Agile Development to Incentivize Health Management

Radiant partnered with the University of Minnesota to design and develop a research-oriented, online, mobile-responsive social intervention program called Thrive With Me. The goal of application is to promote improved medication adherence and disease self-management among men with HIV. Radiant was responsible for system design and software development, infrastructure design, maintenance and ongoing user support. In addition to developing the intervention software, we also provided expert consulting regarding overall intervention design, user experience, and field implementation.

Our Solution:

Radiant implemented an iterative development approach that featured frequent stakeholder review, automated testing, and continuous integration/continuous deployment (CI/CD). Our agile process implemented the Scrum framework as follows:

  • Before beginning development, the product team collaboratively developed the overall technical approach (technology stack, tooling) and working methods (definition of ‘done,’ testing, and continuous deployment methods).
  • Desired product functionality was captured in the form of User Stories and collected in a Project Backlog. The Product Backlog was pruned and prioritized regularly by the Product Owner with input from all project stakeholders.
  • In collaboration with development, the UI/UX team utilized interactive prototyping approaches to quickly model and verify approaches with the client and end-user stakeholders.
  • User Stories were estimated using a relative estimation method (modified Fibonacci series).
  • Work was organized into two-week sprints; the Product Owner prioritized User Stories in the Product Backlog, and the development team selected stories for the sprint based on this prioritization.
  • Sprint velocity was tracked and measured weekly; overall project velocity was tracked and measured at the end of each sprint, permitting the team to predict the story points completed by the project release date.
  • Throughout the development process, end-user perspectives were gathered from a cohort of representative users in a community advisory group. Perspectives included aesthetic concerns, evaluation of content, usability, and overall user experience.

The agile process was supported by a technical infrastructure that enabled continuous release of code:

  • The CI/CD process utilized Tuleap ALM for continuous integration. The system integrated Github for source code management and Jenkins for automated testing and deployment from developer machines to staging and production environments.

Using this agile approach, our team delivered a solution that incorporated the following features:

  • An interactive online social space wherein participants can share text, videos, and images. This social space also implemented related features such as commenting, “liking,” and flagging and was integrated with a game mechanics system.
  • An extensive game mechanics system that awarded points to users based on their activities throughout the site. Based on these point awards, participants earned badges, progressed through levels, and were recognized on the site via notifications and leaderboards.
  • An expert content system that displayed skills-training content to each user daily and highlighted content that was particularly relevant based on its profile.
  • An automated participant onboarding system that integrated with an external survey tool (Qualtrics). Leveraging custom code and Qualtrics’ API, study participants were automatically provisioned user accounts after completing a baseline survey, and survey data were stored in a user profile. These survey variables were utilized for content tailoring. This feature greatly reduced the work burden of study administrators.
  • A configurable, interactive SMS-based medication reminder system that allowed users to configure a set of daily reminders. Each reminder collected medication-taking status and mood. These data points were then collected into a “weekly check-in” that allowed users to review their medication-taking and reflect on the relationship between their mood, meds, and substance use.
  • Extensive moderation and content management controls for study administrators, including user management and condition assignment, flagged content alerts and review, process data export, content creation, editing, and revision workflows.

Our technical solution incorporated the following components:

  • Drupal CMS/AMF, with custom modules written in PHP
  • Qualtrics API integration for automated participant onboarding
  • Twilio API integration for interactive SMS
  • Responsive UI based on Bootstrap framework and developed in HTML5. Utilized automation tools such as Less preprocessor and Grunt task runner.

Radiant continues to support the intervention software during an ongoing randomized controlled trial.

Results:

  • CI/CD process permitted code release daily.
  • The scrum approach ensured that the highest-value features were implemented with available project resources.
  • Automated testing increased overall solution stability throughout the project.
  • The responsive web approach permitted access to the intervention on any device running a web browser.
  • Integration with Qualtrics yielded more efficient study management and the ability to tailor and highlight content, making the intervention more relevant to end-users.
  • Working directly with end-users during development yielded a user-focused product that was very well received during subsequent usability/feasibility testing.

Conclusion:

Digital transformation is about sustaining a competitive edge in an increasingly fast-paced and competitive business environment. Adept application transformation can increase innovation speed, allowing your organization to deliver new products and experiences rapidly.