pain project.

healthcare, health systems, hospitals, service design, user research, UX, experience design, print, information design, visual design, audio, storytelling

what we (really) talk about when we talk about pain

Pain is ubiquitous, but accurate, compassionate ways to talk about pain are less so. My team was tasked with addressing key barriers to accessing quality, risk-aware pain treatment through visual design, plain language, and human-to-human moments of connection.

2017
UC Davis Center for Design in the Public Interest (DiPi); UC Davis; Hill Country

roles
+ designer
+ researcher
+ radio producer

recognition
+ SAPPI Ideas that Matter (2016)
+ IIID Award, Gold (2020)
+ SF Design Week (2018)
+ SEED (2018)

pain is obvious. pain treatment is mysterious.

Trying to access pain treatment is fraught with operational and relational complexities — addiction risks, social stigmas, medical jargon, onerous procedures, and plain old misunderstandings.

project goals

Translate medical complexities into plain language.

There's a lot for patients to consider in navigating pain treatment, especially when it includes controlled substances like opioids. However, plenty of crucial information about risk is often conveyed in dense, legal and medical language that is either poorly understood by patients, or skipped over entirely.

Create a sense of possibility for pain treatment options.

There are many different ways to treat pain in the short and long term, but many patients aren't exposed to all the possibilities available to them (which often results in medication being the default).

Support patients and doctors in shared decision-making.

Patients and doctors alike benefit from interactive tools to help guide clinical conversations, surface key issues, and help patients make decisions that support their healing.

Break down stigma and create community.

Living with pain can be profoundly isolating. Affirming the struggles and sharing the stories of pain patients helps dismantle the silence and stigma that so often surrounds pain.

process

stakeholder interviews & process analysis → medical document redesign & prototyping → patient education materials → community radio storytelling

In an effort to improve the pain patient experience, my team partnered with two very different organizations — UC Davis Medical Center in Sacramento, and Hill Country Health and Wellness Center in rural Shasta County.

Through rounds of stakeholder interviews, focus groups, and process-mapping workshops with clinicians, we began by mapping out each clinic's ecosystem of pain treatment. We identified and logged each touchpoint and document that a patient would encounter in their care journey, logging moments of friction and conflict as we went. This process yielded several key discoveries:

There are a lot of appointments involved.

For chronic pain that requires a prescription for a controlled substance, the patient journey requires multiple visits, screenings, and assessments. Once a medication is dispensed, regulatory requirements require additional visits and restrictions on refills — all of which can be burdensome for patients.

There are a lot of documents involved.

If a controlled substance is deemed necessary, patients have to complete a lot of paperwork indicating that they inderstand the risks of this medication and that they agree to adhere to the clinic's controlled substance policy. However, these documents are often dense and wordy and are frequently signed out of desperation, without close review.

Patients often feel frustrated and like they're not trusted.

As many appointments and heaps of documents pile up, patients can easily resent the fact that they're forced to jump through so many hoops in order to get relief. Even within a single appointment, regulatory pressures on providers to be cautious about controlled substances can sometimes result in tense conversations where patients feel like they're not respected.

controlled substance agreement redesign

turning a medical form into a conversation piece

From our initial discovery research, it was clear that the controlled substance agreement (a form that all patients need to sign in order to be prescribed opioids) is a pivotal moment in the pain treatment journey for providers and patients alike.

However — typically presented as a nondescript wall of dense text, it was a missed opportunity for providers and patients to have a meaningful conversation about risks and expectations.

Prescription opioids come with many considerations for patients, and receiving them requires an informed consent process wherein a provider explains what pain medications do, the risks of taking them, side effects and other drug interactions to watch out for, and clinic policies to follow. However, this “consent” is often secured through the use of lengthy documents that are time-consuming and difficult for patients to read. Because of this, important information about the drugs is easily missed.

We took existing opioid agreements (originally in the form of dense, unformatted word files) from both UC Davis and Hill Country and worked closely with providers at each clinic to co-design new documents that would serve not only as "contracts," but would help facilitate meaningful conversations. We applied information design best practices and plain language revisions to make dense information easier to understand and risks easier to talk about.

patient education materials

a suite of tools to support patients in their decision-making at every moment of their treatment

Through our research with providers, we also identified a need for an accessible, welcoming, and nurturing ecosystem of educational materials to wrap around patients in their treatment journeys.

Pain treatment is a tedious and difficult process, where much of the information presented to patients is unfriendly and complex. Providers asked us for materials that would demystify the treatment process, create a more expansive sense of possibility, support patients in their decision-making, and explain complicated topics in plain language. We created the following suite of materials.

New pain patient comic folder

Pain patients receive a hefty packet of documents to work through. We designed a folder to house these documents that also doubled as an explainer for how pain treatment worked. We used graphic novel / comic book style illustrations and easy-to-follow language to help patients know what to expect. (Hill Country)

Pain treatment options poster

Realizing that not everything needed to be on printer paper, we designed a poster of pain treatment options to expose patients to a variety of different non-medication pain treatment modalities. Patients can absorb these options by perusing posters in the exam room while waiting for their provider. (Hill Country)

Pain treatment decision cards

We prototyped a set of cards exploring an interactive approach to pain treatment — by inviting patients to select and rank cards that interest them, providers could engage patients in a more balanced two-way conversation than with a document alone. (Hill Country)

Intro to opioids explainer video

Alongside providers, we also co-created an animated video to help prospective pain patients get oriented to pain medications. This video is housed in the hospitals EMR and was designed as required viewing for patients getting a new prescription for an opioid. (UC Davis)

outpatient radio

a patient-to-patient chronic pain listening project

Most of pain treatment unfolds beyond the exam room walls, too often in isolation. To connect directly with patients (and help patients connect to each other), we piloted a radio special of chronic pain stories.

Weaving together the stories of eight chronic pain patients from Solano, Sacramento, and Shasta Counties, Outpatient Radio explores ways to help patients and communities talk about chronic pain and chronic pain treatment. Through collecting and sharing stories in-person, on-air, and online, we sought to connect, inform, and support communities through listening and conversation. The project was produced in collaboration with Hill Country Health and Wellness Center (Shasta County) with support from Art Rx at the Crocker Art Museum (Sacramento County). The program originally aired on KKRN 88.5 FM in Round Mountain, CA. It has since aired on on KDVS 90.3 FM in Davis, CA and is available for streaming online. Our goals:

combat the stigma and isolation of chronic pain by sharing patient stories
improve patient and public understanding of the many issues surrounding chronic pain and pain treatment
engage the North State community in this issue through radio programming, interactive listening events, and more

more work

Public Service Sampler PackDesign

Headspace HighlightsDesign

DARB 1000Design

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trace manuel.

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tm@tracemanuel.com
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