Project Overview
Having a medical imaging appointment can be overwhelming and distressing for young patients. The Royal Children’s Hospital, Melbourne (RCH) and Conduct have developed a mobile and tablet application that utilises games, videos, photography and text to prepare children and families for medical imaging scans in a fun and engaging way. The application explores CT, MRI, ultrasound, nuclear medicine, X-ray and fluoroscopy in detail. A research study was conducted in conjunction with development. The study demonstrated that app usage was successful in reducing parent and radiographer perceptions of patient anxiety, increasing patient compliance and reducing preparation time required in hospital.
Project Commissioner
Project Creator
Team
Gigi Williams
The Royal Children’s Hospital
Head of the Educational Resource Centre
Project Manager
Siobhan Greene
The Royal Children’s Hospital
Senior Educational Play Therapist
Content Manager
Dhanuka Kaluarachchi
The Royal Children’s Hospital
Web Developer
Technical Manager
Charlie Pohl
Conduct
Digital Project Lead
Managing Director
James Cook
Conduct
Creative Director
Creative Director
Simon Krambousanos
Conduct
Solution Architect
Technical Director
Project Brief
Okee in Medical Imaging is the only application currently available, that prepares children for imaging in the areas of MRI, CT, X-ray, fluoroscopy, ultrasound and nuclear medicine. Targeted at four to eight year olds, Okee the Octopus acts and friend and mentor, leading users through the underwater game world, which reflects the imagery at the hospital. First there are three training games that teach skills required in multiple modalities: keeping still, breath holds and administering IV contrast. Then there are then six imaging missions, preparing children for each imaging modality, by highlighting and having fun with potential stressors. MRI centres on the camera and noises, while CT makes a find and seek game of the stickers on the camera. In X-ray, users simulates the experience of moving the camera around. Ultrasound introduces the gel and transducers, and nuclear medicine and fluoroscopy games explain requirements for seat belts and drinking contrast, in addition to their cameras.
Videos link the underwater world with the reality of imaging in the hospital. There is also a wealth of information for families, with numerous photos, tips, things to practise, wearing the right clothes and frequently asked questions. Additional hospital information such as maps, contact numbers and parking information complete the package to reduce stress for parents navigating the hospital system.
Project Need
Okee in Medical Imaging was developed because many families would arrive at hospital with very little understanding of what their medical imaging appointment would entail. Breath holds, contrast injections and the equipment required came as a surprise to many parents who were unfamiliar with the procedures and regularly told their children very little about their appointment. Unfortunately fear of the unknown and misconceptions about what a hospital visit means, are major causes for anxiety and distress in this age-group. By introducing the medical imaging concept via interactive games, a concept that is engaging and familiar to most children, we have bridged the gap in understanding.
The ability of Okee to turn what was previously a scary experience into an enjoyable one, is invaluable to the parents of thousands of children undergoing imaging. Prior to its introduction, it was very difficult to prepare this age group appropriately, at home, without the specialist skills of an Educational Play Therapist. Now families can take back some control and engage in this process prior to their arrival. This allows children time to familiarise themselves with the department and become comfortable with imaging without the pressures that come with being in the hospital environment. Decreased anxiety and increased compliance allows for fewer delays, less cancellations and fewer appointments needing to take place under sedation or general anaesthetic, which means an improved, faster and safer service for staff and families.
User Experience
Parents and children are informed about Okee in Medical Imaging via their appointment letters and conversations with staff prior to their arrival at hospital. The focus of the app is the underwater world, introduced by Okee the Octopus, to encourage children to explore the training games and missions. The use of the underwater world helps bridge ties with the hospital environment, where the imaging department is also underwater themed. By engaging patients with a positive experience immediately, it is possible to shift potential negative perceptions of the hospital before they can develop further. This is achieved through friendly and appealing characters, positive reinforcements throughout, games with challenges that allow for improvement and growth and developing a sense of peer experience via video guides. While in development, games were tested regularly with users to ensure they were engrossing, retained high replay-ability and worked within the capacity of children in the target audience. This was important to allow children time to gain a sense of mastery over the experience, providing them with a sense of confidence and improved skill acquisition prior to their appointment. These elements are key in reducing anxiety and increasing compliance.
Project Marketing
Marketing of Okee in Medical Imaging has been approached in a number of ways. Primarily parents are alerted to the application via notification on their appointment letters, as well as in conversations with medical imaging and play therapy staff. Additionally the hospital’s internal marketing team have highlighted the application via the Royal Children’s Hospital website and Facebook page, an article in the Herald Sun and promotion via the hospital’s closed circuit televisions. Key decisions were made to support maximum uptake, including making the application free to download without ads, and available in both smartphone and tablet versions. The application is available on both the App Store and Google Play globally. This strategy minimises the number of families who cannot access the application.
Exposure to clinicians has been achieved via presentations at the Association of Child Life Therapists Australia conference, the International Child Life Council conference on Professional Issues, the Victorian Paediatric Radiology education seminar, the National Allied Health conference, an international live webinar and numerous hospital based presentations both in Australia and in the United States of America. Articles have been published in Heartkids, Spectrum and SoundEffects publications and email campaigns have been sent to thousands of paediatric clinicians across the world. Additionally, the project has been presented at the Australian Graphic Design Association ‘Design Means Business’ series and UX Australia conference.
A research study has been completed and the subsequent manuscript will be submitted for journal publication in 2016.
Project Privacy
The application follows best implementation practices for IOS and Android development standards. No user details are collected or stored, we only monitor unidentified user behaviour on the application to measure performance and future improvement.
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