Founder’s Note #3: Designing for the Bad Days
One of the weird/neat/confusing things about building a healthcare product while actively going through treatment is that the product lessons will find you whether you're looking for them or not. And often, they will make their presence known—loudly and unapologetically.
Last week was one of those weeks.
Chemo hit harder than usual due to a modified protocol (one of the joys of having a chronic illness). I was tired, foggy, and operating on a pretty limited amount of mental energy. I was able to make it through about a third of my to-do list, and for those who know me, that's highly unusual.
And somewhere in the middle of that brain fog, I started thinking about Health Harmony—and more specifically, usability.
I've been thinking a lot about what patient-centered design actually means when you're building healthcare technology for people living with chronic illness.
On the whole, when we test software, we tend to ask questions like:
Can the user find what they're looking for?
Can they complete the workflow or a designated task?
Do they understand what they're supposed to do next?
All important questions. People should be able to use your application without needing a master's degree.
But the longer I'm in this space, a deeper, more interesting question keeps coming to the surface for me:
How much capacity are we assuming the user has when they do it?
Just in my day-to-day life, my capacity changes. Add a chronic illness on top, and you've got a recipe for weeks that swing wildly between two poles.
There are days when I can sit down, organize information, prepare questions for an appointment, and generally feel pretty on top of things—you know, generally function like a human.
And then there are days when opening an app feels like more effort than I want to give anything. Those days you'll usually find me in my couch pillow fort with the cats.
Same person. Same product. Very different capacity.
"Easy to use" can still ask too much
This is the part I've been wrestling with throughout my build of Health Harmony, but also just in general in the healthtech space.
A workflow can be perfectly logical and still require too much mental effort.
Maybe there are five perfectly reasonable steps.
Maybe the information is organized beautifully.
Maybe every button is exactly where usability testing says it should be.
Everything can be technically correct and executed flawlessly.
But the patient still has to think.
They have to remember what they're trying to accomplish.
Make decisions.
Interpret information.
Figure out what matters.
Remember to come back later.
On a good day, those things might barely register.
On a bad day, every one of those tiny decisions costs energy—their "Health Points," if you will.
What does designing for a bad day actually look like?
Quite honestly, I'm still figuring that out—because everyone's bad day looks a little different.
I don't want to design specifically for my bad day—which, according to my husband, is like his best day ever. 😂 My husband's bad day is barely getting out of bed.
That's part of the challenge. There isn't one universal "bad day" to design for. The goal is to build something that can accommodate people when their capacity is very different from what it was yesterday.
Here's what I absolutely don't want:
I don't want this principle to become one of those nice-sounding product philosophies that gets written on a website and then has absolutely no effect on the product.
If I'm going to say "Design for the bad days," it needs to change decisions in how the product functions for actual users.
Right now, I'm starting with a few questions:
What can Health Harmony remember so the patient doesn't have to?
If someone enters something once, how can we avoid asking them for it again?
What can we surface instead of making someone search for it?
The information technically existing somewhere in the app isn't enough if finding it requires five steps.
What decisions can we eliminate?
Every choice adds cognitive load. Sometimes flexibility is valuable. Oftentimes, it's just more work.
What matters today or in this moment?
A patient shouldn't necessarily need to understand their entire health picture every time they open the app. Sometimes they just need the next appointment, today's medication, or the question they wanted to remember.
What happens if someone doesn't come back?
Healthcare apps love streaks, reminders, and engagement metrics. But illness isn't particularly interested in maintaining your streak—the number of ick days in a row is not a metric I'm striving for. If someone disappears for a week because they're sick, the product shouldn't punish them—or make returning feel like catching up on homework.
That last one is something I'm thinking about a lot.
Having an illness you can't control is punishment enough. I don't want people to feel like using the app is another job.
The goal isn't less functionality
Designing for bad days doesn't mean stripping everything down until the product barely does anything. And it definitely doesn't mean assuming patients aren't capable of understanding complex information
Patients are incredibly capable. They're also human. This is a core principle that I keep at the forefront of every decision I'm making.
Their energy changes. Their attention changes. Their symptoms change. Their responsibilities outside healthcare don't disappear just because they're having a bad day.
The challenge is building something powerful without requiring the patient to bring their best self every time they use it.
That's a much harder design problem. But I think it's the right one.
Where I'm leaning
I'm starting to think about Health Harmony less as a place where patients manage their health information and more as something that should help carry some of that management burden for them.
That's a subtle distinction, but it's becoming an important one for me.
I don't want someone to open Health Harmony and think:
"Great. Another thing I need to keep updated."
I want them to think:
"Oh good. I don't have to keep all of this in my head."
I'm not sure I'll always get that balance right. That's part of building, learning, and growing with my users.
But I know the question I'll keep coming back to:
Does this still work for someone on their bad day?
Because healthcare shouldn't require you to be at your best when you're using it precisely because you're not.
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