Octave Bioscience

Providing Care between Visits

Type: Zero to One (Startup) | Role: Founding Designer | Design: Mobile, Service | Duration: 6 Months

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1 Time for Complexity

HMW enable People with MS to ‘extend the visit’ allowing time for complex MS topics?

PROBLEM

Neurologists and their Multiple Sclerosis (MS) patients were trapped in a broken system - 30 min visits every 6 months but completely disconnected between those visits. This resulted in rushed decisions at their short visit, lack of shared knowledge of what happened between visits, and patients having to figure out many things on their own between those visits.

OVERVIEW

THE ASK

How might we design care delivery between neurologist visits for People managing the complex, lifelong, and ambiguous nature of Multiple Sclerosis?

2 Lifelong Motivation

HMW keep People with MS motivated to manage and track their lifelong condition?

3 Navigating Ambiguity

HMW help People with MS recognize and respond to ambiguous MS symptoms

Octave Bioscience is a healthcare startup that received funding to build their first Multiple Sclerosis (MS) offering, a hybrid app and nurse service for People with MS that culminates in a summary report for their neurologist to use at 6 month visits. Their goal was to create the largest MS data platform by providing services to neurologists and patients in exchange for MS data.

MY ROLE

As the founding designer who led the zero-to-one process from discovery to post-launch, my challenge wasn’t just to design an app, but to architect an entire system from first principles.

  • Product Designer – Worked with founders to workshop and explore solutions to problems.

  • Service Designer – Map journeys and care workflows between People with MS, MS Nurse, and Neurologists.

  • User Researcher – Conduct and synthesize sessions with Neurologists, People with MS, MS Nurses, etc.

  • UI Designer – Build out flows, screens and mockups for development.

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1 TIME FOR COMPLEXITY

HMW enable People with MS to ‘extend the visit’ allowing time for complex MS topics?

With a hybrid mobile app and MS nurse service, the Care Partner would have regular check-ins with the patient as a way to extend the visit.

This was a service design challenge to design laterally across touch points and the interconnecting role that the Care Partner (MS Nurse) would play in this system.

• Identify the role that the Care Partner (MS Nurse) and the process of providing value through a service blueprint.

• Identify ways that the Care Partner and the App could augment each other through planned and unplanned check-ins.

“I felt forced to change to a different MS medication because my MRI was showing new lesions but I actually felt fine. I wished I had more time to discuss this with my Neurologist at my visit as I had bad side effects when i changed medications the last time.”
— Mother of 2, MS for 8 years

Based on internal discussions and user interviews, I created this framework to clarify the connective role that the Care Partner would play in this offering.

Snippet of ‘Time for Complexity’ Design Process

  • Augment Check-Ins with the App

    For planned check-ins, I emphasized preparation to help people with MS organize their concerns. For unplanned check-ins, which may be urgent, I prioritized quick access to various contact methods for the right type of support.

  • Connect Patient In-App Actions to Care Partner

    I made sure to interconnect patient input such as severe symptom changes or actions such as triggering the relapse screener to automatically notify the Care Partner so that they can follow-up if the patient doesn’t follow through.

  • Co-creating the Service Blueprint

    I facilitated a co-creation workshop with internal teams to align on key elements of the Care Partner program: check-in topics, frequency of contact, and timing sequences like visit preparation 1 week before their 6-month visits.

‘Between Visits’ Service Blueprint

I mapped out the co-created Care Partner Check-ins process and interconnected check-in topics, data points from the app to align the dev & data team on what was needed.

Interplay between Nurse and App Check-Ins

Planned & Unplanned Check-In Final Mocks

Connected the App to Care Partner Check-ins by enabling better preparation for planned check-ins and displaying Care Partner availability for unplanned check-ins.

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2 LIFELONG MOTIVATION

HMW keep People with MS motivated to actively manage their MS (& track their data) for a lifelong disease?

Unlike diseases that you can ‘beat’ or that have a defined timeframe like months, MS lasts a lifetime and I wanted to help users manage it in smaller chunks of time.

I also recognized that it was essential for the summary report to be actively used by the neurologist for the visit as it would justify the data tracking done and motivate them to do it for the next visit.

• Find creative ways to break down the lifetime management of their disease into manageable phases.

• Design the improved visit experience and how the summary report would play an essential role in that experience.

“My patients are at two extremes: those who track everything with overly detailed notes that I can’t really use and those who come in and try to remember what happened in the last 6 months. We often waste precious time just doing this but if I don’t ask, I don’t really know what happened.”
— Neurologist for 11 years

Snippet of ‘Lifetime Motivation’ Design Process

  • Inspired by the Cyclical Nature of Fertility Apps

    Recognizing the cyclical, long-term nature of MS care, I used fertility apps as inspiration to structure the design around neurologist visits as both the starting and ending points of each care cycle.

  • Align on the Moments that Matter

    Through the quick storyboards, we identified the moments that matter: sign-in at the counter, waiting for the neurologist, and the doctor visit itself. I aligned the team on efforts to ensure the report would be used.

  • Summary Report Testing with Neurologists

    I designed the report in a way to avoid overstepping on the neurologist's role, but learned through feedback that they actually preferred more detailed input and analysis from the Care Partner due to her MS specialization.

App Cycles & Summary Report Mocks

Both neurologists and People with MS responded well to the cyclical concept and the summary report. For Neurologists, the concept that their visit was central to the app resonated with them. For People with MS, it fit their mental model and they loved the fact that they knew what to track.

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3 NAVIGATING AMBIGUITY

How might we help People with MS recognize and respond to ambiguous symptom changes?

The challenge with MS symptoms is that it is similar to everyday symptoms such as numbness, tingling, or fatigue. The usual advice is to wait 24 hours and see if it goes away. However, infections, fever, or even being in the sun for too long can make People with MS have symptoms that last longer than 24 hours. And not all symptoms are the same—some need a trip to the ER right away, others don't. People with MS are left figuring this out on their own, and even when they do call their neurologist, it can take a while to hear back.

• Hard to tell whether a symptom they were experiencing was MS-related or just life.

• Patients had trouble deciding what to do based on severity of their symptoms: wait 24 hours, ask for help, or go to the ER.

“There are days when you wake up with a numb arm and you wonder whether you slept on it or you’re about to get a relapse.

I know my doctor’s busy and don’t want to bother him until you know it’s more serious.”
— Avid Hiker, MS for 6 years

Snippet of ‘ Navigating Ambiguity’ Design Process

  • Standardize MS Symptom & Severity Thresholds

    I was surprised to find no standardized MS symptom list, so I worked with multiple MS nurses to create one with 4 severity levels that would determine how the app responds based on each symptom and severity.

  • Building my first symptom and relapse algorithm

    As there were numerous flows and spreadsheets, I converted the different symptom and relapse screener responses into a flowchart for development and QA to implement the algorithm.

  • User Research with People with MS

    Interviewed People with MS to understand how they think about symptoms, how they track, and concepts that excited them. Interestingly, the most exciting feature was seeing all their symptoms in one place.

Symptom Screener Final Mocks

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Outcomes & Reflections

It’s rewarding to work on a project that has such great impact on people living with an incurable disease. Being able to listen to their stories and feel their excitement when we explain the program & show them the work brings meaning and purpose to my work as a designer.

The offering was ready for Neurologists and Patients from UC San Diego’s MS Center in the desired timeframe of 6 months. As the program has scaled, it has proven to show value with 92% of all patients remaining engaged with the program through continued use of the App (8+ times a week) & Care Partner Check-ins after 6 months.

In this project, my role as a designer was not only to design a single touchpoint (such as the App), but rather, to design the process and experience of the entire platform. This constituted different touch points and the “in-between” spaces that intersect/build on top of each other. 

It was heartening to celebrate our work by being the finalist in Fastcompany’s Innovation by Design Awards 2023 and a winner in the UX Awards 2024.

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