Digital Health: Design for Patients, Not the Problem

June 3, 2016
The good news: technology has enabled a burgeoning universe of digital solves to help patients manage their health. The bad news: the digital health universe is staggeringly fragmented and for the chronic disease sufferer, exceptionally overwhelming.

Here’s a surprising stat: Almost half of the American population suffers from chronic illness. Here’s an even more surprising stat: almost one in four Americans (approximately 75 million people) have multiple chronic conditions.  And here’s an alarming one: chronic illness (ex: hypertension, respiratory diseases, arthritis, heart disease, diabetes, cancer, dementia) is the leading cause of death and disability in the U.S.

The good news: technology has enabled a burgeoning universe of digital solves to help patients manage their health. This universe, though still in its relative infancy, is huge: there are over 165,000 apps and digital services ranging from basic tools such as fitness trackers to research platforms connecting patients with doctors.

The bad news:  while some of these digital services offer a lot of value to patients, the majority of them fall significantly short. The digital health universe is staggeringly fragmented and for the chronic disease sufferer, exceptionally overwhelming. Yes, there are some platforms being developed to help address that fragmentation, by trying to make it easier for developers to build apps that encourage collaboration and data sharing from device to doctors, nurses, health coaches, and caregivers.  But, given the current digital health landscape, that collaborative community ideal is still only conceptual, especially for chronic illness sufferers.

Jamie Nicholson

The What: Increasing the Patient Burden

Let’s look at one of the one in four Americans living with multiple chronic illnesses. In this case that’s Bill, a patient living with diabetes and rheumatoid arthritis (RA). On a day-to-day basis Bill will be tracking his blood glucose level, thinking about diet, taking insulin, and likely a drug for RA. At a broader level, he might be seeing a general practitioner, rheumatologist, endocrinologist and a dietitian. Now let’s throw digital solutions into the mix: Bill may have an app to track his RA, another to manage his diabetes, a dieting app, a prescription med renewal and monitoring app, and a fitness tracker; the list is seemingly endless.

The point is that many of the digital solutions on the market today have niche utility, tackling a specific element of an illness. The proliferation of niche services only serves to create more work for Bill, not less.  Instead of applying technology to ease the burden of managing healthcare, we are essentially taking the fragmented analogue system and making a fragmented digital system.

 The Who: Pharma and Insurers and Tech, Oh My

Digital services have potential to transform patient care.  Equally important, there is a large market, ripe for the taking.  Companies that can develop services that address holistic, instead of niche, patient needs and unify fragmentation by prioritizing collaboration have the opportunity to assert market dominance in what could be an exceptionally profitable industry.  But who are these companies?

Pharmaceutical providers, health insurance providers, hospital groups and health IT companies that recognize the market opportunity all have a place at the table.  That said, it’s important to define that place, per player.

Pharma companies, for example, have deep expertise in disease and medical maintenance, but limited visibility into the full patient picture. So while pharma companies can and should develop a solution specifically around their drug and disease expertise, they need to build it on collaborative platforms or find partnerships with other companies in order to better integrate their digital solution into a patient’s life.

Technology companies, on the other hand, might be best positioned to unify market fragmentation. These are the companies own the platforms in development, the key tracking devices (our phones) and have the technology capability and access to pull calendar, e-mail and location data in order to provide timely and contextual notifications for the patient.

The How:  Stop Designing for a Problem, Start Designing for People

But, no matter the industry from which a market leader emerges, that company will have to follow one golden rule for digital health development in order to maintain success: design for people, not the problem. For companies seeking a meaningful place in the digital health space, there a four guiding (and currently overlooked) principles to follow in designing digital apps:

·       Understand the user: It’s critical to understand the broader context surrounding the problem and think about how the solution will integrate into patients’ lives. Ethnography and qualitative user research are valuable tools to help achieve this, by observing and working directly with patients in the development process, companies can better understand the context behind a problem and subsequently develop solutions that better integrate into someone’s life, reducing their workload.

·       Understand the user journey: The way people interact with services occurs over time, not in a bubble. The context of what a person is doing before she/he uses the service/app, is a critical piece of (largely missing) insight that should inform the digital design.  How are users moving through the service? What experiences are they having with the app? What are they doing afterwards? Thinking about the solution in the context of time will enable more seamless integration into patient life.

·       Lay the foundation for collaboration: The current lack of integration across digital health services puts the onus squarely on the patient to manage all the data being produced. That’s the absolute wrong paradigm. Cloud based software platforms and open APIs (application programming interface) are a positive step toward better connecting fragmented services and reducing patient workload. Such platforms can make it easier for companies to securely share data and integrate solutions.

·       Share the data, share the wealth: Sharing data can create a more personalized and cohesive experience for the patient making it easier to manage the disease. Diabetes management apps, for example, should be built to sync data from various other health-related products and services such as fitness tracking apps and connected glucose meters to provide personalized guidance around condition management.

Digital health has the potential to tackle the growing pandemic of chronic illness and comorbidity.  From a commercial perspective, it’s a market in its infancy but with unlimited potential. The companies who begin transforming the current landscape by designing for people, not the problem have the opportunity to plant their flag in a wide-open field.

Jamie Nicholson is a senior design strategist at Smart Design, a design and innovation consulting firm. Recently, Nicholson moderated a panel of leading healthcare experts in collaboration with the Service Design Network entitled: “A new era in healthcare – designing new services for the informed patient.”