The prevalence of chronic diseases within the world has risen significantly over the last 50 years, primarily due lifestyle factors, and present significant social and economic burdens. Clinical studies have shown that regular contact between physicians and patients can benefit disease maintenance, but unsurprisingly healthcare systems lack the resource to provide such a standard of personalised care. Technology could perhaps fill the gap.

Conventional chronic disease management systems rely entirely on the knowledge and engagement of patients in order to provide effective treatment. Increasingly, medical device manufacturers are looking to add value to their offerings through smartphone connectivity; offering data visualisation and support, along with the ability to share usage data with relevant HCPs.

The next wave of connected medical devices will enable evermore intelligent and personalised approaches through Artificial Intelligence powered algorithms. These systems learn patient behaviours and physiological parameters to assist patients in better understanding their conditions and planning medication and wellness routines.

An example of this is MedicSen, who are applying artificial intelligence and sensor tech to predict future glucose levels and provide advice to patients at the appropriate time.

Such technologies will be able to apply both deductive and inductive reasoning to give patients deeper insight into their own conditions and the parameters which influence them. Insight can enable patients to take fervent ownership over the management of their disease, and ultimately improve outcomes, however to achieve these touted benefits, systems should:

Camouflage

For patients with chronic conditions, disease management is a life-long process. Overly prominent systems are an unwelcome and intrusive reminder of their diseases, and can detract from their own value propositions by disrupting lifestyles. Moreover despite the technology push, medical devices don’t need their own flavour of Siri; the novelty of a mobile doctor in your pocket will soon fade, leaving patients desiring intellectual tools rather than effegies.

Systems should require minimal interaction, and blend seamlessly into the workflows and routines of users.

Be Tangible

Today’s world is full of constant distractions – adverts and notifications vying for our attention – making it difficult to identify and filter the wheat from the chaff. To incite behavioural change, patients will need to be presented with relevant information, but the format and timing of the nudge are critical.

  • Messages should come only at the point where an action should be taken. Often notifications generate to merely re-engage the recipient, but over time superfluous nudges become associated with annoyance and are a deterrent to interaction. Understanding the subtlety of nudges may mean that some potential notifications are withheld to maximise the impact of more serious and pressing prompts, which are therefore more exceptional and unexpected.
  • They must be specific and concise, and presenting in a bite-size manner. These lightweight interactions should require no more than 10 seconds of user attention. The Apple Watch has demonstrated the simplicity of a graphical notification – 3 colour coded rings representing daily targets, shaded to the percentage complete.
  • Amsterdam Airport infamously placed fake flies in the urinals of its bathrooms to provide a physical target for men to aim at. The urinal fly has been shown to measurably reduce ‘spillages’ by playing to the instincts and sensibilities of its target users. Likewise, disease management tools should provide meaningful targets in a format which the patient can best relate to. This may not always be empirical units of medicine, but instead tangible measures like food items, minutes of exercise or daily activities.

Up-Skill

Although promising improved adherence and outcomes, use of AI in disease management may induce lethargy, potentially leading to knowledge loss and lower vigilance in self-monitoring. Designers must consider how efficiently users will be able to resume control if the technology fails; imparting the skills, understanding and awareness to control their diseases, rather than encouraging over-reliance on technological assistance.

As such, disease management systems should be designed to augment patient capability, not bypass it. IBMs ‘Deep Blue’ supercomputer could best world champions at Chess, but when partnered with merely a ‘knowledgeable’ player, the human-machine pairing was unbeatable.

Author
Tim Phillips
Senior Human Factors Engineer

Tim is a Senior Human Factors Engineer, with a background in Design Engineering. He has a particular interest in the evaluation and integration of emergent technologies into medical devices.