Existing COVID-19 tests have a terrible user experience. You have to wait in line, sometimes for hours, to get one. If you’re getting tested, you probably already feel quite ill. And then you may have to wait hours, even days, for results.
Several companies are working on improved tests. Abbott Labs developed a five-minute screener for clinics that works on-site without sending samples to a lab. Cue Health is working on a 25-minute nasal swab test. And now, the Los Angeles-based company Scanwell Health is developing an at-home test kit for SARS-CoV-2, the virus that causes COVID-19.
Pending FDA approval, you would be able to order the $70 kit through the mail, take your own blood, and get results at home in 13 minutes—using technology licensed from the Chinese manufacturer Innovita that can analyze blood while sidestepping a lab. The company hopes the tests can move through governmental approval and be on the market in six to eight weeks. Scanwell Health is one of many companies rushing to build tests for the U.S., but this one stands out for its unique approach for personal use.
Whether or not the company is able to meet that aggressive schedule, Scanwell shows what a test might look like when it prioritizes the needs of the user. That’s because Scanwell Health is as much a UX company as it is a medical one. It currently makes at-home kits for urinary tract infections and has a test for chronic kidney disease in clinical trials with Kaiser Permanente, Johns Hopkins, and others. From its earlier products, the team has learned best practices it can duplicate across other products. “I like the term living bible,” says Michelle Kim, UX designer. “Graphic designers like to say they have a brand book. We have our own living product book.”
For instance, the team has learned that its packaging of an at-home test needs to work hand in hand with its app. Each step needs to be very short, with a brief sentence and a GIF or looping video demonstrating the next action. “We try to start with the perspective that the user has never had to prick themselves and extract blood,” Kim says. “We try to think of the most challenging scenario and work backwards from there.”
The Scanwell Health team is currently developing the SARS-CoV-2 test under quarantine, conferencing from their homes via Zoom, pricking their fingers in teleconferenced group meetings, and working to develop the easiest, most foolproof test they can.
It’s no simple feat. Users will have to prick their fingers with a lancet. The blood pools on their finger—it’s not a “flood” Kim says but it’s more than a diabetic would collect for a blood sugar reading. Then the blood needs to be collected into a pipette. That blood is then poured onto a test strip. The person adds a couple drops of a solution to distribute the blood across the strip. The strip then detects antibodies, which signal the virus is or has been present in the person’s body.
So how do you convince someone to break their own skin to take blood? “It’s the fear of not knowing what it will feel like when you prick yourself—that’s the main pain point we need to tackle,” says Kim. “A lot is giving people a preview as to what to expect.” So the app breaks down the process into steps. First you pull out the lancet. Then you push it against your finger. When you push the button on it, the pain feels like a pinch. “We have to be descriptive,” Kim says. “The more that a user who has never done this before has a clear picture of what will come, the less they’ll be afraid.”
The physical kit itself plays a role in this too. “Small differences of the shape [of the lancet] make a big difference in how people interpret it,” says Scanwell Health CTO Pavel Bozdog. The company has been sourcing different lancets, trying them firsthand, to see which is the least intimidating. “We’ve been sacrificing a lot of our fingers for the last week, testing different lancets out,” Kim says.
The final design challenge is the wait: The test takes 13 minutes to show results. To fill this time, Scanwell has educational components in the app, including potential next steps if you test positive or negative.
The team has made the decision that the test will not offer someone a clear positive or negative result at a glance. Instead, you scan it with your phone, and a doctor calls you with the news. That might seem counterintuitive, but Bozdog argues that Scanwell doesn’t want to add hysteria to the pandemic, and that a medical professional can help contextualize the news. (Though it should also be added that you could go online and deduce your results for yourself; the test strip itself is a standardized product created by Innovita.)
After Scanwell has validated the work internally, the FDA handles clinical testing; the test is vetted alongside validated COVID-19 tests on patients who have tested both positively and negatively for the virus.