Hira: Conversational AI Designed to Listen
I led early research and design for Hira, a patient support tool developed with UPMC's Gynecologic Oncology department. Initially scoped as conversational AI for symptom guidance, I reframed the product after discovering patients' deeper need: feeling emotionally heard rather than simply advised.
Through co-design with patients and clinicians, I developed a "listen, don't solve" strategy. This shaped Hira's interaction model to create a non-judgmental space for expression while passively capturing symptoms—helping patients process emotions as well as prepare for and engage in appointments.
This reframing aligns with health system goals around care quality by improving patient-provider communication and patient satisfaction.
“This aligns with exactly what patient care needs right now. Plus it’s helpful for doctors too. Please keep on building.“
Solution
From our stakeholders
“I can see this being huge, especially for patients who don’t have anyone to go with them to appointments.“
In short: While clinical experts know their field deeply, they don’t live the patient experience, so we prioritized ongoing patient feedback throughout our process. We also explored feminist approaches to communication, experimented with grounding haptics and sound, and created some unconventional prototypes to help us better understand and express the emotional depth and humanity we were designing for.
Process
Methodologies
Shadowing
Research
I observed both patient appointments and charting in-between. I noticed that patients often recalled symptoms or questions after the visit ended, requiring follow-up through email or triage staff.
Through previous conversations with the staff, I knew that patients commonly experienced intense anxiety before appointments and brain-fog during them.
Co-design
We asked patients to design their ideal virtual caregiver. We learned that they didn’t want advice or solutions, just to be listened to.
“My husband has learned I don’t want solutions, just presence and acknowledgment that this sucks. Our dogs are great support— they never judge and are always there to listen.”
“My friends tell me “It will be okay,” but that only makes me feel misunderstood. Sometimes, I feel like I need to rant into the void and not get answers back.“
Simplicity
The right amount of technology and required attention is the minimum needed to solve the problem.
Non-intrusiveness
Move easily from the periphery of attention to the center, and back.
Based on Calm Tech Principles and Best Practices for watchOS
Building Design Principles
Embrace humanness
Let people stay anchored in their world through their senses and emotions, not their screen. Amplify what humans do best and let machines handle computing.
Design Detail
Technology thats communicates, but doesn’t need to speak
Research
We took a radical approach to conversational AI by designing Hira to only listen—without anthropomorphic backchannels like “uh-huh” or “mhm,” which can disrupt emotionally charged moments.
Instead, Hira conveys amorphous presence, not a persona, through rhythmic visual pulsations and making recording the central interaction. This preserves users’ emotional flow and prevents fears of judgment or social friction.
1 Howell et al., 2018. Emotional Biosensing: Exploring Critical Alternatives 2 Cho et al., 2022. Alexa as an Active Listener
Design Detail
Surfacing the right information in the right way at the right moment.
Research
Many patients shared that although they know what questions they want to ask, stress, brain fog, and time pressure often cause them to forget. We designed the app to transform voice logs into clear, actionable talking points that appear naturally alongside appointment details and not hidden in menus.
This approach draws on research around cognitive load and self-advocacy: by distilling information into concise, contextual actions under the patient’s control, we help them feel clarity without adding cognitive burden.
3 Nguyen et al., 2019. Fear and forget: how anxiety impacts information recall
Design Detail
Communication that supports patients’ sharing boundaries and energy levels
Research
Through conversations with patients, we learned about their complex feelings on the burden of keeping loved ones informed without making their cancer feel public with email chains and websites. They appreciated texts and calls of support, but many felt overwhelmed by the pressure to respond when their energy was extremely low.
Support Taps were designed to provide a natural way to share voice updates with a trusted circle who can reciprocally send Taps as low-pressure gestures of care that don’t require a response.
4 Ussher et al., 2006. What do cancer groups provide which other supportive relationships do not?
Design Validation
Alternative Physicality Explorations
Before we decided on using the Apple Watch, I did exploratory studies on physical AI and robotics.
I was inspired by Paro the robotic seal and The Hug by Jodi Forlizzi, particularly in how they use soft textures, gentle haptics, and subtle sounds to create emotional comfort. These projects informed my approach to designing a tactile and responsive experience that feels warm, calming, and expressive. I aimed to evoke a similar sense of connection through visual materiality and interactions.
Along with exploring the use of textures, light, sound, and haptics in other products, my team closed our eyes and noticed how the physicality of objects dropped into our hands made us feel.
