Dentist, ASD & Design Thinking: accessibility first
Going to the doctor is something hardly pleasant for anyone. It alters our routines, it occasionally requires us to undergo uncomfortable tests and can lead to an unfavorable diagnosis. In particular, dental specialisation adds to the financial expense, since Spanish social security does not cover all necessary treatments.
The challenge that was posed for us was to improve the user experience in dentist appointments in Spain. It was undoubtedly a complex goal, but also one full of opportunities.
Methodology
In order to tackle such a broad objective, my team and I decided to use the Design Thinking or Double Diamond methodology. How does it work? This method consists of four phases: first of all, an extensive documentation to understand the problem in all its length. Second, a synthesis that summarizes all learnings in insights, focused on the most important points for improvement. Third, ideation, using these insights to find a specialized and efficient solution. Finally, in the creation phase, the team lands these ideas in the form of a concrete and well-defined value proposition.
Research
My team carried out both exploratory documentation (desk research, benchmarking, ethnography, netnography, etc.) and evaluative documentation (interviews and surveys) to gather the widest variety of information in the shortest time possible. To achieve this, we drafted a series of research questions, classified them according to the topic, and studied which techniques could best be used to obtain each piece of information.
With these questions helping us target our objectives, we conducted a total of six in-depth interviews (with both patients and clinic professionals), a survey answered by more than 100 users, a safari, in-depth benchmarking, desk research focused primarily on social security dentists, and a very extensive netnography.
Throughout the research process, we found many ideas were repeated. However, one of the most relevant was a tweet found during netnography, which gave us a new perspective that no member of the team had considered: accessibility for neurodivergent people.
Wait, but what’s neurodivergent people? They are people with atypical neurology. The term is used to refer to people with ASD (Autism Spectrum Disorder), but it can also refer to people with other divergences, such as ADHD. Many of them have hypersensitivity to external stimuli, that is, they receive sensory stimuli with much greater intensity. There are also people with hypersensitivity who are not neurodivergent.
At this point, we redirected our research, focusing it on this type of user. In order to do so, we conducted another in-depth interview, this time with Alba, a 28-year-old girl with autism, who told us about her experience going to the dentist. We discovered that small things that for neurotypical people only influence comfort (lights, sounds, music, smells, colors), for some people with different degrees of autism are a problem and can make a big difference.
“I think my best dental appointment was this one time when Spotify started playing Fleetwood Mac and I was just living my best life while I was getting my tooth sawed off.”
This how our Design Thinking became an accesibility challenge.
Synthesis
Once all the information was gathered, all members of the group shared the conclusions we had drawn from the documentation phase, highlighting those aspects that had caught the attention of several of us. These were our insights:
- People care about their oral health, but price is an issue and it would be taken more seriously if it were included in the public health system.
- Communication is the factor patients value most in medical appointments.
- Noise is one of the most unpleasant factors for patients.
- There is currently no accessible service for neurodivergent people.
- There is a lack of education in general about oral health. The fear of the dentist is lower in younger people, because they have received better education since childhood.
We decided to focus on accessibility for neurodivergent people, noise and communication, as we realised they were interrelated and a single solution could improve several aspects of the user experience.
To know exactly how to address this problem, we used the resource of the User Persona, that is, we created a model patient that would collect the most important aspects of the user experience: their goals, their motivations, their frustrations and their most notable characteristics.
Once we established our model user, we created their User Journey, that is, we analysed each part of their experience to detect which moments and problems were most important to focus our solution on. We discovered that with some small changes throughout the experience, such as the atmosphere in the waiting room and in the medical room, we could greatly improve the visit to the dentist for hypersensitive or neurodivergent people.
The synthesis process helped us so much in understanding the problem that when the ideation phase arrived…
Ideation
…we all had it clear! We already knew what we wanted to focus on, how we wanted to approach it, and it was very easy to reach an agreement because the whole team was already on the same page. In any case, we did a small idea selection process (based on the desirability-feasibility relationship) in which the first idea we had discussed was chosen by a landslide: designing an adaptation plan for dental clinics that would ensure accessibility for neurodivergent people.
Of course, once we had decided on the approach we wanted to take to this solution, the first thing we did was carrying out a new benchmarking: what are the clinics like today? Are there any clinics already adapted for neurodivergent people? We discovered that there were, although not many, and that they had two characteristics in common: extremely good reviews on the internet and enough relevance for some users to travel long distances to access them.
We also investigated the needs of patients with ASD and neurodivergences for these clinics. We highlighted good communication and close relationships, as well as sensory adaptation of spaces, including noise cancellation and adaptability of lights.
To finally put the concept into practice, we created a Business Model Canva, a document focused on the more technical aspects of the product, such as defining the clients, partners, resources we need, our value proposition, costs and benefits.
This is how the Teehtistic Plan was born. We were ready to begin the creation phase.
Creation
One of the strengths of Design Thinking as a design method is that, once the team reaches the creative part, it is impossible to be blocked. Designers have so much information and are so familiar with the problem that solutions will always emerge. Of course, the efficiency and effectiveness of these solutions will depend on the level of commitment, creativity and effort of the team.
Our solution, the Teethtistic Plan, consisted on creating a plan to adapt dental clinics to achieve accessibility for neurodivergent people. We discovered that the solution had to be analogical, because the biggest pain points were in the physical aspects of the visit. We didn’t want to come up with a solution for a specific clinic, since we wanted to cover all possible cases; nor a protocol, since the needs of our users required physical modifications in the clinics.
We developed the value proposition by analyzing our product, which parts of it would alleviate users’ current frustrations or pain points, and which parts would generate joy. We also considered what problems our solution could find, such as the low social awareness of Autism Spectrum Disorder.
With all this information, we outlined all the measures we wanted to implement for adaptive improvements in dental clinics through information architecture. Thus, we defined what requirements each of the rooms in a dental clinic had to meet to be part of the Teethistic Plan.
Firstly, we proposed the supression of odors throughout the clinic, as well as a cosy decoration, which, accompanied by indirect and warm lighting, would make it much easier for hypersensitive people to deal with the waiting times and the tension that builds up before the appointment.
In the reception area, we were proposing a review of the staff interactions with patients. We discovered that a close and familiar conversation made all our interviewees feel calm, even the neurotypical ones. We also added soft background music, to further differentiate ourselves from what would be a regular medical consultation.
The waiting room is one of the most important spaces, as patients tend to spend a great amount of time there. To make it neurodivergent-friendly, we proposed comfortable furniture, temperature-adjustable lamps, Smart TVs with platforms (this measure is optional, depending on the budget available, but would improve the ability of younger neurodivergents to distract themselves), as well as games for children.
Regarding the medical room, the strongest point of our solution, we proposed a division of spaces. On the one hand, the history area, where patients can have a calm conversation with their dentist, aimed at giving them personalized attention. We also proposed that the explanation be clear and without technicalities, to make the process easier and calmer to the patient.
On the other hand, the medical area, but adapted to the needs of a patient with neurodivergences: noise-cancelling headphones and a mask to avoid direct light on the face, a pain indicator button (since people with ASD cannot always communicate easily), dental tools with noise reduction and soundproofing of the room, to prevent sounds from reaching other areas of the infrastructure.
Once the theoretical part was defined, we designed the more aesthetic side of the project, which was equally important, considering that the adaptation of lights, colors and environments is a fundamental part of our solution. In order to do this, we started with a moodboard:
Finally, we applied the concepts of information architecture together with what was designed in the moodboard by creating wireframes for our analog solution, which illustrated what a customized consultation should look like:
Testing
To finish the creation phase, we carried out a concept testing, that is, we asked three patients with ASD what they thought of our solution, whether it would really impact their experience at the dentist and whether they thought it would be a good accessibility measure. All three gave positive feedback, especially Laura, who told us about her experience of forgetting her headphones on one occasion.
“It would be great, I always have to take my headphones with me and it’s a pain […]. The mask for the lights is also a very good idea.”
Conclusions
Having completed the research, synthesis, ideation and creation phases, and having also carried out a small testing of the designed product, the team reached two conclusions regarding the Teethistics Plan:
- This accessibility solution guarantees that a large part of patients with neurodivergences can comfortably access a dental consultation.
- Its viability is high, adaptable to different budgets, with a very good investment-results ratio.
Therefore, we conclude that it is an effective and feasible solution.
