How patient engagement can be driven by great user experience

This staple UX rule applies across all digital products: If you don’t know your users, you certainly can’t design for them. Femtech is no exception. At the heart of a strong user experience is a keen understanding of what users feel, want, and need. “My #1 UX principle is to design solutions in a human-centered and inclusive fashion out of a deep understanding of people’s needs, pain points, motivations, and beliefs,” says Stodieck, “Listen to your customers!”

Though a product team member’s gut or personal experience might provide one helpful data point, it’s important that insights are constantly gathered from real product users (or prospective users in the case of early-stage startups). This information gathering can come in many forms, but qualitative research methods allow teams to hear perspectives directly from users in their own words.

Methods:

• User interviews: Conduct interviews with your users to learn more about their needs, desires, and concerns
• Focus groups: If budget allows, conduct focus groups to learn more about your product space through moderated group discussions
• Usability testing: Even on a shoestring budget, usability testing is crucial to identify areas of poor usability and gather ideas for improving your product
• Diary studies: Get into your users’ heads by having them record experiences in your product space over a period of time
• Empathy mapping: Using qualitative insights from the activities above, create empathy maps with team members to keep user thoughts and emotions top of mind
• User journey mapping: Visualize your customer’s entire journey with your product to ensure that needs are being met at each step

While these user research methods typically sit on the digital product or UX team, user insights can also be gathered and shared cross-functionally. “We have a care navigation team that is constantly talking to members to guide them on their fertility and family forming journeys,” explains Venkatesan. “The insights and feedback we receive from that team, in addition to our own research, help inform the work the product design team does every day.”

In translating user insights into design decisions, it can also be helpful to start from square one. “Don’t necessarily emulate what other digital products are doing,” advises Delaney. “You should question everything and get answers from the users who will benefit most from your product’s impact.” Beginning with qualitative user research at the very beginning of product development—as early as ideas on a whiteboard or a paper prototype—can ensure that a product is actually meeting a specific need in a method that makes sense for users.

“Every customer’s journey is unique to them and their needs may vary based on their unique conditions like disabilities, lifestyle, and personality,” says Stodieck. “The types of customers I have in mind can range from visually impaired people who need to navigate a website to people with periods who don’t identify as women.” Knowing your users doesn’t just mean knowing the users who live in your city or those that you hear from on social media. It’s important to be specific about the differences within any audience that may impact an experience with a digital health platform—whether location, age, gender identity, sexual identity, race or ethnicity identity, disability, or other factors.

It can be tempting to test new ideas or digital features with users in closest reach…team members or colleagues working in your office. And although doing some internal preliminary testing may be helpful to spot bugs, it’s crucial to take a more holistic approach to testing.
“There is no ‘trickle down’ effect; if you only test your digital products on new devices or with financially secure users, you may miss very important obstacles (physical, mental, emotional) facing your actual target users,” explains Nasca.

It’s also important to be aware of how a user’s relationship to a product or service may change over time. If your company serves users in many different life stages or stages of care, it’s important that those different stages are represented in testing. “Fertility and family forming can span long time horizons,” says Venkatesan. “Members use Carrot over many years and their journeys can change drastically during that time. For example, a member may pursue fertility treatment at first. Then, years later as they continue building their family, they may turn to adoption. Those journeys are quite different, so the resources and support we provide are equally different.”

User research groups can help establish a pool from which to draw for representative user testing. If your company already has a communication channel with a large number of users—social media, newsletter, etc.—reach out to those users and invite them to participate in a user research group. By asking users to fill out a quick survey that collects demographic information as well as location and device details, your team can compile a database of users to reach out to with research opportunities. Some companies even create a slack channel dedicated to discussing new products or ideas with their most active users. Incentives such as gift cards can help increase participation in more involved activities like usability tests or long surveys.

Most analytics tools provide a snapshot of audience device use, which can help inform the QA process before each launch. It’s generally inexpensive to collect older devices from a range of vendors to ensure that even the oldest smartphone or tablet used by your audience supports your digital product.

While there are benefits to in-person usability testing, one of the limitations is that it generally only represents users who live close by. “Tech and UX communities tend to be based in large cities,” says Delaney. “As someone who grew up in a low-income rural area, I acknowledge that being in New York for 9 years has biased my understanding of the world. Reaching the users you want to reach gets harder—your bias grows and your understanding of them diminishes.” Conducting remote moderated testing with users in different physical environments is key, particularly if a digital product ties in to an in-person experience such as medical appointments.

There is a growing movement to increase web accessibility for audiences with visual or hearing impairments, cognitive differences, or other differences that may change the way that digital platforms are experienced. “For the past year, my team at Thinx has been working with an outside vendor who specializes in accessibility to ensure our designs and the way we develop those designs meets the WCAG guidelines,” explains Nasca. “Thinx made a decision to be a leader in this space, and I’m so proud to be a part of that.”

Just as it’s important to listen to users, it’s also important to follow quantitative data uncovered through site analytics or A/B testing. “Data and evidence are highly necessary for proving why any medtech product is necessary,” says Capriccio, “But also user data can help develop the product as populations change. For instance, it would be interesting to see what some femtech products are doing with collected data referencing coronavirus and how that will shape their product.”

• Site analytics: Track site or app traffic to identify high and low-performing pages, common paths, big shifts in conversion rate, and audience breakdown by device and location
• A/B tests: Quantitatively test page layouts, brand messaging, and imagery through A/B testing
• Click tracking: Analyze what CTAs are most impactful for your audience and how users tend to navigate through your product
• Heat maps: Identify areas of high and low user interest
• Surveys: Answer specific product questions with a representative sample of users

While data can be hugely impactful when making product and company decisions, it’s important to protect the sensitive nature of user data. This means everything from maintaining HIPAA compliance for any systems handling protected health information to anonymizing user testing results before sharing with the broader company.

“When it comes to a user’s personal health data, femtech products need to take extra precautions about how this data is used, accessed, and secured,” explains Capriccio. “The product might be solving a huge problem for women’s health while simultaneously creating a security risk for users (i.e. location tracking or requesting sensitive or controversial information).” In addition to making data security air tight, thoughtful UX design can actually help communicate a user’s data preferences and how their personal information is being used. When presented clearly and transparently, this information may empower users to make more informed decisions about how and when they release personal information.

There is a common “keep it simple” sentiment that applies to many aspects of digital product design. Streamlining interfaces and cutting information down to the bare minimum can help guide users through a short, clear path. However, one area where this maxim does not apply is digital health education, particularly frequently misunderstood topics within women’s health.

“Through user research I found that traditional ecommerce website design does not work well for our users.” says Stodieck of her work at The Flex Company. “Good website design usually entails very little copy and an extremely streamlined process from landing on the page to checkout. However, for our products, people want a lot of information and truly need to understand what our products are and how they work before making a purchase decision.”

Not only is education key when introducing a new product, but there are many aspects of women’s health—from menstruation, to fertility, to pregnancy, to menopause—that are not well understood by the general public. “Reproductive health information is probably the least well-known or understood by our culture at a base level,” says Delaney. “When this information is lacking—which it usually is—misinformation rears its ugly head. The first step in designing in this space is understanding how little your least educated user knows and what misinformation they’ve obtained. From there, your job is to untangle the web of confusion before you can educate and help.”

Nasca adds, “When we were conducting research for Spot On, Planned Parenthood’s birth control tracking app, we faced many such misconceptions from simple misnomers such as users confusing their ‘period’ with their ‘cycle’ to larger education gaps such as users on hormonal birth control requesting to see which days they were ovulating. Many of our users didn’t know that if they were staying on track with their hormonal birth control, they wouldn’t ovulate—so our app had to deliver that sort of education as well. These issues can be just the tip of the iceberg, specifically in terms of women’s reproductive health.”

“Educate people step-by-step and present information in a way that makes sense to them. The right information has to be presented at the right time so the cognitive load is reduced and the barrier to entry is lowered,” advises Stodieck.

While the rallying cry for increased focus on women’s health is an important step, it’s also crucial that women are not seen as a monolith. Companies working in the space must strike a careful balance between building community over the shared experience of health phenomena—such as periods—while not assuming that these phenomena are experienced the same way by all users.

Beginning with the very use of the word ‘women,’ many companies actively avoid gendered messaging to be more inclusive. “Traditional period products have been designed by men and have been advertised to women. But not all women menstruate and not everyone who menstruates identifies as a woman,” explains Stodieck. “It’s important to listen to people and not to make assumptions.”

Many companies focused on fertility, pregnancy, and family planning also hope to dispel the myth that their solutions are built only for women. “We believe fertility is a part of human healthcare, it’s broader than women’s healthcare” says Venkatesan. “Fertility is something relevant to all people regardless of gender. So the challenges we face are not limited to just women’s health.”

From the models featured in brand imagery to the depiction of individuals in illustrations or diagrams, many brands working in women’s health are aware of the importance of representing their entire audience. “Around the time I joined PPFA, we started to make serious headway on using gender-neutral language and culturally, racially, and ethnically inclusive diagrams and imagery. To this day I’m proud and in awe of how groundbreaking this is,” says Delaney.

“I think Thinx has led the industry in showing real menstruating humans; our models have real bodies and aren’t prancing around with flowers, smiling about how great their periods are,” adds Nasca.

“If you are targeting a diverse audience, you need to have a diverse team,” emphasizes Capriccio. “Technology is biased towards those who make it, therefore making a point of selecting team members is essential.”

It’s an exciting time for the burgeoning femtech industry. As more and more products enter the market, it’s more important than ever for teams to stay connected with their users. Building positive user experiences and being in sync with the ever-changing needs and desires of an audience are crucial to market differentiation.