Background

In the current market landscape, fecal sample tests are take-home largely because no one can have a bowel movement on command. However, because these tests are notoriously unsavory, the test are often left unfinished. As a result, many patients may go undiagnosed.

Problem: Our client approached us to understand why the rates of return for their fecal sample tests were so low and to determine new ways they can redesign the sampling experience.

Patients described collecting their own stool samples as "traumatic" and "disgusting," while all the clinicians that we spoke to chuckled sarcastically when we inquired if there were any pain points. It's poop. No one wants to touch it, but someone has to process it. So how do we design a better fecal sample collection experience?

One of the primary focuses for this kit is to test for H.pylori, Salmonella, Para typhi, and Clostridium difficile. Patients who are typically testing for these are already ill and experiencing GI upset and loose stools. Sample consistency and baseline volume for testing were major components that we took into consideration in our designs.

My Achievements:

1. Engaged people in conversations over sensitive topics. Pooping, in general, can be hard to talk about, especially with strangers. Talking about the intricacies of collecting a stool sample puts people in vulnerable positions. I was particularly aware of creating safe spaces during the project, and made sure that I provided reassurance during interviews and limited the number of observers/notetakers to one additional team member other than myself.

‍2. Won over a hesitant stakeholder to the importance of research. Our clients on this team were hesitant about generative and analogous research. My design lead and I set up separate meetings with our clients to discuss their concerns, and I provided strong reasoning behind each step of my research roadmap. By the end of the project, our clients were fully on board and excited to share this project with their stakeholders!
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3. Emphasized inclusive design, even for poop. Toilet habits differ all over the world, and having a NA-based team meant that our designs would be biased for western toilet habits. I pushed for desk research and global diary studies to learn more about stool testing and toilet habits globally, and as the only team member with experience using squat toilets, I constantly reminded them that our designs would also need to fit them.

4. Inspired the team with analogous research. The stool sample testing kit is one of the least-innovated products on the market. Because of this, I wanted to ensure that the team was feeling inspired before our ideation sessions! This research plan was built to innovate, with an astronaut, owl pellets, a focus group with backpackers, and global toilet habits desk research!

On the right, we're warming up for standup by sharing household items that we thought could catch poop.

Challenge

How might we uncover new opportunities for the fecal sample collection experience within the current clinical practice for diagnostics?

Framing the Research Approach

1. What is the current patient, clinician, and ecosystem workflow for sample testing and collection?
2. What do patients have to do today for self-collection, and what would be the ideal experience?
3. What aspects of the workflow are driven by user experience and adoption versus clinical standards, regulatory restrictions, and accessibility?
4. How might a range of sample qualities be accounted for? What are the moments of error due to user experience?
5. What is the current market landscape for outpatient facilities (e.g. clinics, pharmacies) and at-home fecal sample collection?
6. What are possible short-term solutions? Long-term solutions?

Research Approach

Research Goals

Our goal was to better surface opportunity areas within the fecal sample collection space, considering touchpoints and stakeholders across the process (such as patients, clinicians, pharmacists), and exploring upstream opportunities to impact the diagnostics workflow. In particular, we wanted to understand the workflow of primary gatekeepers such as general practitioners, pharmacists, or health outreach workers in order to expand the use of these tools.

My research was tightly scoped and thoughtfully recruited to surface rich stories that will inspire innovative thinking and unearth meaningful design opportunities.

Key Methods

Desk research: To learn about the various bathroom habits, sentiments, and environments around the world, focusing primarily on the client's target countries outside of the U.S.
Stool tests for the team: To learn more about the various tests kit, equipment, and materials available in the market. We documented our personal experiments with various stool sample tests (i.e. microbiome) so that we could gain a deeper understanding of the intricacies of the sample collection process.
Owl pellet dissection: To understand our own attitudes towards handling stool and “getting comfortable” with it–particularly stool that is not our own, and that is often dissected as a form of play and discovery.
Client stakeholder interviews (9): To learn about the goals, desires, and needs from client stakeholders around the world, and to understand the market landscape and internal decision-making processes. We had 5 conversations with stakeholders, and sent out a survey to 4 who did not have the time to meet with us.
In-depth interviews (7): To dive deeper into various human experiences with stool sampling. I spoke with 5 patients (including 1 parent), 2 clinicians, and 1 diagnostics program expert.
Practitioner focus group (3): To learn about clinical standards in fecal testing and to understand the various touchpoints of the journey between patients, clinicians, and labs. I designed a journey mapping activity for clinicians with experience diagnosing GI tract issues and order fecal testing.
Athlete focus group (3): To get inspired by how athletes who spend much of their time outdoors (a.k.a. "extreme poopers" in the context of this study) handle their waste when they are not near a toilet. I designed and led a co-creative a focus group session with backpackers and rock climbers.
Diary study + survey (13): To uncover pain points along the stool sample collection process and gather concept feedback from people around the world. We followed patient experiences with their sample kits and tested sacrificial concepts with a digital diary study that was launched on DScout. This study was released in 4 parts. Parts 1-3 (general background, test kits, and testing environment) were released earlier, followed by Part 4 (concept testing) during the latter half of research.

Timeline

Impact

Product Impact:

Innovative designs for a test kit that has not been redesigned for years.
Comprehensive designs for all touchpoints of the user journey.

Strategy Impact:

Key opportunities backed by research for both the short and long term that reach beyond the sampling kit. For example, recommendations ranged from alternative collection methods, such as a rectal swab, to educational campaigns that empower patients to understand and select their preferred sample collection method.
Complete test kit recommendations for the short, mid, and long term opportunities.

Stakeholder Impact:

This project gained a lot of traction at both client and internal companies, strengthening our relationship and leading to future work together. For months after this project's end, I continued to share this project during various gatherings and meetings around IDEO.

Learnings & Reflections

Analogous research is gold. This was one of my first times implementing so much analogous research into the research roadmap. However, each analogous experience, from owl pellets to astronauts to extreme poopers, inspired the team and helped us view the fecal sample experience from another angle. I learned that you can truly find inspiration in the most random places.
Love the problem space, but don't get too attached to a specific solution. The entire team and I were excited about one specific design that we (as individuals who lived in North America) felt would make the fecal sampling experience more intuitive. This design was inspired by toilet paper. However, we learned from our survey that using toilet paper would actually be uncomfortable for participants located in some parts of Asia, where bidets and washing methods are more common for cleaning after bowel movements. As a result, this idea would not be as intuitive and accessible as we had hoped and we continued diving into the problem space to reiterate on other solutions.
You don't have to be a "Designer" to ideate well. Perhaps it's because this project touches on the universal experience of pooping, but this research sprint was one of the most collaborative experiences in my career thus far. That's saying a lot! All of our ideation sessions were an all-hands team moment, where everyone dove in to generate concept ideas. One of my concepts, inspired by jewelry prongs, ended up as a final concept (after some iterations from our industrial designer, of course)!
Stand in your expertise. At first, our clients were extremely hesitant about my research approaches. This was difficult for me initially, since I had previously worked primarily with clients in the design field who were used to diverging moments early on in the design thinking process. My project lead and I set aside extra touchpoints with the client to keep them informed along our process and answer their questions. I made sure to clearly lay out my reasons for each part of the design research plan that I shared with them. Our client reps ended up being our biggest advocates at the end of this project!
If I had more time... I would implement field research into the study, especially for our target countries abroad. Even though we spoke with many practitioners, we didn't get the chance to see any labs (the needs vary based on rural vs urban locations) or watch how tests are assembled by clinicians. This would be valuable as we continued to iterate on our concepts to ensure that our designs could be used across a diverse audience.

A Better Fecal Sampling Experience (IDEO)

Background

Challenge

Framing the Research Approach

Research Approach

Research Goals

Key Methods

Timeline

Research Outcomes

Research Findings

Journey Map

Collection Tool Design

Impact

Learnings & Reflections

Return to WORK

I'm always open to fun projects. Let's chat!