Case Study

Tablet-Based Health Counseling App for Substance Abuse

PathWell, a tablet-based, touch screen enabled application, enables Health Educators to gather data and provide enhanced feedback during the motivational interview process without losing rapport with the patient. The system enables the patient and practitioner to explore and co-visualize the consequences of behaviors in such a way as to provide insight and motivation for more empowering alternatives.



Key to successful motivational interview (MI) sessions is the rapport the practitioner can sustain with the patient. For example, in the case of a patient who is at-risk for alcohol use, the practitioner works with the patient on the patient’s terms for discussing and exploring the substance use. Sustaining rapport while using a computer assistive tool required the computer not take away from the quality or comfort of the human-to-human interaction or the ability for the interview to change directions as the patient desired. Thus, the user interface needed to have flexible navigation and use very simple interactions that would not require a heavy degree of focus on the computer screen.

Orthogonal used working sessions with the client to brainstorm a wide range of data gathering methods that involved simple typing, touch screen interactions and hybrids. Next, a prototype was created that brought the methods to life so they could be tested by actual users. From user feedback, a second honed down prototype was created and tested with users to validate the refinements.

Having a validated set of low effort interaction methods, the team set out to design a product that could support the entire interviewing process, including pre-screening, the interview itself and support of billing procedures.



The design problem had similarities to designing a “wayfinding” system of environmental signage. Signage works as we walk or drive through an environment without creating a lot of cognitive overhead. This was also the goal of the PathWell UI, so key characteristics were borrowed from wayfinding design:

  • At-a-glance processing of screens
  • Simple touch interactions with large hit areas that can be seen in peripheral vision
  • Feedback of information in forms that can be insightful to the patient (billboards that make impressions)
  • Use of short words, symbols and directional indicators to lower cognitive load (the elements of signage)
  • Organized using a “districts model” for non-linear navigation oriented around places the interview may go free of any particular path to get there