Nuora

At-home Preeclampsia Monitor

Duration: 10 weeks (AUT19)

Solo project with consultations from Tactile

DESIGN 445: Advanced Industrial Design

Roles: UX Researcher, UI/UX Designer, Industrial Designer 

Tools: Figma, Adobe XD, Rhino, Keyshot

Overview
 

Preeclampsia

Preeclampsia is characterized by sudden high blood pressure during pregnancy. High blood pressure can put strain on the mother’s arteries and the heart, which affects how oxygen and blood is transported to the fetus. If left untreated, it can lead to the deadly condition, eclampsia.

 

Fortunately, early detection of the condition can help reduce the negative impacts on the mother and the fetus. 

How might we design a product that allows pregnant women to monitor their daily health in relation to preeclampsia so that they can treat it early on and reduce the negative impacts of the condition?

Context & Problem Space
Solution

Bottom-Up Innovation:

Supine Pressor Test

Researchers have recently developed the Supine Pressor Test, a method that predicts if and when a pregnant woman is expected to develop preeclampsia. Using a blood pressure cuff and accelerometer, the results are calculated by the changes in blood pressure from when a pregnant woman lays on her left and then on her back (Original study image, by Purdue University). After a woman discovers she is expected to develop preeclampsia, it is recommended that she works closely with her care team to monitor her health. 

This new medical advancement allows for women to decrease the negative impacts of preeclampsia through early detection and treatment, helping them feel more control of their pregnancy.

Step 1: Record blood pressure laying on left side

Step 2: Record blood pressure laying on back

Preeclampsia Monitoring

Nuora allows pregnant women to take the Supine Pressor test at home using the connected blood pressure cuff, accelerometer (purple piece) device, and belly band assistant.

 

If the mother is predicted to develop preeclampsia, Nuora helps connect the mother with her care team to develop a treatment plan, which involves tracking daily vitals (blood pressure, weight) and sleeping habits at home through the app.

Additional Sleep Tracker

Studies show that pregnant women should sleep on their sides to avoid restricting blood flow to the baby, a result of sleeping on their backs, which applies pressure on their major blood vessels. The accelerometer can be removed and worn on a belly band during sleep to track the woman’s sleep positions. If a woman is found to be sleeping more on her back than her sides, better sleep habits will be recommended to her to improve her sleep comfort and her baby’s health.

Supporting Smartphone App

The app connects to Nuora via bluetooth to allow for convenient data tracking, reminders, and monitoring instructions. This also connects the mother to her personal healthcare team so that they can track her health without her needing to visit the clinic, allowing her to collect data consistently without the white-coat effect (increased blood pressure due to being recorded in a medical setting versus at home). 

Benefits

As a result, Nuora can help women feel more prepared and in control of their health leading up to the birth of their baby. Because this device can be used at home, it can also help reduce costs and time spent at the doctor's office for many women, especially for those who live in more remote locations.

 
Research
Medical Research

Preeclampsia: high blood pressure during pregnancy

Characteristics

  • High blood pressure

  • Edema (Swelling due to kidney issues)

Current Treatment & Cure

  • Give birth (often times preterm through induced labor or C section)

  • Monitoring of blood pressure before giving birth

    • Magnesium supplements to keep the heart and blood pressure under control​

Early medical research of preeclampsia helped me prioritize what data my product should collect (blood pressure and weight) and how that data can used by doctors during treatment.

Supine Pressor Test (Credit: Purdue University)

The Supine Pressor test can detect preeclampsia risks.

The Supine Pressor Test can predict if and when a pregnant woman will develop preeclampsia by calculating the changes in blood pressure of when a woman is laying on her left side, and then on her back.

 

As of now, this method has been solely restricted to medical research but allows for a great design opportunity to become a consumer product as this test only requires

  • a blood pressure cuff

  • an accelerometer

  • and a smartphone to give instructions and collect data

It is best to sleep on your side during pregnancy.

When I presented the Supine Pressor Test in peer critique, I was challenged to consider how I can encourage people to monitor their pregnancy health beyond just the a one-time Supine Pressor Test, since the product may feel disposable if it’s one-time use. And if it’s one time use, it’s not able to follow the mother through her pregnancy so how could I use other elements of the Supine Pressor Test (the accelerometer and blood pressure cuff) to help further support the mother’s pregnancy?

 

As I researched more on blood pressure during pregnancy, I found that sleeping on your side during pregnancy can help​

  1. Help prevent stillbirth

  2. Allow for the best blood flow to the fetus

  3. Decrease the risk of high blood pressure and preeclampsia

Sleeping on your back later on in the pregnancy can apply pressure to a major artery, blocking blood flow to the fetus.(Credit: Expecting Science)

Market Research

Competitive Analysis

Currently, the only market product that helps monitor preeclampsia is your average blood pressure cuff. Current consumer blood pressure cuffs are great for monitoring one’s blood pressure at home to reduce doctor’s visits and the white coat effect.​

But users can benefit from

  • reminders for how to prepare for an accurate reading

  • reminders for when to record their blood pressure

Pregnant users can additionally benefit from pregnancy-related feedback, so that they understand what their reading means for them, being pregnant, versus someone who is not pregnant. At this moment, no blood pressure cuff or any market device is meant for detecting preeclampsia, which allows for a huge design opportunity.

User Research

User Journey through Preeclampsia

Because the symptoms of preeclampsia are similar to common pregnancy symptoms (swelling, frequent urination, nausea), the condition often goes unnoticed by pregnant women until they return to the clinic for a blood pressure test.

 

After a diagnosis, the stress of needing frequent doctor’s visits and worries about harm to the fetus can contribute to an increased blood pressure.

Persona

Rachel, 27 year old Future Mom

Medical Background: 17 weeks pregnant with her first baby

Current Care/ Pain Points: Visits her prenatal doctor, who is 40 minutes away, monthly

Goals: To have a healthy pregnancy and a healthy baby

 

 

Much like any other pregnant woman, Rachel, my persona shaped by online stories of preeclampsia survivors, has a goal to have a healthy pregnancy and a healthy baby but her long commute time to her doctor makes visits inconvenient.

 
Problem Framing

No pregnancy-related feedback

Current blood pressure cuffs don't inform users of their measurements in relation to their pregnancies.

Difficult to detect preeclampsia

Symptoms often go unnoticed as they are similar to common pregnancy symptoms (nausea, swelling, headaches)

Need for regular monitoring

Blood pressure needs to be monitored everyday to track the development of preeclampsia.

Design Insights

Watchful

Help users become aware of health issues early on so they can seek treatment as soon as possible and reduce the impacts of preeclampsia

Empowered

Help women take control of their pregnancy and their health so they feel powerful in overcoming preeclampsia

Design Principles

Connected

Create strong patient-healthcare team relationships to improve quality of care.

How might we design a product that allows pregnant women to monitor their daily health in relation to preeclampsia so that they can treat it early on and reduce the negative impacts of the condition?

Ideation
 

Product Ideation

Early sketches explored how I could incorporate the elements of a Supine Pressor Test into common pregnancy products and therefore, help pregnant women incorporate this product more naturally into their routine. A maternity belly band (used to help pregnant women cover their bellies when wearing clothes as their belly grows) became my top choice as it could hold the accelerometer during the SP test, while also be worn as a daily accessory when not taking the test.

App: Flow Diagram

Based on these early UI sketches, I mapped out a more detailed flow diagram.

Sketches

Next, I sketched key screens from my flow diagram, focusing specifically on ways to

  • create motivation in the user by displaying progress

  • explain and guide users through the Supine Pressor Test

  • display sleep habit feedback

User Testing Feedback

When testing sketched app wireframes, I discovered that

  • the menu bar needs to be reorganized as the tests and past results were difficult to find, being nested within "Track Health"

  • the sleep movement graph is difficult to decipher due to its unfamiliar form

  • the participant would like a way to view previous recordings to see changes over time

  • the participant liked how the home screen displayed the baby's progress, making her feel encouraged

Iteration
 

App: Updated Flow Diagram

Based on user feedback, I incorporated (in black)

  • past measurements

  • easier navigation to track health

Early Wireframes of Key Features

Next, I created mock ups in Figma to​

  • improve the sleep habit tracking chart so it is easier to comprehend

  • incorporate past measurement charts

Product Iteration & Foam Prototyping

To better imagine the user experience of these concepts, I created simple foam prototypes to explore its interactions with the body, sizing, and how these multiple components would fit together within a system.

User Feedback: App

  • Break down instructions into more steps, especially for the Supine Pressor Test as it is unfamiliar

    • Use photos to help give instructions​

  • The participant liked the use of the big, bold progress bar at the top of the screen during measurements.

User Feedback: Physical product

  • The belly band seems like the best method of incorporating the accelerometer into the product.

  • The chest adhesive accelerometer does not seem reusable nor comfortable for nightly use.

  • The blood pressure cuff is going to need more volume in terms of mechanical function.

Refinement

High Fidelity Mock Ups in Sketch

Product Form Refinement

After deciding that my product will consist of a blood pressure cuff and a bellyband accelerometer, I explored many form studies, including ideas that allowed the accelerometer to dock into the cuff for storage and charging functions.

Refined Prototype

A prototype was created using a 3D printer and fabric to test the docking feature, size, and overall usability.

 
Design Solution

Design Features

Provides pregnancy-related feedback

Pregnant users can understand their health measurements in relation to not only their bodies, but also their pregnancy and their baby's development

Detects and monitors preeclampsia through new medical advancements

Utilizes the Supine Pressor Test and sleep research findings to best provide care and information for the user

Encourages regular and accurate blood pressure monitoring

Reminds the user to monitor their blood pressure daily, especially if at risk for preeclampsia. Also reminds users on how to accurately take a test (avoid caffeine, feet flat on the ground)

Storyboard

User Journey with Nuora

Without Nuora, a preeclamptic mother's journey is filled with stress. But with Nuora, my goal is to help women work out a treatment plan with their care team before preeclampsia develops so that they feel prepared when the condition develops and hopefully, gain a better sense of control over their health.

Smartphone App Features

The home page allows the mother to track her baby's development, which as a result, motivates the mother to continue keeping up with her health.

The app also

  • guides the mother through the supine pressor test and results

  • allows her to set reminders for blood pressure monitoring

  • allows her to view her sleeping habits

Product Details

Reflection & Takeaways
 

The ups

Although I hope to start my own family in the future, living with lupus categorizes my future pregnancy as a high-risk pregnancy. Through this project, I was able to learn a lot about preeclampsia, ways to detect it, and ways to treat it. Knowledge is power and the lessons I have learned along the way can truly save my life.

The downs

Based on the agenda of this studio class, I was unable to speak in person with preeclampsia survivors. I believe this class was designed this way as many of the health conditions us students designed for can be sensitive and difficult to discuss. Fortunately, I found real life patient stories on a preeclampsia survivor blog which revealed both heartfelt and heartbreaking moments that eventually became my user journey.

Moving Forward

For this 10 week timeline, I focused primarily on designing the Supine Pressor Test to be user-friendly and easily integrated in a pregnant person's routine. With more time, I'd like to add to Nuora a product that can also track edema (swelling) since that is another key symptom of preeclampsia.

Design System

©2019 by Jay Ma Design