Quintal is a platform for sustainable and engaging reporting for Health Care Workers where plants represent patients that need care.

Quintal is my BA Thesis project, where I worked for 4 months in primary and secondary research, concept development, prototyping, coding and testing.

I learned how to work with NodeJS and MongoDB from scratch to make it work.

DETAILS

It’s a web-based platform accessible by phone, tablet or desktop. Each Primary Heath Care worker have a yard (quintal) with their plants (patients). To make these plants grow beautiful they need each other’s help: they will only blossom after being watered by another health worker.

CHALLENGE

How can we leverage communication within primary health care teams to improve the quality of health services in a sustainable way?

MY ROLE
(SOLO PROJECT)

  • Research
  • Concept Development
  • Prototyping
  • Interface Design
  • Code Implementation

OVERVIEW

Family Health Teams are responsible for the health of a particular population, having as their main actress for the field work the figure of the Community Health Agent. They use tools of general use to supply the lack of professional communication resources.

This project aims to understand the context in which these workers are inserted and design a technological artifact that increases the quality of communication between them and, finally, improving the quality of the health services offered to the public.

RESEARCH

Contextual Inquiry

Field research was 3 weeks long, took place in two health centers and two patients homes in the northeast of Brazil. Both professionals and patients were interviewed.

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Entrance of Health Center

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Inside-view

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Card-sorting with Health Care professionals to understand roles and responsibilities

Key Findings

Since there are no official tools, they invent their own, such as this notebook with patient data labeled with codes.

1. Lack of professional communication tools

To meet de demand for work communication, these professionals use tools such as WhatsApp to exchange information about patients and schedule. Calls are made when there is an urgency.

Everyday the physician makes a written-copy of the official patients list for the day before handing it in to the recepcionist.

2. Information is not accessible

The lack of resources and tools make information storage a problem. In one of the health centers the patients data is inside an archive that is at the physician’s room – it means that whenever other professionals need these infos, they will need to interrupt any medical appointment happening. Another example is for the patients list: everyday a transcript is made in a piece of paper.

During a workshop they exchanged information about routine and common problems. Miscommunication in spontaneous demands was a critical point.

3. Spontaneous demands for communication

During the day many demands appear, such as patients that want to be scheduled for the same day, people with doubts and emergencies. For these cases, the key professional in situation needs to be contacted, but that sometimes doesn’t happen due to many reasons: work overload won’t allow communication, forgetfulness, the key professional is busy, etc.

Focusing on Community Health Workers

During the research, the figure of the Community Health Worker stood out as the important link between the Health System and the community. I decided to focus on them because of their importance in the functioning of the system.

“Perhaps the most important developmental or promotional role of the CHW is to act as a bridge between the community and the formal health services in all aspects of health development… the bridging activities of CHWs may provide opportunities to increase both the effectiveness of curative and preventive services […]”

Kahssay H, Taylor M, Berman P (1998). Community health workers: the way forward. Geneva, World Health Organization

The Community Health Workers’ Routine

1. Fill in Home and Individual Registers

Every house and individual in a family need to be registered with detailed data.

2. Visitation planning

For each house the agent goes to, she needs to check the health of every individual. This planning is made by themselves, usually written in a notebook.

3. Visiting patients and filling Visitation Form

They visit the patients every cycle. The cycle is shorter if that patient is sick of bedridden. Every visit needs to be registered in a form.

4. Request scheduling of Home Visits and Sample Collection for exams

Visits with physicians and nurses are scheduled to the bedridden patients’. Because of that, their agenda needs to match.

5. Deliver results of examinations / referrals to bedridden patients

After any appointment or exam, they usually deliver the results in person to check the patient’s condition.

6. Entry visitation data and deliver papers

All CHW need to enter visitation data in the E-SUS web system and submit visitation papers to the Secretary of Health of the municipality. It’s the step they dislike the most, so the data and papers accumulate to the last week.

IDEATION

The key findings brought clarity and focus to what would be our challenge from now. After gathering data from different markets, reading articles, doing field research and identifying the main pain points in the system, it was the time to craft a meaningful and actionable problem statement.

How might we leverage communication between health care professionals in a team, for better Primary Health Care services, in a sustainable and engaging way?

Requirements

Promote Communication

Research has shown that ineffective communication is one of the keys for their work. The solution aims to promote work-related communication in a way that is easy to understand and transmit.

Work well on old smartphones

Since their salary rate is from low to average. It is common for them to use low-tier phones.

Low data usage (3G)

Their data is pre-paid and mainly needed because of WhatsApp and Facebook. There is no hope about having the municipality paying for it.

Concepts

Concept 1: Gianbot – Chatbot assistant

Gian is a chatbot that helps the team managing schedules and patient records. He facilitates the contact between CHW and physicians/nurses for appointment management and patients list. He’s based on Rede Globo‘s actor Reinaldo Gianecchini, who once played a butler in an advertisement.

Technologies used: PHP, Telegram

Concept 2: Quintal – Collaborative gardens

Every worker has a Quintal (“Yard”), where their plants are their patients. To make and maintain a beautiful quintal, they need each other’s help because watering your own plant is not allowed and you need your friend’s help.

Technologies used: HTML5, CSS3, NodeJS, MongoDB

Prototyping

The preference of Quintal over the bot was clear when the Community Health Workers highlighted the visuals of the gardens. While Gianbot’s interface is mainly through text (keywords combination), Quintal would offer much more appealing features. The emotional aspect here was visible, and that would come to battle the lack of engagement due to bad work conditions.

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Gianbot’s features

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First sketches of Quintal

A worker trying a prototype of Quintal

Final Solution

Interesting?

Let’s chat and find out how we can help each other.