2017

SMARTi - check drugs interaction for your safety

HFES Student Design Competition – Mobile Health Apps GALA NIKOLAEVA

SMARTi - check drugs interaction for your safety

SMARTi - check medication interaction for your safety

Contents

Why it is important to know? .............................................................................................................. 2

Why it is important to care of yourself? ........................................................................................... 3

What do we have on market now? ..................................................................................................... 4

Additional issues with existing applications: ..................................................................................... 4

What are users’ needs? .......................................................................................................................... 5

Main persona ........................................................................................................................................ 5

Other personas ..................................................................................................................................... 5

Journey map .......................................................................................................................................... 6

What is SMART interaction app? ......................................................................................................... 7

Ergonomically friendly universal design ............................................................................................ 7

Theory and principals under SMARTi design ................................................................................... 8

Priorities Matrix ..................................................................................................................................... 8

Work flow for basic function ............................................................................................................... 8

Conclusion and perspectives................................................................................................................ 9

Business model ..................................................................................................................................... 9

SMARTi - check drugs interaction for your safety

SMARTi - smart medical interaction for your safety

Why it is important to know?

No doubt that certain categories of people are at

a greater risk for serious adverse effects related to

unwished interactions. For example, people who have

preexisting conditions such as high blood pressure,

diabetes, renal or liver disease and who take multiple

medications. However, those categories of people and

their physicians can be more aware of the problem, compare to the younger/healthier

population. Despite the fact that FDA suggest talking to doctor or pharmacist about the

drugs one takes and discuss all OTC and prescription drugs, dietary supplements,

vitamins, botanicals, minerals and herbals, as well as the foods every time when doctor

prescribes a new drug, a lot of people still have false sense of security regarding medicinal

plants or/and OTC medications. The interaction between a medicinal plant and a drug is

usually overlooked due to a belief in the "safety of medicinal plants." In addition to that

people tend to “forget” about medicine that they take for a long time on a regular basis

(such as oral contraception or high blood pressure medication) and

food/smoking/drinking habits. However, all these factors can cause side effects in a light

to fatal range of severity that can be preventable. FDA says that it is not only important

to read labels, but it also important to read labels every time that you use a drug, even if

you used it before since drug labels may change as new information becomes known.

http://www.fda.gov/downloads/drugs/resourcesforyou/ucm163355.pdf

http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2500064

http://www.nps.org.au/topics/ages-life-stages/for-individuals/older-people-and-medicines/for-health-

professionals/polypharmacy

Drug interaction – alteration of the effects of a drugs by reaction with

another drug or drug, with food or beverages, or with preexisting

medical condition. Mosby’s Medical Dictionary, 9th edition © 2009, Elsevier

Over a third (36%) of older

adults in the U.S. regularly use 5

or more medications.

SMARTi - check drugs interaction for your safety

Why it is important to care of yourself?

In ideal world all information that regards to your health should be available

to all health professionals across all institutions, if you choose so; in fact, this

is rarely happened. Every time you come to a new dentist, change your

insurance, hospital or even particular hospital brunch a huge chunk of

information can be lost, and it is your responsibility to provide that information. In

addition, some information is time sensitive, so they will ask you over and over again.

Health professionals that care for you should be the most reliable source of

health information, but you may not always be able to talk to them.

Sometimes we need a quick and easy way to check if it safe for as to take an

aspirin pill, or if it is ok to grab that bottle of vitamin C from a supermarket

shelf. In a bad scenario we might need to give a list of our allergies to paramedics.

Sometimes we do not have time to plan ahead that type of events, and we need “here

and now” a solution.

Human factors. Even if all information

about your health is current and

accurate in a hospital database, there is

always a risk that doctors and

pharmacists would miss something important due to

alarm fatigue, time constraints, busy workflow, and

other factors that affect perception and cognition

processes.

http://www.nps.org.au/media-centre/media-releases/repository/Dr-Google-is-here-to-stay-So-how-do-you-do-it-

safely

http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AdvisoryCommitteefor

PharmaceuticalScienceandClinicalPharmacology/UCM370539.pdf

https://www.ismp.org/newsletters/acutecare/showarticle.aspx?id=109

“You need to play an active role in your health by knowing where to find information about health conditions,

medicines, test and treatments. Having the right information will help you to get the most out of your medicines –

and to make better health choices for you and those your care for”.

NPS MedicineWise spokesperson and pharmacist Aine Heaney

Alarm fatigue - is sensory

overload when clinicians are

expressed to an excessive number

of alarms, which can result in

desensitization to alarms and

missed alarms.

SMARTi - check drugs interaction for your safety

What do we have on market now?

Search on Google play (applications for Android phones) showed that there are no

many applications that can assist user in learning about medications interaction, along

with interactions with food, and medical conditions, and help to avoid that type of

complications.

Most of the existing application can be divided in three categories:

Applications look like a list of medications that user takes and work as reminders.

Applications that you have to be a medical professional to be able to use. Plus, in

most scenarios you have to have access through you company/hospital or/and pay a lot

of money.

Applications that can show you some interactions, but still more oriented on

medical professionals and have complex functionality without ability manage user

personal data.

Additional issues with existing applications:

https://www.caregiver.org/women-and-caregiving-facts-and-figures

http://www.dailymail.co.uk/health/article-2080238/Women-pop-doctor-men-really-ARE-sicker-sex.html

https://www.healthwellfoundation.org/story/millennials-are-shaping-the-future-of-health-apps/

Applications ask for private information such as insurance, drivers ID, and even SSN, however, provide very few or none security

measures.

Design of all checked

application is not universal, and not include for example mode for people with impaired vision.

Approximately 66% of family caregivers (health provider, manager, surrogate decision-maker etc.) are woman, they also

have more chronical conditions that men, plus millennial women spend 200% more time on health app than on any other app. However, it does not look that existing application take into account these facts.

Only one application provides some opportunities for collaboration between users, others assume either complete

independency of users or complete dependency from a “main user”/caregiver.

SMARTi - check drugs interaction for your safety

What are users’ needs?

Main persona

Other personas

Bryan, 5

Elsa’s and David’s son. Has mild allergy

to citruses, gets influenza easily. Should

start kindergarten in 3 months. In a process

of getting his DTaP, MMR, VAR, IPV

vaccination.

Elsa, 35

Married, employed. Mother of a boy (5 y.o.). Elsa does not

smoke, drinks socially, takes oral contraception, vitamins

occasionally, and ibuprofen “as needed” for migraine. Has

allergies to some antibiotics. Has (65) mother who leaves

independently 60 miles away, has high blood pressure, pre-

diabetes condition, and hyperopia.

Her responsibilities related to her family health needs:

Elsa takes care of her son and his vaccination, make decisions in case he gets sick.

Want to be sure that her mother is doing well. Help her when she needs assistance

or advice.

Sometimes reminds her husband David about annual checking, flu vaccination, or

diet restrictions because of his stomach problem.

Edna, 63

Elsa’s mother, has controlled

hypertonia, wearing glasses “for reading”.

Recently was diagnosed with prediabetes

condition. Edna wants to be as independent

as possible, but feel more secure when she

can discuss her problems with her daughter.

SMARTi - check drugs interaction for your safety

Journey map

Tell to others

What tool is the best for me?

What medicine are you taking?

You have an allergy to what exact antibiotics?

What is your cycle day today?

Do vitamins count? There are five

antibiotics, but I cannot even

pronounce their names! I know it

should start next Monday, but on

what day I am now? 21 – 6, is that

15 day of the cycle?

Physician

1

2

4

5

6

7

I need to have

this information

easy available 3

?

I need one that will let me have all information at one place, it should be easy to use, keep my records secure and private, help me communicate with my doctor, take care of my family, and aware me if medication might be not safe to take.

Information

Safety

Privacy

Communication

Control

*More details below

Download Try Sign Up Use Purchase

SMARTi - check drugs interaction for your safety

What is SMARTi interaction app?

SMARTi is smartphone application that allows user

immediately check if medication or supplement might have

negative effects due to interaction with medication that one

already takes, or condition that he/she has.

During on boarding process user put in all known information

about medications, supplements, conditions, allergies etc. Each new medication

compared to existing. In case there is possibilities of interaction or/and allergy/cross

allergy the app warns a user.

To help user keep all information up to date we use gamifications of the process

together with notifications. To assure user that it is safe to input sensitive information to

the app we incorporate “private mode” as an addition to a “fingerprint password”. We

also help to have information that needed most often “on fingers’ tips”.

Ergonomically friendly universal design

Thumb zone focused on

female’s hands

“Bigger font” option for those

with impaired vision

Haptic feedback

Custom simplified design for

those who might not need a full

version (teenagers, elderlies etc.)

http://gsrealdesign.tistory.com/entry/Bottom-navigation

http://www.dailymail.co.uk/sciencetech/article-2903179/Which-smartphone-best-fits-hand-Graphic-reveals-device-matches-

thumbzone.html

“Read for me” function allows take photos of medicine package,

instruction, and other documents, recognize it and replay text through

phone speaker.

SMARTi - check drugs interaction for your safety

Theory and principals under SMARTi design

Priorities Matrix

Many users Few users

Use often

Type in a new medication

and check interactions,

side effects, possible

allergies, etc.

Take care of somebody’s

else medication’s list

Use rare

Look up for allergies

and/or menstruation cycle,

medication’s list.

Ask questions about

medications and their

interactions. Share lists.

Work flow for a basic function

This information should be the

most prominent.

Second important

ok

Type in

Med. Interaction

Allergy

Condition

Dosage

Ignore

Make note

Report

Other

pages

SMARTi - check drugs interaction for your safety

Conclusion and perspectives

With innovative digital technologies, cloud computing and machine

learning, the medicalized smartphone is definitely the future of

technologies and is going to change every aspect of health care. As a

good representative of that, SMARTi application addresses safety issues,

provides freedom and self-reliance for users by giving them tool to get

health related information in a fast and efficient way. Further development plans for this

promising application are to refinement synchronizing, enhanced user-to-user and user-

to-doctor collaboration mechanisms, incorporate refill reminder and medicine order

options, improve cybersecurity system, along with constant usability studies on existing

and new functions.

Business model

http://www.ehfg.org/blog/wp-content/uploads/2014/03/Health-apps-patients-standards-and-policies-white-paper-March-2014.pdf

http://www.forbes.com/sites/ciocentral/2012/06/04/5-ways-mobile-apps-will-transform-healthcare/#53ff7b116509

http://www.wsj.com/articles/the-future-of-medicine-is-in-your-smartphone-1420828632

https://www.healthwellfoundation.org/story/millennials-are-shaping-the-future-of-health-apps/

Step #1 – user can try app first

without signing in

Step # 2 – to get “basic version with

her/his data” user has to sign up

Step #3 – user can have a trial for an “extension

version” (with collaboration, send instant message

and other functions) for 30 days for free

Step #4 – then user has to pay once for the full

version

Step #5 – user can choice to pay for annual drugs

information updates, since new interactions

discovered every year. Use also can get discounts for

signing up her/his friends and relatives

Potential partners:

Corporations and

pharmacies that have on-

line tools, but do not have

mobile applications

Independent researchers,

and non-commercial

organizations

Health-

related IT

companies.