Background
At Somerset NHS Foundation Trust, the Beacon Centre provides the very best of cancer care to patients. Patients usually find information about cancer treatment through medical leaflets, from online resources, or on an ad hoc basis from medical staff. The wealth of information about what to expect from cancer treatment can be very overwhelming for patients, not to mention the challenges with accuracy and relevance to each individual patient. This challenge has only been exacerbated in the light of the Covid-19 pandemic, with increased pressures on the NHS across the board.
There is no ‘standard’ course of radiotherapy treatment for cancer; the frequency, number of sessions, and dosage are all dependent on a number of variables. As a result, the preparations patients need to make ahead of treatment and the side effects they may experience can be wide ranging - and currently there is no simple way to guide them through this process. Research showed that patients wanted a simple way to access all the information about radiotherapy and their cancer treatment.
The Idea
The Beacon Centre wanted to harness technology to transform this process. Based on the insight that 75% of patients indicated they would download an app which could deliver tailored information, The Beacon Centre approached Bad Dinosaur to help create a sophisticated companion app that radiotherapy patients could use throughout their treatment, called “Beacon Buddy”.
The aim of the app is to manage the anxiety of patients, act as a centralised point of access for patients' specific treatment guidance and advice, and serve as a resource hub for patients. It exists to complement and enhance the current service rather than to replace it.
The design of the app is intuitive and accessible to a wide range of demographics, allowing all users to easily navigate through registration and the patient dashboard. The copy and tone is reassuringly medically accurate, while remaining friendly and supportive - neither too clinical, nor too fluffy. The app is a companion for some of the most emotionally turbulent times in a person’s life, something that was considered at every level of design and development.
While there are other apps available as a resource portal for cancer patients, Beacon Buddy’s USP is the ability to deliver specific tailored information.
As a radiographer I often hear patients say ‘that's one more [treatment] crossed off the list’ when we are getting them off the treatment couch which is why we wanted a countdown function - so patients can have a visual aid for each important step. We really hope this app is useful to our patients and we will be collecting feedback to continually improve and adapt to what is needed.
Vicki Hands, NHS Somerset Foundation Trust
The Project
The project kicked off with a product Discovery Workshop in September, 2020. We assembled a diverse team to review the project and understand exactly what was needed from the clients. We brought together a senior designer with front-end development skills, a back-end software developer with product design expertise, and our head of partnerships, together with representatives from NHS Somerset Foundation Trust.
In the discovery workshop we outlined the challenges the team were facing, and conducted a deep dive into the target audience. We went through every possible step in the user’s care journey and distilled each part down to its core function. This approach helped us to build in a lean, agile way, allowing space for pivoting and optimising along the journey, while keeping our target users front and centre.
Weekly co-design sessions between Bad Dinosaur and Somerset NHS Foundation Trust ensured that the project was kept on schedule, allowing everyone to review what had been built to date, test it in a staging environment, and make real time decisions about the design and development of the app.
We liked how Bad Dinosaur worked through the initial quote with the brainstorming session, it was very useful to clarify what we actually wanted and needed, and understanding what was possible. The proposal and quote was laid out well, and clear to understand. The regular progress and feedback meetings were very useful and the team were generally quick to respond to queries.
Kate Moorman, NHS Somerset Foundation Trust
The Users
During our workshop session with The Beacon Centre team, we outlined various aspects of the project including an analysis of the key personas who will use the platform. This is a key step in our product design and strategy workshops that helps both the agency and the client to connect with and understand the users of the app.
Breast Cancer Patient
Katie, 34Katie is a 34 year old mum of two who is about to start her first round of radiotherapy after a successful lumpectomy. Although she is grateful that her lump was caught early she is very nervous about the radiotherapy and the possible side effects. She has been googling what to expect during her treatment and feels overwhelmed by the amount of conflicting information. A straightforward way to understand the details of her particular treatment would be really helpful, not only for her own sanity, but also to help her young family to know what to expect.
Prostate Cancer Patient
Owen, 64Owen is receiving palliative radiotherapy to slow the spread of his prostate cancer. Sometimes he forgets to drink enough water before his treatment, or to empty his bowels - this can add to the distress of the procedure. A method of keeping an up to date diary of his treatment and side effects, with reminders about how to prepare for his radiotherapy would be really useful for him. His consultations can feel like a barrage of information and a handy way to record this information to then update his family would be helpful.
Radiotherapist
Nadia, 41Much of Nadia’s job entails reassuring and comforting patients through their treatment, and explaining their treatment course, dosage and side effects. The amount of misinformation her patients receive from external sources can scare them and cause a lot of confusion. Being able to provide patients with tailored information relating to their individual treatment plan would be really beneficial. A companion app for patients to operate as a point of reference throughout their radiotherapy journey would save so much time and energy for both patients and Beacon Centre staff.
The App
The Beacon Buddy app allows patients to identify their cancer sites, and input high level information about their treatment, like the number of sessions, and whether they are receiving palliative or radical radiotherapy. This then generates bespoke content about their side effects, things to expect throughout their radiotherapy journey and a countdown of their sessions.
The app provides information about the Beacon Centre building, staff, facilities, a site map and travel options. The contact details of the patient’s consultant, nurses, Macillan team and other support services are all available from the dashboard.
The app features a journaling area for users to document key information questions to be shared with their medical team and/or friends and family. There’s also a hints and tips section on the app which lists remedies for side effects, ways to reduce the side effects and practical support techniques.
One of the core features is an area for patients to access the side effects of their treatment plan, so that they know what they can expect and the severity. This is key to managing the patient’s anxieties and giving them a headstart on what they should expect. In a ‘My Treatment’ section of the app, patients can access resources and media about radiotherapy, CT scans, follow up consultations etc.
A visual countdown representation of the number of remaining treatments a non-palliative patient has is another central component within the user dashboard. This counts down after every treatment session, and when it reaches zero a visual fanfare (confetti cannon) is triggered to celebrate the end of their treatment.
All information, resources, and media within the app is managed directly by the Beacon Centre admin team, who can log into the Content Management System (CMS) with an email and password and easily keep the app up to date.
The Technology
The app has been built as a Hybrid Web app, using Microsoft Xamarin, which is a cross-platform framework that enables releases across multiple app stores.
The back-end API was built using a .NET core. .NET is a free, cross-platform, open source developer platform for building lots of different types of applications. With .NET, you can use multiple languages, editors, and libraries to build for web, mobile, desktop, games, and IoT (internet of things). The compatibility, usability, and easy maintenance aspects of .NET make it our first choice for building digital products. And, we’re not alone. .NET Core was the most loved framework among developers in Stack Overflow’s 2019 survey, and is trusted by the likes of Cisco, Intel, Microsoft, Morgan Stanley, Mayo Clinic, Cognizant, JP Morgan Chase, Capgemini, Siemens, GoDaddy and more.
For the front-end, we used Blazor. Blazor front-ends work well with .NET back-ends.
The Outcome
Beacon Buddy was successfully launched in Summer 2021. The digitisation of the radiotherapy support process has hugely benefited both the patient users and the medical staff at NHS Somerset Trust. The app augments and enhances the brilliant care and guidance given to patients from staff. The primary benefits and outcomes of the project include:
- A reduction in paper leaflets being distributed, which is better for the environment
- The ability to keep all information up to date, making it easier to remove outdated information from circulation
- The app helps patients' families to understand the treatment better and are better equipped to support their loved ones
- Having information in one place means that care staff have a singular destination to point patients and their families to, rather than multiple
The Bad Dinosaur team continues to work with the Beacon Centre on optimisation of the Beacon Buddy app. Future functionality, such as appointment scheduling, read-only access for friends and family, and self-care reminders, has already been proposed and scheduled for development. Bad Dinosaur are immensely proud to have worked on this project.
Bad Dinosaur shared good advice and guidance with us throughout the process, we wouldn’t hesitate to recommend Bad Dinosaur to others looking to build an app
Kate Moorman, NHS Somerset Foundation Trust
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