IHME Local Burden of Disease

Problem

The Institute for Health Metrics and Evaluation (IHME) creates visualizations of global health that inform global response, philanthropy, and public health policy. Their Local Burden of Disease tool is a highly detailed interactive visualization of health trends in Africa. Unfortunately, global health workers using the tool are left with unanswered questions about the validity of sources going into the visualizations.

Solution

A page displaying the source data that makes up the visualizations, filterable by country and health indicator, directly connected to the functionality of the tool

Watch Demo Video (2 Minutes)

Client

Institute for Health Metrics and Evaluation (IHME)

Role

All 3 team members played the roles of UX Designer and UX Researcher. I was
Project Manager during the Design Phase, and Facilitated all but 1 Usability Test

Team of 3

Methods

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

  • Whiteboard ideation

  • Affinity Analysis and Empathy maps

  • Personas

  • Journey Maps

  • Interactive Wireframes

  • Usability testing

Tools

  • Adobe XD and Illustrator

  • QuickTime Screen Recording

  • Whiteboards

  • HappyScribe

        Date

        January 2018, Ongoing (through June 2018)

        Watch Demo Video

        Learn about the problem

        2 of my peers and I partnered with The Institute for Health Metrics and Evaluation (IHME) as part of our HCDE Capstone Project (the final course in our degree). 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.

        When we met them at their office for the first time, IHME presented their problem space: 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 was designed as a research project. IHME had not considered how the design of the LBD tool could effectively support the goals of their users, which included global health organizations, directors at research foundations, students and policymakers. They wanted to increase uptake by better supporting 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 zoomed out to focus on how potential users of this tool currently use health data. 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.

        Analysis

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

        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 separated quotes and concepts into distinct stages.

        Analysis > Empathy Mapping

        Think

        Feel

        Do

        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?"

        Uncertainty
        "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

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

        Brainstorm

        There were 2 ways we thought we could make IHME more useful for global health workers

        We briefly brainstormed design changes for each of the above options, focusing on how we could address the needs of our personas (see Analysis). After spending about an hour on each, it was clear to us that Direction 1 could make a larger impact because validating source data was a key step in each of our personas' workflows.

        Brainstorm > Direction 1: Source Data Transparency

        The local burden of disease landing page (leftmost box) could link directly to information about the source data. A filterable source data page would let global health workers find sources related to specific locations.

        Brainstorm > Direction 2: Narrative behind data

        The LBD has filters that change the state of the map. We could give example questions that could be answered within the tool, and let users jump into a visualization with certain filters pre-selected.

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        Design, Test, Iterate

        We set out to make source data behind the LBD Visualization more transparent. We decided we needed to embed the option to explore sources within user's current process of exploring the visualization.

        Our 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

        To test our decisions, we had 5 global health professionals from various organizations/foundations use our interactive prototype within a task-based scenario (pulling use cases from our focus groups)

        4. Refine interactive prototype

        We learned a lot from our usability tests. We refined our designs based on feedback we got (See 'design decisions' below).

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        Our solution

        Potential Users of the LBD Tool wanted to know how source visualizations are created. 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.

        Key Design decisions

        Summary of Design Decisions

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

        Rationale - 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?")

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

        Rationale
        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.

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

        Rationale - 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

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

        Rationale - 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.

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

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

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

        Rationale - 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")

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

        Rationale
        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.

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

        Rationale
        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.

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        What I learned

        Working with a real organization is hard. 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 how research informs design decisions.

        The focus groups were not what we expected. We thought our participants had 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.

        Also, it takes a surprising amount of time and energy to keep a client looped into your process! Keeping IHME updated on our progress was a project in and of itself, and we struggled with this in the initial stages. Luckily, our sponsor was able to gently nudge us when they wanted information, so we found a rhythm of keeping them updated about the most important information.

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