Redesigning Twistle–a health communications platform

design case study


  • Recommend UX patterns for the Twistle Android app
  • Redesign the Twistle Android app


  • List of most potentially significant UX improvements
  • UI design compsUI design redlines, measurements, and notes
  • Small icon set


1 month (January 2018 — February 2018)

1 sentence summary

Twistle is a communications app that enables providers, their services, and their patients to communicate through text messages, photos, and more.

The problem: branding & polish

Twistle (rhymes with whistle) approached me with a unique problem: over the years, their iOS app had pushed ahead of its Android sibling in terms of visual appeal. To make matters worse, the app could be confused for Google’s Gmail app because of their similar color and layout!


To really understand their problems and business goals, I spoke with Twistle’s CTO and Director of UX. They explained the app’s branding difficulties, and helped me understand that Twistle is primarily a means of connecting patients to their healthcare providers.

To that end, the app’s redesign would have to center around the patient and the clinician. The kinds of questions I asked at this stage were: What do patients want most from the app? What about clinicians? Are their needs different?

The Twistle folks had already given the matter plenty of thought; they knew the answer to their two-part problem lay in Google’s design system, Material Design, and the user experience patterns that it defines. My questions then became: How can Material Design help patients and clinicians communicate? What patterns exist to facilitate their goals?

Now I had a good understanding of the problem; I knew that patients and clinicians needed to talk to each other easily. I knew that I’d be using Material Design as a frequent reference, and I knew generally what parts of the app were most conducive to meeting users’ goals.

One last thing: the new version of the app needed to be live in less than a month, so I needed to get moving.


I kicked things off by researching Material Design’s existing components and patterns. I kept an eye out for anything Twistle could make use of, especially if the current app was using something custom to solve a common user interface problem (e.g. input fields, date pickers). My goals were to bring the user experience closer to what Android users are accustomed to, and to make the app’s design consistent.

‍I delivered bite-sized takeaways– suggested changes that would make the biggest difference to the quality of the user experience.

The research phase’s deliverable was a series of small takeaways.

I frequently referred to the Material Design guidelines during this phase, especially noting the intentions behind a component’s design. Knowing the intention would make things easier later, when designing custom UI that felt consistent with both Twistle and Material Design.

I also researched competing apps and took note of their UI patterns.

Design process

Using Material Design components and patterns made a dramatic difference in the app’s look and feel, but I was far from done. Twistle also frequently uses custom-made components and patterns, things that don’t have any counterpart in Material Design. Namely their branding, registration flow, and conversation view.

For these things, the guidelines had no answer. So I designed new solutions for each, while keeping as many similarities to Material Design as I could.

Branding (or, adventures of a human color picker)

First, I needed to find new color combinations that Twistle could use throughout the app for their branding and UI. Many of Twistle’s users are older, and the app needed to be comfortably legible for everyone.

To ensure legibility throughout the app, I chose colors that pass the strict contrast requirements defined in the Web Content Accessibility Guidelines. This way, Twistle users would be able to read everything from bold headers to fine print comfortably.

Twistle’s message bubbles have a safe 7:1 contrast ratio.

Messages from "you" and "them" are both safely legible.

With colors picked, I turned to the company’s branding needs. They needed to distinguish themselves to their users, and distance their visual style from Gmail’s. I focused on two areas where Twistle could build their in-app brand recognition: the launch screens (a.k.a. splash screens), and the registration flow.

Launch screen

This was one of my favorite discoveries during this project. Material Design suggests two ways to use launch screens:

As placeholder UI, to improve the perceived time-to-load of an appAs a brand launch screen, to improve the brand recognition of an app

I mocked up both possibilities, conferred with the folks at Twistle, and refined the version they chose: the brand launch screen.

Potential launch screens with potential brand colors


The second area to build in-app brand recognition: the registration flow. I wanted users to become more familiar with the brand’s colors and logo while they’re signing up, logging in, and otherwise beginning to engage with Twistle.

While Material Design has no suggestions regarding registration flows per se, using its components and iconography should help make the registration process more intuitive to users. I also used Twistle’s new primary color and a simplified logo in an attempt to make the app more memorable.

Twistle’s registration screens use 7:1 contrast ratio for text, and standard Material Design elements where possible


Lastly, and arguably most importantly, the conversation view. The Twistle folks impressed on me how important conversations are to their users. So it’s no surprise that we spent the majority of the project on this area.

Attachments in particular are frequently used in conversations. Clinicians and patients alike need to fill out forms, read PDFs, view tabular data, and look at photos and videos. Not to mention everyone needs to send and receive all of the above.

To properly design a solution that works in these scenarios, I needed to get my head around the situations that different users encounter while using the app.

For me, that meant starting with a whiteboard. (I ❤ ⬜)

Two participants in a conversation can see differently-prioritized attachments

I asked the folks from Twistle to walk me through what different users need from the various attachments. It did take me a few tries to account for all the details, but they were supremely helpful and patient.

Some messages’s attachment can be acted upon multiple times. Every message & attachment is important to someone, but not equally so to everyone. The solution also needed to account for at least three of the aforementioned file types (unfilled forms, filled forms, and tabular data). People in this scenario want to know things like: Did I fill this form in? When?

Taking all these conditions together, I worked on several iterations of a solution. In the end, I designed three “tiers” of attachment: prominent, regular, and subdued (also used for disabled states). Depending on how important an attachment is to a particular user, they’d get an appropriately attention-grabbing UI.

People in this scenario want to know things like: Did I fill this form in? When?

The final solution in whiteboard form

The most prominent version of attachment.

A less prominent variation of attachment.

The least prominent variation of attachment.

Icon set

As for the attached files themselves, I created a small set of icons that could visually describe the kind of file that’s attached (an unfilled form, tabular data, and a filled form).

Icon iterations

The final icon set.


To wrap up, I want to say that this project was incredibly rewarding for me. The design challenges were engaging, and Twistle makes a difference in people’s health every day. I couldn’t ask for anything more.

Thanks for reading!

Twistle is available on the Google Play Store and the iOS App Store. Please talk with your healthcare provider about how you can use it together.

This article was first published on Medium.