Empowering Cancer Patients and Clinicians through Simulation
Mobile Application
March - September 2023
Product Designer
The Simphony app aims to reduce the duration of cancer treatment by empowering patients to practice prescribed breathing exercises at home, using simulations to enhance preparedness for the actual treatment. Additionally, the app offers progress tracking and sharing capabilities with the care team, along with a comprehensive FAQ library on cancer and treatment options, fostering discussions and supporting patients.
As the culmination of my graduate capstone project at the University of California, Irvine, I collaborated with a team of accomplished product designers to tackle pressing challenges within the cancer radiation industry.

Our esteemed client, Varian, a leading healthcare technology company, engaged our team as contracted partners with a paramount mission:

"Uncover a groundbreaking solution capable of significantly reducing treatment time for cancer patients."
Preparation of patient for treatment with Varian's TrueBeam radiation system.
Uncovering Inefficiencies
Our journey began with an eye-opening meeting where Varian presented us with a focus study conducted across their facilities in Switzerland. The study's findings revealed a startling inefficiency in the radiation treatment process.
Average duration of cancer radiation treatment in Switzerland.
Out of a 15-minute treatment session, a mere 2-3 minutes were devoted to administering the vital radiation beam. This striking revelation meant that a staggering 80-87% of the treatment time remained underutilized, highlighting critical areas ripe for innovation and optimization.
Framing the Challenge
With such a complex problem presented to us, defining the boundaries of our project scope proved to be an ongoing exercise; we started by translating the problem statement to this:

How might we facilitate human connection in radiation treatment that involves respiratory motion management?
Diagram of the Double Diamond framework.
Leveraging the Double Diamond Framework
Throughout the design journey, the Double Diamond approach served as a guiding framework. By oscillating between expansive thinking and focused execution, our team ensured we remained user-centric, adaptable, and innovative, leading to a design solution that was both thoughtful and effective.
To get started with such a project, our team knew it would be important to set the stage with a comprehensive understanding of the radiation therapy landscape.

As novices in the field, we needed to start with the basics and gradually work our way into more complex material. From there, we could begin compiling information about competitors in the oncology technology space to learn about how we might potentially differentiate Varian’s product offering from that of existing solutions. Finally, to grasp what a tangible solution might look like in reality, we wanted to visit the Varian facility in Palo Alto, where we could begin applying our insights into a physical space.

To accomplish these goals, our group decided to:
• Complete a Literature Review
• Conduct a Competitive Analysis
• Perform an On-Site Visit
• Host Clinician Interviews
• Construct Visual Models
Literature Review for Deeper Context
With no familiarity with the radiation therapy space, let alone the oncology technology sector, our group began the exploratory phases of our work with a literature review.

In the literature review, we compiled information about:
• Cancer as a disease
• Radiation therapy as a practice
• The forms of radiation therapy in use today
• The importance of precision and dose in radiation therapy
• Motion Management solutions
• Varian’s Motion Management technology and its applications
• The limitations of Varian’s existing motion management solution
• Competitors in the field

Our literature review helped paint a broad picture of the oncology field, helping us understand the complexities of cancer and cancer treatment, as well as some of the key problems experienced by individuals leveraging Varian’s motion management solutions today. With these insights in mind, we wanted to take a closer look at the solutions of other oncology technology companies to determine what sort of insights we could glean from Varian’s greatest competitors.
Scoping the Competition
With a basic understanding of radiation therapy captured, our team next decided to analyze some of Varian’s key competitors in the motion management space. We evaluated each company’s product based off of three key criteria; patient experience, clinician usability, technical capabilities.
Competitive analysis chart of motion management for radiation treatment.
Following the conclusion of our competitive analysis, our group determined the following insights:
• The majority of motion management products either do not interface with others or do so only with a select few competitors.
• Competitors often employ a combination of motion management techniques in order to reduce patient discomfort and improve radiation accuracy.
• Motion management solutions are highly customizable but still require constant manual use, reducing time spent with the patient.
Onsite Visit
Three members of my team made the trip to Varian’s Palo Alto campus to take a closer look at Varian’s existing technologies and to develop a deeper understanding of the ergonomic requirements of treatment facilities.

We left the on-site visit with a collection of videos, photos and transcripts that we were able to share with our broader team. These artifacts shed light on the barriers that exist between care teams and patients, the manual processes that radiation therapists are forced to complete, and the UX/UI design of the devices that are available with Varian’s TrueBeam system.  
Photographs collected from the onsite visit to Varian Headquarters.
To make the most out of these findings, our group began constructing a series of visual models in order to further situate ourselves within this context.
Conducting Interviews
To begin our stakeholder interview journey, we leveraged the findings from our literature review to identify the key stakeholders involved in the radiation therapy process. We knew that we would need to interview radiation oncologists, radiation therapists, physicists and dosimetrists to get a sense of the full radiation therapy picture. With these roles identified, we worked with a radiation therapist at Mayo Clinic to recruit participants from each of these professional backgrounds for our research.

In total, we recruited and interviewed;
• Four Radiation Therapists
• One Radiation Oncologist
• Two Physicists
• One Dosimetrist
• One Veterinary Radiation Oncologist

Over the course of several weeks, our group completed 1-hour long, recorded interviews with each participant, documenting findings along the way. When our interviews concluded, we participated in an affinity mapping session to triangulate the common themes that emerged amongst our participants.
Physical Model
Our findings from the on-site visit helped us construct several different models to make sense of our data. Thinking holistically about the experience, our wireframes weren't just isolated screens but represented a user's journey through the product.

This hands-on encounter paved the way for creating a physical model that not only bridged theory and reality but also served as a constant reminder of the user context, profoundly influencing our design process and ultimately leading to the development of a product that is truly impactful and aligned with real-world demands.
Floorplan of Varian’s Radiation treatment site in Palo Alto, California.
Radiation Therapist’s view from
within the Control Room
Flow Model
Next, our pursuit to better understand the complexities of radiation treatment led our team to craft a Flow Model. Given the intricate nature of this medical procedure, which demands precise planning and coordination, we faced misunderstandings and misinterpretations due to our relative novelty in the field. To navigate these challenges, we delineated the crucial stages of treatment, emphasizing the interrelatedness and dependencies between each phase.

Rather than a mere linear representation, the Flow Model accentuates various facets of the treatment journey, such as:
• Preliminary activities such as patient consultation, imaging, and devising treatment plans
• Routine tasks performed during the treatment phase, including the calibration of machines and patient positioning
• Subsequent protocols after treatment
Flow model of radiation treatment journey.
Empathy Map
To gain deeper insights into the traits and perspectives of our interviewees, we crafted Empathy Maps. In creating these maps, we captured our future users’ emotions, thoughts, and behaviors to gain an empathetic understanding of their needs, challenges, and experiences - the ultimate goal being to develop a solution that truly resonated with our target audience.
Empathy maps for a therapist and patient.
Workshopping Ideas
Once our group was aligned on the problems we felt were most significant to our stakeholders, it was time to determine what we could actually do about them. To determine a path forward, our group compiled our insights in a single Figma board and completed a light-speed ideation session.

the course of an hour, we spent time generating solutions for each insight and overall problem statement. We developed our solutions independently and jumped from statement to statement in five-minute increments. Once we covered all insights, each member of the group took five minutes to present their most compelling ideas.

One individual from our group operated as a notetaker, jotting down each individual idea and combining ideas where there was significant overlap. At the end of presentations, we sorted our ideas into an impact-effort matrix that helped us think about the practical viability of each solution. Once we finished sorting, we voted on the idea that we felt would create the greatest impact with the maximum effort we could afford.
Figjam file of impact effort matrix documenting potential solutions.
While scope proved to be a constant challenge throughout this project, we concluded that the most effective way to support clinicians was by designing a solution that naturally empowered patients. The obvious starting point was to redesign the screen that guides patients through the various breathing exercises necessary during treatment.

To go beyond the bounds of in-person treatment, we also decided to create a take-home solution for patients to familiarize themselves with the interface and practice the required breathing patterns.
Pushing Forward
To accommodate our tight schedule, we split our team into two groups. Three team members focused on refining the overall design, while the remaining three initiated interviews with cancer patients to gain deeper insights.
By initiating our project with wireframing, our team was able to establish a shared vision of the product's structure. This helped reduce ambiguities and
misalignments that could arise later in the design 
phase, ensuring everyone was on the same page from the get-go. By laying out potential features and content elements visually, we could prioritize and sequence them based on user needs, ensuring the most crucial elements received prominence.
Initial wireframes for Simphony's mobile app.
The tangible nature of wireframes also catalyzed discussions among team members and facilitated feedback sessions, enabling productive critiques which ensured our design was refined at every step. Thinking holistically about the experience, our wireframes weren't just isolated screens but represented a user's journey through the product. This visualization highlighted any potential navigation pitfalls, making certain that
the final design would offer a seamless and intuitive
user experience.
Finding our Niche
For our first phase of feedback, we wanted to engage with potential users to determine the level of complexity we should incorporate into our product. In the nascent stages of our product’s development, we debated the level of connectivity our product should offer. To gain clarity on the subject, we conducted two different 1:1 interviews with cancer patients who were familiar with the relevant breathing techniques and who had experience receiving cancer treatment.

These interviews revealed that:
• Both participants had a poor experience communicating with their care team throughout
the treatment process
• Not all patients use a smartphone device to use such an app
• Patients are looking for a way to practice
relieving anxiety
• Other apps with greater complexity exist, just not with the new breathing exercises we developed

Following this round of research, our group understood that we needed to:
• Ensure that our product would facilitate communication between patients and their care teams
• Develop a brand identity and language that acknowledge and accommodate for the anxiety that patients experience when undergoing treatment
• Explore roadmaps for the future where the product offered connectivity with existing patient portals and EHRs
Visual identity for Simphony.
Building a Brand
Following the first round of research, I worked closely with the other designers to create a cohesive brand identity, encompassing the brand name, color scheme, and logos. Following multiple iterations, we settled on the name "Simphony" to convey the harmony between the patient's simulated experience and their treatment journey.
Early names and logos for Simphony.
Deepening our Empathy
As we continued to explore wireframes, the group of designers needed more input and perspective from cancer patients to better orient the direction of the application. For our second phase of research, we shared updates to our wireframes and focused the discussion primarily on care provided throughout their treatment process.
Low-fidelity mockups for Simphony's mobile app.
Over the course of an hour and a half, we facilitated a virtual discussion amongst four patients, who revealed that
• Patients are forced to advocate for themselves aggressively and, oftentimes, in the face of apathetic and dissenting providers
• Educational materials are important for diagnosed individuals and their loved ones
• Patients conduct their own research understanding that the care they want/need does not often align with the care they receive
• Patients experience mental fog during the treatment process, making it more difficult to understand everyday things.

With these insights in mind, our group understood that we needed to:
• Develop a comprehensive onboarding experience that would accommodate for users’ mental fog and educate them on the app’s benefit
• Add a resource library into the app where users and their loved ones could learn more about important concepts explored in the app and other frequently asked questions
• Create uniform, easy-to-follow language throughout the app
• More demonstrative tutorials that could educate
users on how to successfully perform each breathing exercise.
Compiling all we had learned from our interviewees about their lived diagnosis experiences, our group next needed to determine how Simphony might fit into the fabric of a patient’s life. To gather our thoughts, our group completed a user journey mapping session, focusing on three key moments in a patient’s cancer care experience:
• Consultation with Radiation Oncologist
• Personal Research
• Onboarding and First Use

Working our way through each moment, our group analyzed the various actions patients would take, their primary needs and pains in each moment, and their feelings throughout the process. Taken together, we began understanding how to create an in-app experience that might accommodate the complexity of a patient’s diagnosis and subsequent treatment experience.
Journeymap created in FigJam for a user's onboarding experience.
Everyday tasks felt more labor intensive, stress and anxiety abounded, and overall cognitive function. And yet, here we were, designing an app that required a considerable level of attention and focus from our users. To maintain the complexity of functionality of our in-app experience, we knew we would need to identify opportunities to instruct our users in a streamlined, simplified manner.

We also knew we would want this information to be readily accessible, should our users ever want a refresher on any material covered. To get started with this undertaking, our group first outlined the core features available to users in our app. Next, we sought to define those features in as plain of language as possible.

With those features outlined and defined, our designers then created accompanying in-app demonstrations as a supplementary teaching device. Once we built an understanding of all that we wanted our primary users to accomplish when first interacting with the app, we immediately identified a problem. Throughout the course of our research, our group continued hearing about the “mental fog” experienced by patients as they were undergoing treatment.
Simphony's initial onboarding experience.
During the tutorial, users would also learn about our in-app tutorial icon. This icon, present on every screen in our app, can be clicked on at any time to activate a guided walkthrough of our app’s core features. By making this material ubiquitously available, we believe that we can ease the cognitive burden placed on our primary users and equip them for effective, meaningful experiences with our product.
Determining Usability
Following our first two rounds of research, our group was able to incorporate the insights we gathered into a more fully fleshed out design of our product.

In our third round of research, we wanted to test this new design with a batch of users who had existing familiarity with other breathing apps or tools. We also wanted to conduct research with at least one user who had a visual impairment in order to assess the overall visual accessibility of our product. 

Mid-fidelity mockups for Simphony's mobile app.
Over the course of three different, one-hour-long interviews, users revealed that:
• Simphony felt like more than a breathing app due to the data, educational resources and FAQs contained within the in-app experience
• They would appreciate more instruction and descriptions throughout the app’s pages
• Some pages felt overwhelming due to the abundance of information featured.
Taking these findings into consideration, our group elected to:
• Permanently store tutorials and in-app guides in a floating tool-tip that follows users from page to page
• Simplify the content and designs contained on each page
• Create more visual cues, as previously highlighted and requested by our focus group
• Personalize the homepage analytics to engage with users more effectively
Iteration of the onboarding experience for Simphony.
Progressing Designs
For our fourth and final round of research, our group wanted to put our near-complete product in front of users for a comprehensive heuristic evaluation of the in-app experience and to validate key user flows.

Over the course of two 1.5-hour, moderated interviews, our researchers asked users to review:
• Registration/Sign-In
• Onboarding Tutorial
• Homepage
• Practice Breathing Exercises
• Reflection
• Learn
• History

At the conclusion of the interview, users were also asked to provide thoughts on their overall impression of the app, as well as any feedback they might like to see incorporated for future iterations.
High-fidelity mockups for Simphony's mobile app.
Reviewing transcripts of these recordings, our group determined that:
• Users had an overall positive impression of the app, making special note of the clarity of information, color palette and accommodation of patients and their loved ones.
• Users had different impressions of what the in-app experience might look like for “caregivers,” interpreting that experience to contain restrictions on data 
privacy or a more robust collection of general 
support resources.
• Users were fond of the analytics we displayed on 
our home screen, but craved deeper insights and consistency of language.
• Users were slightly confused about the labeling of
the calendar contained on our History screen and 
the overall purpose of the Reflection screen since it 
wasn’t immediately clear that it was tied to a breathing exercise.
• Users were slightly confused about our Practice
icon, mistaking it for a “Play” button for a video.

While there were areas for our in-app experience to be optimized, users were overwhelmingly receptive to our concept and were thrilled to see the resources available
to them through our product.
Finalizing the In-App Experience
With the fourth and final round of research complete, we relayed our key findings to our design team to make the last set of adjustments to our in-app experience. Namely, our Designers spent time:
• Establishing a clearer distinction between Registration Screen animations and buttons
• Adjusting units of measurement for in-app analytics
• Associating iconography with intended functions
• Developing a progression indicator for our initial onboarding tutorial
• Incorporating more real-time feedback to users during practice session sequences
• Adjusting color contrast of buttons and the Expiration Hold screens
• Improving the structure of information presented within the Learn section of our app

Over the course of the final week of our project, our Designers incorporated these changes to bring our app’s final designs to life.
Future State
When we initially embarked on this project, six months felt like an eternity. But as time passed, we became poignantly aware of our temporal limitations. While many meaningful, valuable ideas emerged throughout the course of our project’s creation, we knew we needed to be judicious about scope to get a fully completed deliverable across the finish line in time. With more time and resources, however, our team believes there would be immense value in adding the following features to future iterations of our product:
• Robust Integrations
• Caregiver Experience
• Enhanced Accessibility
• Breathing Exercise Customization
• Personalized Analysis & Actionable Feedback
• Free Journal/Edit Reflections
Robust Integrations
Following our initial rounds of usability tests, our group learned about the value patients found in using our product to foster dialogue with their care team. Today, Varian has a product called “Noona” that allows patients to accomplish such a task. By integrating Simphony and Noona into one cohesive product, our group believes 
we can bring real-time conversations to life with the enhanced functionality we have outlined in this project.
Integration of data between Noona and Simphony.
Caregiver Experience
In both our foundational stakeholder research and our usability testing sessions, we learned about the vital role caregivers play throughout the patient treatment experience. Today, patients feel their caretakers lack the support they need and deserve to navigate this time of immense hardship. For future iterations of this work, our group believes more time should be spent learning about how we can modify our product’s existing functionality to provide greater support, resources and assistance to caregivers of patients.
Caregiver selection during account configuration.
Upgraded Accessibility
During our on-site visit to Varian’s Palo Alto campus, our group learned about the many compounding factors that influence the treatment delivery experience. Patients come from a varied range of backgrounds, managing deafness, blindness and limited mobility. To account for these conditions, our group believes future iterations of this product should contain haptics-based instruction, audio coaching and voice-based commands.
Practice availability on haptics-based smart watches.
In the late stages of our usability tests, we heard from patients about their fondness for our design and its existing color palette. However, when presented with our various breathing exercises, patients were drawn to some designs more than others and expressed a desire to customize certain visual elements of their in-app experience. For future iterations of this work, our group would like to grant users the ability to adjust color schemes, breathing visualizations and audio preferences to fit their needs.
Lessons Learned
Diversity in Teams
Our project highlighted the power of diversity within project teams. A diverse team brings a wide range of perspectives, which can lead to more informed product development. Team members with accessibility and healthcare industry experience proved invaluable.
Recognizing Time Constraints
Our project experience demonstrated the challenge of managing time constraints. At times, ambitious ideas had to be shelved due to project timelines, teaching us the importance of scope management and feature prioritization.
In conclusion, our capstone project with Varian has been a transformative journey. We conducted in-depth research, designed the Simphony app to enhance patient experiences, and received outstanding feedback. We've learned the value of diversity and ongoing research, setting the stage for future enhancements to Simphony. This project has shown the potential of design in healthcare, and we're excited to continue improving the patient experience.