Viva: Anonymous + Accessible Teletherapy Ecosystem
︎ University of Washington
Tags: Design for Good, Healthcare, Telehealth, Mental Health, Design Research, User Experience, Human-Centered Design
An anonymous mental health ecosystem for undocumented or vulnerable persons in need of safe and accessible therapy services. Exhibited at the 2020 Microsoft Design Expo, under the theme “Designing for a Healthier Future.”
This project was a collaboration between the 2021 MDes Cohort, which consisted of myself and 3 other designers, with oversight provided by Dr. Axel Roesler. In the general realm of healthcare, mental healthcare is often overlooked by patients and even sometimes practitioners. This is especially relevant for undocumented and vulnerable persons, who encounter significant barriers in seeking and affording healthcare overall. Additionally, these populations often have trouble building trust and revealing personal details to health care services, even if individual practitioners may appear reliable. With the advent of the COVID-19 pandemic, the experience of seeking healthcare has become even more difficult and complicated.
Considering these issues, along with the growing prevalence of telehealth services, we created Viva. Viva is an anonymous teletherapy service that utilizes blockchain technology and facial recognition software to obscure and anonymize users’ identities while allowing therapists to observe their body language and maintain essential ‘face-to-face’ communication. Viva is a full ecosystem, meaning it does not solely depend on the use of potentially inaccessible technologies (such as laptops or smartphones) and is available through library computers, landlines, communal devices, and more. Payment is flexible to the users’ needs and is based on a sliding scale approach. Users can interact with Viva in whichever way is most convenient to them, whether that be through engaging with an AI therapist assistant, or an actual therapist, and users can choose whether they prefer to talk through text, a phone call, or video chat.
Designer, UX/UI, Animator, Illustrator, Design Researcher, Speaker
Axel Roesler, Overseer
Taylor Miles Hopkins, Designer
Fei Shao, Designer
Solji Lee, Designer
2020 Microsoft Design Expo Website
Anonymous + Accessible Teletherapy
Early on, our group was interested in the mental healthcare space. This was not only because we, as a group, had personal experiences and issues with seeking dependable and affordable mental health services, but also because our research indicated that there was an incredible need for better, more accessible resources. Problems with mental health are an invisible wound, and many people are hesitant to seek or even discuss issues. And yet, according to MHA National, 46% of Americans will meet the criteria for a diagnosable mental health condition sometime in their life.
Access to and prioritization of mental health services is even lower, yet arguably more critical, to vulnerable populations. Washington State, at the time of our study, was home to 240,000 undocumented persons. Out of these undocumented persons, 23% met the criteria for a significant mental disorder, in a relevant NIH study. Seeking standard healthcare, let alone mental healthcare, is incredibly taxing to vulnerable populations. To access healthcare means to 1) be able to provide varying forms of identification and personal documentation to the clinic, thus exposing your immigration status, and 2) to be able to pay potentially significant and financially variable bills. Additionally, many U.S. hospitals and clinics are legally required to report any undocumented persons in their care to relevant authorities.
Considering these issues, our group found it prudent to explore real-world solutions and engage in the creation of an anonymous, affordable, and accessible solution in the mental healthcare space.
Viva is a blockchain-based anonymous and accessible teletherapy ecosystem. With the creation of Viva, we wanted to address the question: how might we design a mental healthcare system that addresses spatial, temporal, linguistic, and cost-related constraints?
Telehealth | Viva is based in telehealth primarily due to its accessibility and stronger guarantee of user safety. We found several reports of clinics that provide services to undocumented persons being patrolled or targeted by ICE officers, which created concerns for patient safety. Additionally, in an E-Visit survey, 74% of participants indicated that they feel comfortable or prefer using telehealth services.
Ecosystem & Sliding Scale | As not every user has access to a smartphone or laptop, Viva can be accessed through landline, cell phone, telephone booth, library computers, and more. Payment to Viva is based on a sliding scale approach, with users paying as much as they can afford to access all features of the service.
Blockchain Cloud & Identity Tokens | Using blockchain technology to obscure our users' identities was essential, considering their potentially vulnerable status. At the same time, it was important for users to have a way to access their health data and communicate with their specific service providers. Using a blockchain cloud allows users to encrypt their data on a private numeric ID token, which would be used to identify patients in place of personal information.
Avatar | When patients select to talk to their practitioner via video call, their identity will be masked with a virtual avatar. Avatars can be used to mask a patients’ gender, age, race, and voice, while still allowing a mental healthcare professional to pick up on their body language and physical signals. Interviewed practitioners indicated that being able to view a patients’ emotions and reactions is essential to successful counseling.
AI Assistant | While AI can be frustrating to many, we wanted Viva to contain a continuously available ‘assistant’ that could translate and communicate medical data, as well as be available to users when a practitioner might not. Viva, the name of the AI assistant, takes on the role of a nurse practitioner by evaluating basic patient data, communicating it to mental healthcare professionals, and fielding patients’ non-essential questions.
Hotline | In addition to the AI assistant, Viva features a ‘hotline’ to be used in emergency situations, such as a mental health crisis. The hotline connects a patient to an available mental health care professional in the event their regular practitioner is not available.
Voce Trusted Community | Voce is a feature of Viva in which a user can input a general location and be provided with a list of trustworthy, sliding-scale, and/or accessible specialists, hospitals, and other medical services in the area. This service is community-oriented, with users being able to comment and rate listed resources based on the aforementioned characteristics.
In preparing to present Viva at the 2020 Microsoft Design Expo, our team continually met and reviewed our work with two User Experience Designers from Microsoft. Our team conducted significant secondary research, with 50+ academic articles reviewed. Additionally, our team met with and interviewed a variety of medical professionals, including telehealth designers, medical doctors, psychotherapists, psychiatrists, and more.
Microsoft Design Expo
This work was created for and exhibited at the 2020 Microsoft Design Expo, the theme of which was “Designing For A Healthier Future”. Our team represented the University of Washington, which was one of seven international universities invited to the Expo.
Selection of notes from expert interviews.
The final iteration of the Viva trailer’s main character, ‘Bob’.
User journey simulating a user’s experience seeking mental healthcare.
Thumbnail sketches from video storyboarding.
More refined sketches of various Viva personas.
Refining the intended user experience, principles, and design goals of Viva.
Document of personal secondary research sources.
Deconstruction of the problem space.