Building With, Not For, Your Communities

At Timshel, we know that to design great products, we have to understand what our stakeholders value. This is true whether we’re designing an engagement platform to help nonprofits and advocacy groups connect with their supporters, or a tool that helps rural health workers with little to no experience with technology collect and disseminate patient information.

So how do we understand what our stakeholders value? That’s where human-centered design (HCD) comes in.

To make sure we truly understand the problem that we’re trying to solve, we have to understand it from the standpoint of the people we’re trying to help. We have to involve the stakeholders throughout the design process to get ideas, and to get feedback on our ideas. Simply put, HCD is a process where you listen and observe from people, experience alongside them, and use what you learn as inspiration in the design of your product.

The Design Process

When designing a product using HCD, there are some basic steps you should follow:

  1. Talk to people
  2. Form insights
  3. Ideate and prototype
  4. Test and iterate
  5. Implement

To help understand this process, let’s look at how we worked with the Lake Tanganyika Floating Health Clinic (LTFHC) to design a tool to help health workers in that region collect patient information, and make that information accessible to the government and outside organizations to deploy resources more effectively.

LTFHC realized that the health workers in the region use a tedious process to take and aggregate patient data manually, and because the data wasn’t electronic, it was difficult to share. This process often leads to health workers devoting two to five days to aggregate the data, and often one to three days to transport that data to a more regional health center. An added problem was that the vast majority of health workers had never seen a computer or even a mobile phone before, so any technology solution would have to be extremely intuitive.

Prior to partnering with Timshel, LTFHC had implemented computers in a few clinics for the health workers to take patient data. These computers went unused because they were complex, unreliable, and provided little value to the health workers themselves. LTFHC then partnered with Timshel to identify a better solution using a more human centered approach.

Step 1: Talk to people

After some initial background research, we undertook the first major step in HCD: we went out and talked to people. We talked with a lot of health workers, ranging from those that had been given the computer system to those that were in more rural areas and had never seen electronic devices before. In these initial conversations, we wanted to understand their current process for taking information, and what they did or did not like about that process. We also tested out a few ideas that we had, such as a very simple tablet app prototype (using, to see how the health workers would react to them. This was a non functioning prototype that allowed the health workers to experience would it would be like to use the app.

Step 2: Form insights

After the initial set of conversations came the next major step: organizing what we heard into themes and forming insights. For example, when we spoke to a health worker who had the computer system, we asked him to show us how he enters patient data. While observing him, we noticed that he made several mistakes (like entering my birth year incorrectly) due to an unintuitive user interface. This, combined with other conversations where we heard and saw similar issues led us to the following insight:

The current technology suite is unintuitive, leading to health workers using the system incorrectly, or not using it at all.

We then took our set of insights and reframed each in a way that provided us an opportunity to design a solution. Given the above insight, our opportunity was:

How might we design a tool that is simple to learn, easy to use, and minimizes the chance of input error?

Step 3: Ideate and prototype

With these questions in hand, we then brainstormed solutions and came up with ideas that we wanted to prototype and test with the user base. The philosophy here is to prototype early and often so that you learn quickly which parts of an idea work well and which parts need improvement, and ultimately get to a working solution faster. For us, we found that the tablet prototype was intuitive, so we used what we learned in the field to create a version that we thought the health workers would actually use.

Step 4: Test and iterate

On a subsequent trip to the Lake Tanganyika region, we tested this more refined tablet app prototype. This was still not a functioning app, but basically crude screenshots that allowed the user to feel like this was a functioning app. After several iterations of the prototype, we decided we had gotten as far as we could on a low fidelity prototype, and that the general consensus was that this was an idea that could work. But getting positive feedback is very different from knowing whether health workers would actually use the tablet app. For this, we had to build it out and do a pilot test.

Step 5: Implement

This is where we are today. We’ve teamed up with a health organization in India called World Health Partners to build this app. Once it’s built, LTFHC is going to test it out over the course of a few months in various health centers. No doubt, we’ll learn plenty about what works well and what needs improvement; not just about the app, but about the entire ecosystem needed to make the tool successful.

When the pilot is over and the tablet app is implemented on a larger scale, the team will continue to listen, observe, and learn from health workers. As long as health workers are using the tool, there will be a need to get feedback and modify the tool to meet their needs. And that iterative loop is the heart of HCD.

To learn more about the work LTFHC is doing, you may visit their website here. To learn more specifics about the HCD process or to dive into additional case studies, visit