Angela Chu

PREVENTING ADVERSE PRESCRIPTION DRUG INTERACTIONS

This was a passion project that came out of Health 2.0's Catalyst Code-a-Thon in 2016. Our team did take first place, but I like to share about this project because it provides a window into my research and design thinking process.

In just over 24 hours, our team (that started out as complete strangers) designed and built a working prototype that utilized three different APIs: Humana, First Databank, and Pokitdok. Since the Code-a-Thon, I've enhanced the visual design a bit too.

BACKGROUND

The theme of the Code-a-Thon was to help seniors understand their health and their health care costs.

The teams had access to data via three APIs:

Humana - Member benefits and utilization
First Databank - A prescription drug database
PokitDok - Out-of-pocket costs for medical services and drugs

There were also panels of senior volunteers available for user interviews and I drew from some of my experience from six years as a Medicare benefits counselor.

INSIGHTS

Everyone had their Zip-Loc bag.

We went in thinking that out-of-pocket costs were the biggest issue and our solution had to address this. But as we talked to seniors, their confusion around medication lists kept coming up. They often had a big plastic bag filled with an assortment of bottles and didn’t know what they were taking and why. I saw this repeatedly as a Medicare counselor too. No one really talked to them about drug interactions until something bad happened. It became clear that preventing drug interactions was a bigger pain point than costs.

Patients didn’t have good access to drug interaction information. Physicians do, but don't always have the time.

Drug info is available online, but is not easy for elderly patients to find and understand on their own.

For physicians, most EMRs include features that check for drug interactions. But they are often too pressed for time during a visit. Or they may have “alert fatigue” because they see so many flags that they learn to ignore them. In addition, if a patient received prescriptions from different physicians, they may not all be recorded in the same EMR.

Because of these things, we felt it was critical that the patient be the owner of the information.

The patient-physician relationship is sacred.

At the same time, we kept hearing about the important of the patient-physician relationship. Clinicians felt that patient care could be undermined by applications and third party information (and there are already a million patient facing health apps out there).

FINAL DESIGN

We didn’t want our solution to put the burden on seniors to manage their own medications. And we didn't want to detract from the patient-physician relationship.

So we designed a tool to raise patient awareness of potential problems and then arm them with the right information to initiate the talk with their physician. Their phone then serves as more of a “conversation starter” than a typical app.

The app would notify patients if potentially dangerous interactions or lower cost medications were detected. The patient was then equipped to raise the right questions, but the ultimate decision over changing medications was up to the doctor. We were careful to make sure the language reflected this.

And while the focus was adverse drug interactions, we got to throw in a bonus feature to address costs too!

View Prototype