What does someone do when they have an ache, a pain or feel unwell?  Chances are they’ll search for their symptoms online before anything else.

“I didn’t know what the hell it was, so I googled it” p108

“I look up symptoms online. The GP is the last resort” p92

Research shows there are millions of online searches a month using terms including ache, pain and rash.

Much of what’s on offer results in a list of possible conditions for you to choose from. You often have to read loads of information to find the symptoms relating to you. It’s a lot of work, especially when you’re scanning names you’ve probably never heard of, like ‘cutaneous candida’ (fungal infection).

Writing symptoms information is difficult

We’ve recently been researching and writing about symptoms, and it’s difficult.

It’s hard to strike the balance of what’s helpful and what’s clinically safe.  Listing every possible warning sign can make the information unnecessarily scary.  However, we don’t want to produce content that results in the user missing important information.

There’s also a concern about people self-diagnosing and getting it wrong.

We worked with Marcus, the GP on the team, about symptoms. What we had to avoid was saying if you have symptom X, then it’s probably condition Y and you should do Z about it.

Instead we opted for a simpler approach:

If you feel like X, you can self care.

If you feel like Y, you should see a GP.

If you feel like Z, you should get help now.

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User needs

Writing content in this way addresses the user needs we discovered for symptoms. It means giving users practical information, even when their symptoms are vague. Instead of giving a list of possible conditions, we’re telling users what they should do (triaging them).

People have very real needs around symptoms. Even when they’re not sure exactly what the symptom is, they know they want to do something about it. We spoke to GPs, NHS Choices users and listened to 111 calls and found needs like:

  • I need to know if I should call 999
  • I need to know if I can treat this myself
  • I need to know when I should be concerned

One size doesn’t fit all

We chose 3 symptoms  –  headache, stomach ache and rash in babies and children. We chose these because they’re some of the most common search terms used.  They also range in severity, anatomy and age of people likely to be affected.

For headache and stomach ache we wrote simple pages focusing on actions.

However, for rashes we found there was a need to know the cause. There’s a different level of concern and treatment for the conditions that cause a rash. Instead of a list of conditions, we listed symptoms to help users find what they were looking for. For example, what to do about the condition ‘milia’, is found under the heading ‘white spots in babies’.

We also added images for each type of rash.

What did users say?

We tested these pages with users during a pop-up research session at a GP practice in Stockwell, London.  This is what we found:

Users like information to be simple

Overall users found the layouts to be clear, simple and easy to scan and the structure of the information was understood.

“It’s really simple to use. Not hard. Very clean.” p97

“I like the language. It’s simple… It can never [be] too simple.” p88

Users like action-focused content

Practical advice was also well received.

“These are the sort of thing I look for. Practical advice” p88

“It’s giving you the info of what to do. But it’s down to you, as to whether you do anything about it”  p104

Emergency information

We list emergency treatment in a red box – it’s high up on the page to indicate importance, but to the side so it’s not the first thing a user sees.

The box had a mixed reaction.  Some users thought it was helpful, while some thought the information was too vague or obvious and wouldn’t have followed the advice.

“It’s good that the first thing you see is the signs for meningitis” p96

“I don’t think I would [call 999]. It depends on your other symptoms” p104

“I wouldn’t be looking at the internet if they were that bad” p102

Also, on a mobile phone a list of useful points becomes long and alarmist. We need to think more about the content of these boxes and make a decision about what actually constitutes an emergency.

Users like pictures, but…

Overall, users liked the images. They used them to navigate a long page on the phone.

We added one picture for each type of rash to show what it looks like.  However, many rashes can look different depending on things like severity or location.  A picture showing a few chickenpox spots might not help someone whose child is covered in them.

Also, using pictures of a rashes on white skin are no help if the child is black or Asian.

“I’d like to see a picture of what that rash looks like on a black child” P100

A need for more?

Users like the content on headache and rashes in babies and children.

However, for stomach ache, some users felt they wanted to know more.  They weren’t satisfied knowing when they should be concerned, they wanted clues as to why they might have it.

“There’s not enough information – I would expect reassurance about what it might be” p104

We need to speak to more users to understand why this might be. It may be because stomach ache isn’t as well understood or as clear cut as a headache.  Or because they weren’t in the moment of having a stomach ache.  Emotion plays a part when you’re unwell and looking for information, and this is something we want to learn more about.

What’s next

We’re going to link these symptoms pages to comparable pages on Choices so more users are able to see them.  This will allow us to get feedback and improve them.

We’ll also build on these learnings in the next 6 months and create a more complete picture of our user experience maps.

This research fed into the symptoms hackday we ran this week.  We worked with colleagues from the 111 service and Choices, who have a wider view of the landscape, to discuss future solutions to symptoms needs.

Look out for blogs about this and more of the research we’ve done around symptoms.

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