Undergoing an MRI scan can be a stressful experience for children. Our holistic solution delivers play-based activities to help reduce the use of general anesthesia and lower the risk of healthcare-induced trauma in pediatric patients. It uses gamification, a buddy system, and augmented reality educational techniques to engage and guide children through their MRI scan journey.

With our Pediatric Coaching solution, children can playfully learn about the MRI procedure and what is expected of them, using the Scan Buddy app at home. They can meet up with their favorite buddy character in the hospital, near the educational toy scanner. And when it is time to have their scan, children are again accompanied by their buddy character, whose familiar voice guides them through the scan.

With this innovative tool, we support doctors to successfully scan a vulnerable age group of 4-8 years with as little sedatives as possible. Parents can be reassured, and the child can feel empowered with a positive healthcare experience.

Design Innovation

Acquiring high-quality images in pediatric MRI can be challenging. Children need to enter a large, unfamiliar machine and lie still for the duration of the scan (typically 10 to 60 minutes) while the machine makes loud, jarring noises. During the scan, children can become agitated and may be unable to lie still. As a result, pediatric scans are often performed under sedation or general anesthesia, which can carry disadvantages such as post-scan irritability for the child, and concerns of repeated anesthesia exposure.

Our solution guides children throughout different phases of their hospital journey. Uniquely, children encounter the same characters, design elements, voice and child-friendly language at home, in the waiting room, and in the scanner. At home, children are playfully prepared with the Scan Buddy app, which consists of an informational movie, interactive game in which children can perform a scan, and an AR-game to learn more about the MRI scanner. It also contains a parent module with information for parents/caregivers, an FAQ, and fun games to do with the child to prepare them for the scan.

When children arrive at the hospital, they can insert a buddy character into an educational toy scanner to learn more about the scan. There are three buddy characters to choose from: Ollie the elephant, Chris the crocodile, and Doris the chicken. When the character is inserted into the scanner, children learn more about why that animal needs to have a scan, and learn about their upcoming scan.

When it is time for children to have their scan, they are guided by Ollie the elephant, who encourages them throughout the scan, shows them how far they have progressed in the scans, and coaches them if they need to hold their breath during parts of the exam. The voice children hear during the scan is the same voice as the voice used in the app and educational toy scanner.

The solution has been created in collaboration with radiologists, child life specialists, designers and psychologists. As a basis for the solution, learning goals were defined describing things children need to know or practice to be able to undergo an awake scan. Examples of learning goals are "familiarization with MRI sounds" and "understanding the need to lie still". These learning goals formed the basis of interactive games in the app. To optimally support the various learning goals, the FIT-for-MRI learning framework was created. FIT stands for Familiarize-Inform-Train. The app and content for the educational toy scanner have been designed to:

• Familiarize children with aspects of the MRI that may be perceived as overwhelming, such as MRI sounds (implicit learning);

• Inform children and parents/caregivers about the MRI procedure (explicit learning);

• Train children to acquire skills that are necessary to undergo an MRI scan awake, such as keeping still (procedural learning).

Benefit to User

The solution aims to make the hospital experience less stressful for pediatric patients and their parents/caregivers. It also aims to enable hospital staff to scan children awake, as the use of anesthesia/sedation in pediatric MRI has been associated with higher costs (appr. 9x higher than for an awake scan), longer time spend in the hospital, longer waiting lists, and a higher likelihood of safety incidents. Moreover, anesthesia use carries disadvantages such as post-scan irritability for the child.

For hospital staff, working with anxious children and/or parents can be challenging. The solution aims to prepare patients and their parents to enable a more smooth and pleasant workflow for hospital staff.

Business Impact

Patient engagement is an important differentiator in healthcare. With this proposition, we provide an end-to-end patient engagement solution, from home to hospital. Our solution uses many design disciplines to create an engaging user experience throughout the MRI journey. From character design to hardware (industrial) design, movie production to game design, all elements harmoniously come together to guide the patient. The solution seamlessly fits the patient-centric nature of the brand, and extends the "Ambient Experience" portfolio to improve the experience of patients.

Besides the company itself, the solution helps hospitals to improve their patient experience ratings (e.g., HCAPS scores), while improving care (e.g., fewer safety incidents) and reducing costs, rescans, waiting lists, and time spend at the hospital.

Benefit to Society

Healthcare systems around the world are under ever increasing stress. While infrastructure investments, technical improvements and workflow optimizations are being developed to keep healthcare systems functioning efficiently, it can be easy to forget that going to a hospital is a stressful experience for many patients. Stress and anxiety can lead to non-compliance with hospital procedures. Timely coaching of patients can improve their experience, increase hospital efficiency, and reduce costs.

By putting a lot of multidisciplinary design effort into an end-to-end patient coaching solution, we want to set an example of how a well-designed patient facing solution can not only create better patient experience but can be a viable option to improve efficiency. Time and cost saved this way can be invested in other patients and procedures.

Aesthetics

The solution has been designed to appeal to young children (aged appr. 4 to 8). It contains likeable, child-friendly buddy characters that guide children throughout the journey. Design elements are consistently used throughout all phases of the journey (at home, in the hospital and in the scanner). For example, children see a "progress bar" showing how far the scan has progressed in the app, educational toy scanner, and during their own scan.

The solution uses consistent, child friendly terminology. For example: the MRI scanner is referred to as "MRI camera", having a scan is "having a picture taken", and the MRI table is called "the MRI bed". Terminology was selected in collaboration with child life specialists and psychologist. The terminology is explained to parents/caregivers in the parents' section of the mobile app so they can use the same terminology when talking to their child.

The educational toy scanner has been designed to have a balanced aesthetics: to be an appealing object for children to want to play with, and to have a general resemblance to the real equipment it represents. With its soft form and mono volume approach it is aimed to be safe for children and easy to clean.