Initially our startup, Benecure only offered a patient facing app focused on cardiovascular disease management. This app used multiple sensors to analyze user behavior and create custom improvement plans to help the user eventually follow physician protocols. After interacting with patients with multiple comorbidities, we created a patient management portal.
To better understand the difficulties faced by Mary (the case study mentioned in this challenge). We spoke to a healthsystem in Chicago that primarily catered to the low income segment of the city, and learned about the interesting hurdles they face. For e.g. patients have limited minutes on their cellphone plan, making appointment scheduling difficult. Keeping this information in mind, we tweaked our existing app and patient management website.
There are two parts for the service, the patient management portal is a website created to help case managers deal with a large number of patients efficiently, the second part of the service is a patient facing app that connects with smart devices to help them manage chronic diseases such as Hypertension/CHF/Diabetes.
Patient Management Portal:
As shown in the video, we have kept the case manager in mind while designing the system. Our latest feature is the use of color coded icons, in the patient list view, you can quickly assess which patients need urgent communication.
In the patient profile view, you can quickly see when a patient was last successfully contacted as well as when the patient last visited the healthcare facility. As mentioned in the Chicago hospital example earlier, reaching out to patients is difficult, rather than just calling the patient periodically during the same time every month/3 months. If a patient has a history of not responding to prescheduled appointments, we try to engage the patient during a different date, to prevent reaching the user when their minutes are up this increases the likelihood of a pickup, (assumption being that patients that finish their minutes prematurely by the end of the month and can’t receive calls, are more likely to pick up calls during the start of the month).
In the patient profile view, the case manager can also pinpoint specific times/meals/days the patient struggles with meeting physician instructions. The case manager can now create a targeted outreach to the patient and assist with specific advice rather than general counsel, which may have limited use if any.
Rather than follow traditional design methodology, we designed to simply the interface to make it easy for case managers to quickly and easily manage a large number of patients. The platform pulls data from the Honey app and is able to provide real time information to the case manager along with a summary of where the user needs most help.
We use the traffic light design principles, anytime you see red, it means the patient needs urgent help, amber means the patient needs assistance and green means the patient is doing ok. For e.g. In the patient profile view a green clock means the patient was successfully reached and an appointment setup, amber hospital icon means the patient hasn’t been to the hospital for her last scheduled appointment.
Patient facing app:
Once a patient has been diagnosed with a chronic disease (such as Hypertension or Congestive Heart Failure), they are given access to the Honey app along with a weighing scale, blood pressure monitor and an activity tracker. The Honey smartphone app aggregates and analyzes data from the sensors to provide a custom care plan for the patient based on their past behavior. As is shown by research published by the AHA, a significant portion of the hypertensive population fails to manage their condition. This is because patients are expected to make drastic changes in their lifestyle, our service is instead focused on making gradual incremental changes to the patient based on their past behavior.
The algorithms are smart enough to recognize the users weak points with regards to following physician recommended changes and push the user to make relevant changes. From a usability study we conducted in four states with a healthsystem, we learned to incorporate gamification elements into the process along with simplifying the design to make it user friendly (instead of intimidating).
The dashboard in the app has been specifically designed to be easy to understand at a glance and quickly see what the goals are for that particular day. For e.g. the user can see how many calories are left for that day before they order lunch so they can make wise choices. We have also implemented the ability to add food within the app as well as physician view that can be shared in doctors visits (for the physician to see data trends on your vitals) and a summary tab of your information.
We have also talked to hospitals that deal with individuals in the low income segment of the population, for this segment of the population, providing $300 worth of devices per patient is not feasible; instead we created a cheaper alternative option. Benecure has setup a partnership with Higi, they make the kiosks you see in pharmacies that allow you to take weight and blood pressure. Honey users can now use a Higi kiosk to get their Blood pressure and weight taken, they don’t need to purchase the devices. For this higher risk segment of the population, all the patient needs is a smartphone and we take care of the rest!
We understand that Mary and others like her may have a smartphone, but they have limits on how they can use it (minutes/data etc.) we account for this in the design of our service.