From the outset of the hackathon it has been our foremost mission to provide a platform that prioritizes accessibility to equitable care while confronting issues uniquely posed by the Covid-19 pandemic. With the transition of much of life’s daily activities online we understood that this cannot necessarily apply to all medical activities. We began by recognizing that the current apparatus of the healthcare system does not provide avenues for certain types of testing remotely. We decided to construct such a paradigm for the monitoring of disease progression in HIV/AIDS. Fears of infection with Covid-19 have a documented effect of discouraging patients to receive medical care. Seeing that HIV/AIDS patients can be immunocompromised we understood these fears to perhaps be heightened in these individuals. To quell anxiety about routine 3-6 month CD4 count checks for HIV/AIDS patients during the Covid-19 pandemic we decided to cultivate a method in which these checks could be conducted remotely. This is how we arrived at the idea to have mailed in finger prick samples for examination of surface Ig antibodies to determine CD4 count. We extended our project to encompass patient adherence after recognizing the particular challenge patient adherence presents in relation to HIV/AIDS and ART.

What it does

Our app is focused on encouraging patient ART adherence remotely. For HIV/AIDS patients we understand that non-adherence with treatment paradigms is a multifaceted issue grounded in the social determinants of health. Our app combines multiple approaches to encourage adherence with a patient-centered outlook. One of which is tracking CD4 count with a home testing kit. Patients submit a secure finger prick sample with our kit and mail it to a designated lab location. The finger prick sample is analyzed for surface Ig antibody from which CD4 count is deduced. This analysis can be conducted with a frequency in concordance with the patient's needs. Results are available on the app with disease progression benchmarks and are accessible to both patients and physicians. This will allow the patient to see how far along their disease is as well as what the effects of taking/missing their treatment are. HIV patients will also be able to see how close they are to developing AIDS as the distance to a CD4 count of less than 200cell/mm3 will be provided. All patients will also be able to see how far away they are from obtaining a severely low CD4 count of 50cell/mm3. Moreover, the home testing reduces the risk of Covid-19 infection in the clinical setting for these HIV/AIDS patients who are potentially immunocompromised and increases adherence if the patient were to skip the appointment due to Covid-19 fears altogether. The app provides other incentives for adherence including a points and rewards system based on medication logging. It also endows the patient with resources to aid in the resolution of the root cause of non-adherence that are specific to each identified cause. These methods of encouragement confront non-adherence and seek to induce behavioral change on an individualized level.

How I built it

Our app has its beginnings on a humble shared google doc of scratched ideas and sporadic feature additions. Once its foundational structure had been mapped out we sought to convert it to an app. We decided to do this using the prototyping website Figma. We used Figma to create interfaces that corresponded to the pages of the app and create the smooth transition amongst these pages. We used python for the data analysis aspect of the points system using the information regarding medication logging recorded on the google form.

Challenges I ran into

We would have loved to have actualized our app in person rather than over zoom. Using an online platform to conduct extensive meetings can prove rather tiresome and the lack of being together this weekend caused some scheduling issues. It was also difficult to attempt to use unfamiliar platforms that required self-teaching, but it also was a fun challenge at the same time. A recurring issue we faced was trying to accomplish all we wanted to do over the course of one weekend. We were frequently confronted with the issue of balancing innovation, ambition and feasibility.

Accomplishments that I'm proud of

We feel that we have made a product that could improve the quality and longevity of the lives of others. We feel our idea is innovative and important to improving the harrowing statistics of HIV/AIDS ART adherence in America. We also believe in our product-- we are confident that it would be effective if marketed. Our product is unique and reflective of our passion for remedying health inequities that stem from the social determinants of health. We also are proud that we were able to make a visibly pleasing product in addition to our content with the concepts behind it. We were able to do so without any prior knowledge of app development and limited coding experience. We are very pleased with our product and hope that it is received in the way we think of it, but even if not-- we are still very proud.

What I learned

As a group our specialities ranged from Biochemistry and Molecular Biology to Material Science and Biomedical Engineering. Although we were able to cultivate innovative ideas with our diverse range, few of us had some coding experience and none had experience in app development. Nonetheless we were able to learn how to create our own prototype for our app and gained exposure to multiple app developing platforms we tested. We also learned how to highlight each of our strengths to compensate for what we may have lacked in a certain area. Our amount of time spent focusing on what idea we wanted nearly spanned that of the app creation. In cultivating ideas for our app we learned how to abstract the most attractive ideas from several pitches. In fact, some of our interfaces for our platform stemmed from ideas originally pitched for a project focused on cancer treatment. In relation to the subject matter, everyone gained more exposure to the intricacies of allergy and antibody tests as well as HIV detection test. We also learned more about the crisis that is non-adherence in HIV/AIDS ART. In looking for ways to remedy non-adherence we learned what might be attractive to a patient in contrast to what might be discouraging (and inadvertently encourage non-adherence). In doing so we learned more about the patient-centered approach to medicine that implies a focus on the emotional as well as physiological needs of the patients.

What's next for EC-ART

The future for EC-ART consists of implementing all of the features that we had hopes of actualizing this weekend, but proved not to be feasible. One of which is including another feature on the physician end that serves as a calculator for drug resistance treatment paradigms. For example, if the CD4 count indicated acquired resistance to a certain drug such as a protease inhibitor, the physician would be provided with a list of drugs that were still effective for the patient (i.e. did not include any other protease inhibitors or any medications the patient were known to be resistant to). This addition to the platform would allow for accessible and cost-effective resistance testing for low and middle income communities-- where it is needed most and is currently lacking. We would also like to use such a resistance paradigm to model and monitor acquired resistance in other diseases like cancer for treatment recommendations. We would also love the opportunity to transform our current prototype into an actual product.

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