NEW MEDIA INTERVENTIONS TO IMPROVE MEDICINE NON ADHERENCE
Sponsor: Honeywell Technology Solutions
NEED This project tries to understand the need for design and technology intervention to help elderly patients adhere to their medication schedule.
TYPES OF MEDICATIONS: Long term medication Short term medication Emergency medications increase
2 1
Admitted in hospital CHANGE IN Doctor visits LIFESTYLE
3 Continuous changes in medicines
As time moves on
SUDDEN FALL ELDER Age: 75
1
Sudden change in health can be a lot to grasp for the elderly
Family alert & worried
2
Physically restricted Suddenly dependent Can’t go for walk
New impositions/ limitations on his everyday activities.
Spike in medicines being taken
3
Increase in the number of medicines. Gets a lot of attention from family and caregiver.
5 Leads to lack of clarity and miscommunication Multiple instructions Feedback
Feedback
Doctor 1
Doctor 2
Multiple medicines & lifestyle restrictions remain
6
Consults multiple doctors for follow up
More tests Too much of attention, which can lead to agitation
ILLHEALTH RELAPSE Elder starts recovering
4
Mixes up advice
Increased anxiety Additional costs
Attention from family reduces
Too many worry calls Domestic help to monitor
Responsibility on spouse increase
Starts feeling a little better, stops taking medicines
Different types of medications: Long term, short term, emergency medication.
5
Prolonged treatment & illness
Miscommunication and misinterpretation of multiple doctor feedback.
6
Stops taking all medications after he feels a little better. Can lead to adverse effects.
19
HONEYWELL TECHNOLOGY SOLUTIONS is a product and engineering innovation company.
COMPANY INTEREST Looking for new insights in the medication adherence market. which may be potential business opportunities.
HONEYWELL PRECEDENTS HOMMED
Care Provider Systems:
Remote monitoring systems aimed at improving communication and transfer of information.
Relationship: Hospital- Patient
Relationship: Relationship: Relationship: Hospital- Patient Patient- Doctor- Family Hospital- Patient- Financer
Patient Devices:
These are monitoring systems to collect vitals information and communicate to the doctor/caregiver.
Lifestream Mobile Devices: Sense of security Device to call caregivers and family in case of emergency or to know more about medication
PRECEDENT STUDY TABLET TRANSACTIONS PHILIPS MED DISPENSER
GLOW CAP
MAYA WIRELESS BOX
REMINDER SYSTEMS DIGITAL CONNECTIVITY AESTHETIC APPEAL
VOCERA
FEEDBACK/ MONITORING LOOP
SKYPE
PHYSICAL TREATMENT GAMIFICATION
VOICE BASED SYMPTOMS TRACKING
INVOLVES SOCIAL CIRCLES GAMIFICATION TO BUILD INTEREST ENHANCES FEEDBACK EXPERIENCE
39
INPUTS FROM THE ELDERLY TRIVENI Strip Identification Language barrier Anixety and fear of change RANGESA Has a caregiver; less efforts are put in by him to manage Medicines are integrated into lifestyle by caregiver (places of keeping, cut and kept, near bed stand)
RAGHUNATH Recognizes meds through: colour and shape of tablet (The packaging of some tablets change frequently) Keeps adding new medicines. Does not bother much about old medicines being wasted.
VIJETA Does NOT like being reminded Leaves medicines as soon as she feels a little better No schedule, medicines not kept properly
Throws away the previous batch, no one knows how many he has actually taken
Technology Some programs like Microsoft Word and mobile banking give them a sense of control Have a lot of privacy concerns while sharing account information
Google & health Like learning new things on Google Allows them to search their illness Can lead to extreme information that might scare them
Enjoyment
UNDERSTANDING THE ELDERLY
Emotional
Contributing amongst friends gives them a sense of responsibility.
Cherish media of their age Pass on family traditions Memory re-runs
Pass on family traditions
Memories hold an integral place in their lives.
Memories hold an integral place in their lives.
Like being in the safe zone Confusion leads to anxiety and resorting to older medium
Associate all with good old memories
Leads to frantic calls to family for help
Associate all with good old memories
Small things give them a lot to cherish
Once they learn something good, they try to stick to it
Learning Curve
ORGANIZING MEDICINES - easy to move around - simple to access medicines - easy to identify which medicine to take - easy to upload medicines - easy to change - more like a game - source of information for medicines - simple to identify if meds are taken - associate medicine timing with activity - open and carry box must be easy
PERSONAL INDIVIDUAL
ENVIRONMENT INTEGRATION - abstraction of health status - dynamic status - mobile wallpaper - living environment helps adhere
LIFESTYLE IMMEDIATE ENVIRONMENT ACCEPTANCE/ SEAMLESS INTEGRATION
CONNECT & COMMUNICATE MEDICINE TIMINGS - integrate in lifestyle - adjust to ongoing activity - alarms that don’t startle - personalize alarms - snooze patterns - overlay new with old sound cues - visual & audio notifications - must be heard in all activities - multiple devices
- overlay medicine schedule on old lifestyle - involve while planning to give a sense of responsibility - acceptance of treatment - accepting new technology(box) - easy to access & does not attract undue attention
DOCTOR PATIENT INFO EXCHANGE APPOINTMENT INFO - tips & important points from appointment - doctor coordination - medicine side effects & info - communicate adherence level when needed
EMERGENCY MEDICINE INFORMATION - list basic medicines that might be useful to patient
DIGITAL CONNECTIVITY
FAMILY/ CAREGIVER - check on adherence remotely - don’t pester asking about medicines too often - indicate when refill is needed - too many snoozes and notify - keep the dialogue going - motivate the elderly - schedule calls
OUTSIDE ENVIRONMENT COMMUNITY SHARING COMMUNITY/ FRIEND CIRCLE - discuss with fellow ill people - involve friends circle - incentive based sharing - Facebook duo - Twitter duo - tag teams to use two boxes
REDEFINED PROJECT BRIEF
10KL
10KL
10KL
10KL
10K
*
* 40AKS
*
100mg 1Y
:90DF HT
100mg 1Y
* 40AKS
10K
ORGANISING & MONITORING
MOTIVATION
COMMUNICATION
INTERACTION WITH TECHNOLOGY
:90DF HT
CONCEPT DEVELOPMENT
Concept exploration
Cap Sensor: This concept is to ensure that patients swallow their medicines. The glass of water has a cap which contains the medicines. T:9 SH 0D
4 g * 0AK 90 HT: DF
KS
PILL 1
PILL 2
PILL 3
PILL 4
PILL 5
PILL 6
10K 1Y
*
MOTIVATION & ORGANISING
10
Y 100m K1
F*
The cap senses the TILT and LOAD on it to determine whether the patient has taken the medicine or not.
KL 10
OPPORTUNITIES BEING ADDRESSED:
1. making the process as simple and mindless as possible 2. enhancing the medicine taking experience 3. one point solution for all medicine related info 4. reduce the errors while extracting medicines
PLEASE TAKE YOUR PILLS
Box indicates when it is time to take medicine from it. It has an LED that glows to indicate.
PLEASE TAKE YOUR PILLS
FINAL DESIGN CONCEPT
PROCESS
PROCESS FLOW: SETTING UP THE BOX He opens the box to load the medicines
After planning the schedule
Patient gets medications and prescription home
Each bottle gets a cap, which is unique to each slot The mobile application helps the patient load the cap on the correct bottle
The bar code on the bottle is scanned by the mobile before loading. The application helps the patient verify if the correct medicine has been loaded in the correct slot
The box then verifies each slot, bottle and cap. Only after complete verification is the schedule approved. Verify if loaded properly If not, a call is placed to the caregiver/ family member for assistance.
PROCESS FLOW: TAKING MEDICINES The patient has to press the button to dispense
*
100mg 1Y
KNOB TO DISPENSE
OR manually turn the knobs in front of the bottles where the LED is ON
* 40AKS
10K
10
KL
BUTTON TO DISPENSE
10
KL
The bottles dispense pills according to preset into the cup below
:90DF HT
Customized alarm tone alerts the patient that it is time for medicine
The adherence chart in the mobile application gets updated to show the patient the progress he has made An alert is sent to the patients family/pharmacist
KL 10
*
10
:90DF HT
KL
100mg 1Y
* 40AKS
10K
The patient removes the cup and has the medicine
CONCEPT BREAKDOWN
INTERFACE: The digital interface communicates information to and from the box. This intformation is stored over the internet and can be accessed from any digital device.
PRODUCT: Stores medicine bottles. Dispenses medicines according to medicine time and dose.
Screen interface on lid. Connects to the cloud database to obtain real time information on medication.
Each medicine bottle has a cap. This cap contains rotating levels that dispense one pill at the time of dose. The lids have unique grooves on the side to ensure each cap goes into the right groove.
The pills are dispensed as per the programming. They are collected in the cup below.
ORGANIZING MEDICINES Easy to move around
Kept on table/ hung on wall
Compact & closed
Simple to access medicines Auto dispense
10
KL
Button on screen
KNOB TO DISPENSE
Identify which medicines are being taken Digital screen shows information about medicines being taken such as: name, illness, quantity, side effects
*
100mg 1Y
:90DF HT
LED indicates which knob to turn
* 40AKS
Manual dispense
10K
10
KL
BUTTON TO DISPENSE
Source of information for medicines Each bar code can be scanned on the box to get medicine information. Important info about the medicine is also accessible through the interface.
Simple to identify if medicines are being taken Load sensor:
Can identify how many pills of each medicine are left in the bottle.
Snooze sensor:
Everytime the patient snoozes or does not take the dose within the time frame, the box records skipped dose. An alert is then sent to the patient’s phone via SMS/call and to the caregiver.
CONNECT & COMMUNICATE Integrate in lifestyle
Allow room for adjustment in medicine timing Kept at places of easy access Multiple platforms
Alerts
Alarms need to increase gradually in volume, so as to not startle Multiple media alarms: audio and visual alarms If the alerts are available on multiple devices, then chances of the elder hearing them are higher.
Green to indicate
.
Personalize alarms
Personalized alarms such as video clips, sounds, fav songs from family and friends can be assigned as alarms.
DOCTOR PATIENT INFO EXCHANGE Appointment information
The box allows the elder to access information from the doctor’s appointment.
Doctor coordination
Sharing of files between different doctors can be initiated through the interface.
PATIENT
Medicine side effects
Relevant information for each medicine is stored in the application. The elder can also make an emergency call to his doctor/caregiver.
Communicate adherence level
Single button to send the medicine adherence report to anybody.
DOCTOR
PHARMACIST
Weekly reports are sent to pre assigned family members and caregivers. Missed dose alert is sent immediately to the caregiver and elder
ACCEPTANCE/ SEAMLESS INTEGRATION Pharmacist and patient plan medicine schedule according to the current lifestyle of the patient involve while planning to give a sense of responsibility acceptance of treatment accepting new technology(box)
FAMILY/ CAREGIVER Remotely follow adherence level Automated indication when refill is needed
Emergency
Immediate alert when dose is skipped
The interface has an emergency button on every screen for the patient.
Reminders to call elder & motivate them
This button directly connects to the emergency helpline or any emergency contact that the patient has listed.
INTERFACE DESIGN
Default screen on application
Alarm indicating ‘Time of Medicine’ The alarm customised and personalised. Example: Video of grandchild asking grandad to take medicine. The page also has a SNOOZE button and a DISPENSE button
Snooze Screen: Allows the user to postpone the medicine timing by a specific time frame.
More Information screen: This screen allows the user to call specific people for more information on medicine. It also provides the user with additional information on medicines. Has provision to send report to family.
Setting up new medicines: The application connects with the cloud to download new medicine schedule. The user just has to scan the barcode on the medicine bottle/strip to identify the medicine.
The application indicates which slot the bottle of medicines is supposed to go into.
Follow same procedure for all medicines.
Follow same procedure for all medicines.
After all the bottles are placed. The application verifies the bottles using a barcode/colour scanner.
Only after all the medicines and bottles are verified, does the application approve the new medication schedule. Any abnormalities and a call is placed to the caregiver for assistance.
FUTURE STEPS This proposal is the first step to a large number of solutions that can be proposed to develop medication friendly ecosystem for the elderly. Some of the ways in which the above concept can be further devleloped are: The box connectivity: Wearable electronics Activity adjustable alarms Box improvements: Modular Box Cutting Medicines3 Adjustable bottle caps The box can have additional provisions for attachments such as BP monitors, Sugar monitors.