At Smart Design we strive to design products, services and systems that improve the lives of people. Whether we create a potato peeler that helps people with dexterous limitations or a financial service that enables efficiency, we are passionate about finding ways that design can contribute to the overall quality of people’s everyday lives. This approach is especially critical, right now, in the healthcare sector.
There is no doubt that we are in the midst of a global healthcare crisis. In America alone, 25% of the population has two or more chronic conditions, which is predicted to increase by 38% by 2020. Chronic conditions, such as arthritis, diabetes and lupus often result in a lifetime of medication, pain management and care.
But even though people know they need to take their medication as prescribed, medication compliance is surprisingly low. In last year alone, a lack of medication adherence will account for a $100-billion dollars of wasted U.S. healthcare spending. The World Economic Forum predicts that the cost of treating people with chronic diseases could reach as much as $47-trillion dollars over the next twenty years. To put this number into perspective, it is three times the current national debt in the United States. This is an enormous cost, especially considering the current stress on our existing healthcare and economic systems.
In parallel, a report published in February 2011 by Park Associates estimates that revenue from digital health technology and services in the United States alone will increase from $1.7 billion to $5.7 billion. This growth can be attributed to the increasing development of wellness applications and programs, alongside smart devices and services. There is clearly a big opportunity for companies to leverage digital technology and help people better monitor their health.
…the first six months after diagnosis is a critical timeframe. How people act during these first 6 months can dramatically affect their relationship with their illness for the rest of their lives.
But, it isn’t just about wasted healthcare costs. Not only does poor medication adherence result in wasted and unsustainable healthcare costs, it also means a lot more pain for a lot more people. Smart Design’s healthcare team has been exploring new ways of improving medication adherence through design; thereby reducing wasted healthcare costs and, more importantly, improving the quality of people’s lives.
The Role of Technology
Today, we are surrounded by digital technology. Microprocessors are getting cheaper, smaller and smarter. This is good news for the healthcare sector, as leveraging digital technology can help elevate the level of care being offered. People are already familiar with looking to digital technology to help them take an active role in their wellbeing. Whether this is a Wi-Fi-enabled cuff that takes their blood pressure and synchronizes the data with their iPhone, or a wellness app that encourage them to focus on better nutrition. In addition to providing a potential platform to enable better healthcare and wellbeing, the digitization of the healthcare sector provides immense opportunity for pharmaceutical companies, hospitals and service providers.
Design for Wellbeing versus Chronic Care
If we take a look at the landscape of opportunity ahead, I believe you can divide the healthcare space into two main areas. The first is what I call Design for Wellbeing. This centers on the idea of designing new devices, apps and services that help people to monitor their health so they can try to avoid getting sick in the first place, otherwise known as preventative care. Here the focus is on how can we use digital technology to help to motivate people to stay healthy?
Design for Wellbeing is already a very successful and saturated market. According to The New York Times in February 2011, there were already 17,000 mobile health apps available. There are also lots of smart devices that measure blood pressure, heart rate and cholesterol levels. While this space presents an opportunity for innovation and design, I believe that it’s the second area – Design for Chronic Care – that provides a bigger opportunity. Design for Chronic Care is about helping people live better lives once they actually get sick or are diagnosed with a chronic disease. The nature of the word “chronic” means living with a serious condition for the rest of your life. The design challenge here is, how can we leverage digital technology to support people after they are diagnosed with an illness?
I suspect that this area is not as saturated because it is more difficult to design new devices and services for chronic care. Designers and developers have to adhere to very strict regulations and the time required for development takes years, not months. You need to read and understand a series of regulation manuals in order to understand the complex regulatory requirements. But designing in this space is not impossible. As designers and developers, we need to understand and acknowledge the regulations without limiting our creativity. We need to simultaneously know how to navigate the rules and focus on the needs of the user.
The First Six Months
Over the past 2 years we have spoken to a lot of people who are living their lives with a chronic condition. What we have discovered is that the first six months after diagnosis is a critical timeframe. How people act during these first 6 months can dramatically affect their relationship with their illness for the rest of their lives.
We have conducted extensive user research and designed countless products that revolve around dexterity issues and chronic diseases, like arthritis. We know that people are in a lot of physical pain when they are diagnosed with arthritis and completing everyday tasks we take for granted becomes a huge challenge. One woman we spoke to said she had to cut her hair short because it was so painful and difficult to brush her long hair and the seemingly simple act of getting dressed in the morning sometimes took an hour because the physical pain is so intense. Even the simple act of sleeping can be painful, as the weight of a sheet can be unbearable.
This pain is physical. It is important to be aware of the complex and interconnected relationship between physical and emotional pain that amplifies the significance of the first six months after diagnosis. When people are first diagnosed the first thing they do is go into ‘panic mode’. During this period people are in a state of intense fear. This emotional turmoil has a knock-on affect, as it increases the likelihood that people will start to miss taking their medication. This is compounded with the fact that people who are diagnosed with one chronic condition are often diagnosed with a second autoimmune disease. These patients face a medication complexity that causes confusion, which causes more stress. In fact, during these first six months, patients need to adjust to living with their condition and grapple with the task of taking multiple medications for the rest of their lives.
For all of the reasons above, people with chronic illnesses consequently face a much higher risk of emotional distress, which typically results in depression. The risk of depression in fact increases substantially. Statistics also say that if you feel depressed you’re nearly twice as likely to miss your medication and this creates a cycle of decline. If I miss my medication because I’m feeling depressed I will inevitably feel more physical pain from my condition. The more physical pain I experience, the more emotional pain I experience. The more emotional pain I experience, the more likely I am to miss my medication. And so the cycle continues.
In an effort to stop this cycle of decline, we believe that design has an important role to play in the co-creation of new devices, services and systems that support people emotionally during the first 6 months. If a company, whether it’s a pharmaceutical company or a service provider, can help people at this critical time this will not only help to reduce people’s emotional pain, but as a result increase medication adherence and by default decrease healthcare costs.
Using this hypothesis as a starting point, I will share some ideas on how to approach designing for chronic care in the coming weeks. In the meantime, if you have any feedback or stories you would like to share – please feel free to get in touch.