Q+A with Erica Yamada, director of UX at Catalia Health

Catalia Health, the Bay Area startup where you are the Director of UX, just received $1.25M in funding for a robot that helps patients manage healthcare. How did you get involved in the company? What did you do before joining Catalia?

I was introduced to the founder of Catalia Health, Dr. Cory Kidd, through Elizabeth Goodman, whom I met through Alfred Lui of ID. Elizabeth Goodman and her husband Mike Kuniavsky are authors of multiple books on user research and design. Both of them have been extremely generous sounding boards for my design career. Previous to Catalia Health, I had worked for three years at the Kaiser Permanente Innovation Center creating future sensing prototypes at the Garfield Innovation Center, a 37,000 sq ft, mock hospital where a variety of products are tested. It was during my time there that I worked with wearables, avatars, robotics, pioneered new ways of testing such as massive simulation tests in the OR, and completed field work in hospitals across the country working with doctors, nurses and patients. Liz and Mike had been helping me design some of my user research projects at KP and were aware of my work. They referred me to Cory when he was searching and he convinced me to join his company late last year.

Previous to working at KP, I worked at Intuit and had been networking and hustling a considerable amount. My design mentors were aware of my background knew that before ID. I had worked as a project manager and multimedia artist in medical education on HIV, oncology, and diabetes pharmaceutical eduction for six years—another job I got by networking.

What's it like working on user experience with robots? What has been the biggest challenge thus far?

I am currently acting as both the Director of UX and Product Management at Catalia Health and there have been multiple challenges. First, we are coordinating software, hardware, and artificial intelligence development at the same time. I am designing a connected platform in addition to the robot with which the user will interact. So, the logistics and scalability are a challenge. Second, "innovative" interaction design that works on tablets may detract from the "robot relationship"—this was challenging to explain to the designers at IDEO while we were being incubated because we didn't have the robot ready at the time to truly test out where to land. Third, we are essentially designing a "character" so things like sounds, voice, animation, backstory, language, accessibility all start to play into the experience—just designing something usable is not enough. Cory Kidd and our other co-founder, Kris Dos Santos are both veterans of the MIT Media Lab so I am learning a tremendous amount from them daily in this field and am being sent to a lot of research labs and events to learn more about the industry. Fourth, navigating good healthcare practices and financial needs for our company depends on our customers. Non-profit integrated healthcare organizations such as KP treat healthcare vastly differently compared to others. Given my KP background, I want to address things in that manner but that's not always possible from financial and workload perspective. Finding the right balance of where to start is a challenge. A fifth challenge is a simple startup one, not enough time, people or money to build everything we'd like to build and prioritize our needs on a daily basis.

Can you describe a typical work day?

I usually bike or drive to work somewhere between 8 am and 9 am and work on calendaring, product management or emails for a while. 11am we conduct scrum in our six person company and align what we are working on. Depending on where the project is, I might go into user research sessions, run design exercises, or design assets from our giant to-do list. We are an early stage in our startup and the company culture is more "bootstrap" than "cash fan" so we usually all bring our lunch and eat together talking about the cheapest sandwich shops and how long we can stretch our cash to build our prototype and get our customers before our Series A funding.  A lot of us are obsessed with cooking so a lot of discussions turn into what we are going to cook together next. We have many customers, advisors, investors, visitors and network with other designers and entrepreneurs in between so there may be occasional lunches or coffee meetings throughout the day. Before we design out solutions, we've also been exploring body storming where we pretend to be one of our personas and act out medical situations in which the patient would interact with the robot. This helps narrow down some assumptions and highlight things to test during user testing. Occasionally we go to the local park and toss around a frisbee. My day ends around 6 or 8, or 9 or 10pm depending on the circumstances. We are a little more relaxed and reasonable as a startup given we are in healthcare and most of us are mid-career and know how to work efficiently—but sometimes we need to work more hours. I cannot lie, I can get tired but I'm having so much fun professionally that I often don't realize where the time goes.

How do you see robots fitting into the healthcare ecosystem of the future?

At KP, I had the chance to see multiple types of robots in the the system. One was called "Tug" and was implemented to haul trash and dirty laundry from building to building and in Southern California. In Northern California, a telemedicine robot pilot was underway which allowed the physician to dial into a robot and have a "face-to-face" conversation with patients through a robot that moves within the hospital. In Portland, I worked with nurses in the operating room who managed surgical robots for procedures that took long hours. At some of the healthcare conferences, I have also seen robots that self drive into hospital rooms and sanitize a room with UV rays. I have also worked with avatars to see how we can help patients get "general" answers to their questions and direct them to the correct resource for questions the avatar could not address. This works well as my experience with patients have often been one of "if the nurse is busy, I don't want to bother them with my trivial questions" but the avatars can patiently answer all your questions as many times as you wish. As a result, robots I have seen in healthcare right now seem to be being implemented as a way to triage the trivial repetitive work and free up the healthcare providers to provide the human to human areas of work.

Given that there is a severe shortage of healthcare providers coming and increased usage of the system with the Affordable Care Act, I feel like growth in the usage of robots is inevitable. Robots can truly alleviate things that are repetitive that can exhaust providers and work as a buffer in the system to provide better care. But given my observations in the field, human intuition and experience is also much too important to be replaced so finding a smart use to be accretive to the system while not cutting out the positives of the system is very important. At Catalia Health, we're building a healthcare companion (currently for cancer patients) that is aimed to chat with the patient on their day to day experiences and make sure they take their medication. We are specifically telling the patients that our robot is not a medical professional and that the input shared with the robot will be shared with the medical providers. The reason why we feel this "extends" care is because most patients forget their day to day details by the time they see their doctors and most care providers are too overloaded to see things at a daily level. By having an engaging robot collect that data on a daily basis our care providers may be able to see a clearer picture of their care on a macro level and hopefully have a deeper impact in the long-term.

You graduated from IIT Institute of Design with a Master of Design in 2009. Tell us a little bit about how you're applying processes you learned at ID to your work today. Are there any tools, methods, frameworks or other teaching that has been particularly helpful?

Some methods that may be more ID specific are probably my tendency to design out systems diagrams of how our service will work. In reality, I personally feel ID taught me the language, overall process, provided some helpful tools and a strong alumni network to ask questions. It established my foundation—but my design career has been evolving and my designer "tool bag" is constantly being added too so I can't highlight one specific tool I have been using consistently throughout.

I'm finding my design education at ID was really just a start and I learned a tremendous amount on the job. At Intuit, I was coached on a lot of Stanford methodologies and used that methodology to implement software revisions. At the startup camps, I was coached through lean startup/MVP methodologies by Eric Ries and Steve Blank and practiced them with mobile app development. At KP, I actually learned a lot about facilitation and got certified in usability from HFI and Nielsen Norman group to navigate the system better and build my credibility. At Catalia Health, we started our first five months at IDEO which has had a big impact but we are also weaving in methods from the MIT Media Lab and I am learning daily about research at an academic level.

I would encourage students not get too obsessed with one method, framework, or tool and use it exclusively. I would rather suggest they fill and evaluate and edit their tool box constantly, have a strong understanding of when, where, and how to use the tools provided to them. Using them at appropriate times is a craft that will take on the job practice. Students should maintain good relations with the ID community because that knowledge can be pulled from other experienced practitioners. Keep in mind that our rolodexes are very much a part of our tool boxes—so treat each other well and be respectful when you receive and ask for help.

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Erica Yamada