discuss in sections, so we could narrow in on the most effective elements of our wireframes and mockups.

        3. Usability Testing

        We asked 5 global health professionals from various organizations to use our interactive prototype within a task-based scenario (pulling use cases from our focus groups)

        4. Refine interactive prototype

        Our solution

        Potential Users of the LBD Tool wanted to understand and be able to validate the data behind visualizations. We designed a workflow (shown below) that brought pathways to source information closer to the surface of the tool to make it more accessible and more transparent. We proposed changes that IHME could embed within their current Website.

        Design Decisions
        The Overall Solution

        A dynamic link from the 'Map Page' to a 'Source Data' Page populated with sources used to create estimates within a given country

        Each of our personas needed to be able to access the underlying data behind LBD visualizations; when they used the visualizations to recommend treatment plans to stakeholders like ministers of health, or to frame a problem in a grant or report, they always fielded questions about the validity of the visualizations. (E.g. "Does this visualization include our district's most recent survey?")

        Create a Source Data page where users can
        filter sources by dataset, country, and year

        Participants wanted access to Source Data while exploring the map, but the Map Page was already pretty crowded with other functionality. We decided to design a new page designated to source data. This gave us more control over how we could display sources.

        Within LBD Tool, provide a dynamic link
        directly to the 'Source Data' page

        All our participants jumped into the actual LBD Visualizations without looking for info about Source Data. As they explored the tool, they were concerned with source data associated with specific locations they were interested in (e.g. "we have a hospital there"). A link that updates with the state of the map gives users power to explore Source Data information at any point during their research process

        On Landing Page, use tabbed content to give multiple
        points of entry to the LBD Tool

        Users struggled to find the Local Burden of Disease Visualizations on the site and were confused about the relationship between the Tool and the Visualizations.

        On Source tables and cards on the Source Data page, describe sources using
        Provider name and year of data collection

        Participants in usability testing said these were the most critical pieces of information. Provider indicates validity, and year of data collection tells them how relevant the data is for current projects.

        Use compact clickable diagram with tooltip on source page
        to explain how IHME creates LBD Visualizations

        Most professionals we talked to had incomplete or incorrect interpretations of how visualizations were created. They liked getting this context on the Source Data page, but when it took up too much space, they missed the actual Data Sources.

        Use tooltips to explain key terms

        Most participants in usability tests either said they were confused by a term or made an incorrect assumption about a term that effected their interpretation of the data (e.g. "I'll just exclude sources labeled "Neonatal" in my research since those aren't being used to visualize "Under-5 Mortality")

        In popup on Source Data page, give clear links to raw
        datasets and original source

        Our persona, Taylor, is using the LBD Tool as one step in a larger research process. She would be looking to dig deeper into the data sources so she could validate them on her own. She would want to link to the original source of the data. One Usability Study participant, a data scientist, was most interested in downloading raw datasets, which IHME makes available on the GHDx.

        On the Source Data page, Give a shortcut to
        citing sources associated with a location and year

        Since the potential user defined in our persona needs to communicate sources to a variety of stakeholders, an automatically generated citation for sources would streamline their workflow. Some participants told us that they have their own citation methods specific to their organization or report, but for more casual usage, this would help.

        What I learned

        Working with IHME, who is relatively new to applying a user-centered process, definitely helped me improve how I explain the value of defining your target user and using research to inform design decisions.

        Conducting the focus groups gave us a few surprises. We thought our participants would have experience with Local Burden of Disease tool prior to the meeting. It turned out that almost none of them had experience with the tool. But this was okay; it helped us learn more about potential users who don't currently find the tool useful.

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