• Sunshine and Zhe Lin
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Title

i-M.A. (i-Medical Assistant)


Design Team

Sunshine & Zhe Lin

Peer Review Team

Caeleigh & Lillian


Overview


Mini, portable medical kit containing small measuring devices that can be wirelessly transferred to a mobile app for outpatient care and medical records.

 

 

 

Top chronic diseases in Canada include cardiovascular disease, diabetes, arthritis, etc. Patients who are diagnosed with these chronic diseases receive personalized medications and separate devices to monitor each of their conditions at home. Purchasing and replacing these devices is costly, and becomes an inconvenience for the patients' mobility when these devices are heavy and clunky. Furthermore, since each device is devoted to a specific condition, the devices do not talk to one another, thus it becomes the patients' responsibility to aggregate all the information in order to track the progress and patterns of their health. Wouldn't it be more simple and less demanding on patients if all these devices in need and the related medical records were brought together in one device?

The purpose of this project is to design and develop a personalized, "smart", medical assistant to help users track their daily physical data (i.e., blood glucose, heart rate) in order to support personalized medical plans. The device is acquired through a medical professional (i.e., a patient with diagnosed diabetes is able to receive one from his or her general physician, in order to keep his/her blood sugar levels in check) or as part of the contract with Greenshield health supplement (i.e., you pay a few hundred per month for the regular check-up and the network of doctors as part of the deal). A physician would be able to help moderate and explain the information to the users when necessary. Users may keep track of their health data anywhere and anytime of the day and get medical assistance from physicians/specialists when necessary. Purchasing the annual premium package of the app, users will be able to access extra guidelines and medical services. 


 Critical functions

  • Perform daily tests of vital signs and an app/cloud storage to track daily measurements.

  • Alert emergency medical services at the first sign of irregular patterns that may indicate high risk/danger to users.

  • Provide a communication platform across patient and health professional communities.

  • Build up a network so that medical history is accessible nationwide


User community

 i-M.A. is a product set designed for all Canadians under the health insurance. Our target customers include:

  • Individuals with chronic diseases (i.e., diabetes and high blood pressure, etc.)

  • Business travelers 

  • Senior population

  • Population living in remote areas with lack of medical resources

 i-M.A. also aims to make contribution to the research study on the treatment and prevention of chronic diseases in the long term.

  • Medical researchers

  • Physician/Specialists


Media Interaction

  • Instant interaction between patients and specialists

  • Communication platform among doctors in specific medical fields 

  • Communication platform among patients with similar physical issue(s)

  • Collaboration with medical research team(s) for mass data analysis

  • Nationwide health/medical service network


Design Details


 i-M.A. is composed of two parts: Wi-Fi medical kit  + App

For the kit:

  • Cardioversion pad – cardioversion, heart rate --> patients with heart disease

  • Finger-clip – blood oxygen --> respiratory or cardiac problems(i.e., chronic obstructive pulmonary disease), sleeping disorders

  • Spirometer – lung disease (i.e., asthma, bronchitis, and emphysema)

  • Blood-testing background – blood glucose --> diabetes

For the app:

1. Convenient health data collection,  cloud storage and professional data interpretation

-Health data collected from the devices will be wirelessly transferred to the app, so that the latter will perform daily tests of vital signs.

-The health data will be stored in the cloud to track daily measurements.

-The health data of the patients is connected to physicians/specialists through the app.

-The app will provide normal value range for reference, and further details can be explained by physicians/specialists if requested.

- Patients can set reminder in the app in order to keep a periodic health check. 

2. Irregular data alert

 

- The app will alert emergency medical services at the first sign of irregular patterns that may indicate high risk/danger to users.

- Navigation/Connection to the nearest available medical service when emergency happens.

- Quick transmission of the related medical data and history (with patient's permission) from the home doctor to the physicians/medical services when assistance is needed.

 

3. Communication platform

 

- The app also creates a communication platform across users and health professionals, providing a "virtual community" to promote information access, healthy lifestyle tips, and improve quality of life to people.

- Premium package for extra guidelines and medical assistance from specialists:

a). Make appointments for video meetings with a specialist to receive medical service through the app

b). Access doctor ratings/reviews

c) Receive professional healthcare guidelines from specialists on dietary or other issues based on personal medical condition.

 

屏幕快照 2016-04-01 21.04.28.png

 

User stories

 1. Business traveler 

 

Brian55 years old, businessman

 

Brian is a 55-year-old sales representative from Toronto. He is single and travels 2/3 of the year across provinces in Canada. In the past ten years, he has suffered from high blood pressure. He was diagnosed with Diabetes (Type I) in the physical check up last year. His doctor also detected a low level of blood iron on his blood report and recommended him to keep track of the blood glucose and blood iron level on a weekly basis. Brian is open to try new medical treatments for Type-1 Diabetes and has been taking pills. He is also looking for information on the diabetic diet and tips on how to slow down the process which may help lead a normal life. His major concern is that he does not have much time to visit the clinic for blood test. Also, he does not have families or friends having the similar physical issues.

Brian takes the mini kit of blood tester and finger-clip sensor with him on the business trip. Often he is reminded by the app on his phone to measure his blood pressure, blood glucose and iron level at night before sleep. Two months ago, Brian felt constantly numb in his hands on the trip to British Columbia. His doctor, detecting an unusual surge of Brian’s blood sugar test, sent Brian an alert on the app with his medical advices. On the forum on diabetes, Brian has found a number of patients with Type-1 diabetes who are talking about new medications, healthy diet and even restaurants suitable for the diabetic. Recently Brian has decided to use a new type of medicine and intended to use i-MA to test the effectiveness through daily check-up.

 

 

2. Seniors living alone

  Daisy, 85 years old, retired

Daisy is 85 years old and lives by herself on the farm close to Elliott Lake. She had a major cardio-surgery three years ago and since then has needed to pay regular visits to the clinic for check-ups on cardioversion and blood oxygen. The drive back and forth to the clinic takes 3 hours and Daisy sometimes waits for months to book an appointment with her cardiac specialist.

Having used  i-M.A. since last year, Daisy measures heart rate and blood oxygen every morning at home and records the physical data on her smart phone. She uses the premium package to have monthly video meeting with her home doctor to ask about general questions related to her health conditions. Four months ago, i-M.A. detected irregular heart rate from the cardioversion in Daisy's account and sent the report to her cardiac specialist. An alert was sent to Daisy's smart phone through i-M.A. App. The app also navigated Daisy to the closest clinic with a cardiologist (10 km away) for a medical appointment. Daisy accepted the i-M.A. suggestion and noted her home doctor about her visit on i-M.A.. With her permission, Daisy's medical information/history was transmitted to the cardiologist at the clinic to visit. 


3. General physicians/Specialists

 Sandy, 40 years old, senior specialist

Sandy is a senior specialist working at the Adult Congenital Cardiac Clinic of Hamilton Health Sciences. The clinic provides ongoing care and follow up of patients born with congenital heart disease. Part of Sandy’s job is to collect and analyze the data from the medical surveillance as over 50% the patients with congenital heart disease will require a repeat operation, catheter intervention or medical treatment for other cardiac conditions during adulthood. During twenty years experience working in the field, Sandy has also found that the families having children with congenital heart disease keep long-term contact to support each other fighting against the disease.

In the past two years, Sandy has been working on a study among the 500 HHS patients with congenital heart disease aged from 18 to 35 in Canada. He has found i-M.A. an effective and useful tool for his medical study because it provides valid and up-to-date information on 95% of the study population. Based on the data collected, Sandy has reached the findings that 29 to 32 years old is a peak period for recrudescence and the related patient group needs extra cardiac care. Sandy has also found that i-M.A. has connected the patients, despite their geographic locations, for exchange and communication on topic of treatment and life style. Sandy introduced the application of i-M.A. into the medical research during his speech at the annual conference of CDPAC (Chronic Disease Prevention Alliance of Canada).

 

Discussion and Future Direction

       1.Nationwide/worldwide medical network

       -Worldwide medical treatment information exchange/communication, provides the patients with more options for medical treatment

       -Avoid waste on medical resources in different contexts (With the app, there might be no need for out-patient department in hospital.)

      

      2. All-in-one technology

       - An automatic health data reading microchip may replace a set of devices (embedded in different parts of body for data collection)

 

      3. Lifestyle apps for disease prevention/ lifestyle  

       - Apps designed for prevention on specific disease(s) related to individual lifestyle (i.e., diet recommendation, physical exercise record, health forum)

       - Platform offered to people with similar lifestyles and health concern (i.e., organic food) for online sharing and meet-up events



      




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10 Comments

  1. Hey E-Mergency Kit Design Team- 

    First off, I just wanted to say I really like your design. The one thing I would encourage you to think about more is the chosen target population. You note that it is for self-diagnosis. Assuming that means that anyone can just purchase this device on, say, Amazon, I'm wondering how you imagine the average user being able to interpret this information. Making medical information available to someone is not the same as making it accessible; many people are not necessarily equipped with the knowledge to understand the implications of the results of a medical test. Providing someone with information that they believe is accessible, but they lack the intellectual tools to process, could prove to create problems rather than solve them. One the other hand, if this device is acquired through a medical professional (for example, a patient with diagnosed diabetes is able to receive one from his or her general physician, in order to keep his/her blood sugar levels in check) then a physician would be able to help moderate and explain the information to the patient, so he or she isn't receiving information he/she is unable to understand. Determining who exactly the target population is and fleshing out some of the logistics of the relationship between the patient, physician, and device may help illuminate some potentially problematic ethical considerations, and strengthen your final design. 

  2. E-Mergency folks!

    Really interesting idea. I'd like to build on Lillian's comments about target users with a few questions about the physical design of the device itself. You've described a number of very useful-sounding features in the form of various integrated attachments. What would the complete package look like (small, lightweight, portable or larger, more robust, compartmental carrier for separate attachments)?

    And what would the complete kit come with? Do you envision this as one or two extremely multi-functional attachments or a suite/series of devices? If the latter is the case, I would caution against the 'clinic in a box' approach for many of the same reasons Lillian mentions above. It may simply get too cumbersome, complex, and overwhelming for the average patient/user (if such a person even exists) to navigate a medical toolkit, even one that's designed for convenience and ease of use. To that end, I love the idea of an app that integrates all existing health monitoring tools/apps the patient or healthcare provider may currently be using. From a utility standpoint, this attribute of your design may in fact supersede the usefulness of providing a host of attachment options - it centralizes the intense cognitive and emotional demands of managing a complex health condition and may provide a truly ergonomic solution for outpatient needs.

    Also, have you considered distribution options? If this is intended as a potential tool for outpatients, would they be 'prescribed' a certain attachment or combination of attachments upon discharge? Would they have to purchase these items, or would a lending-library model be appropriate? Would they be available to the public as well, say, at local drug stores and health clinics? What other kinds of support infrastructure would you have to consider to ensure patients were using the devices correctly? Where could they turn to for technical support and/or device training?

    The educational potential of your design is certainly intriguing, but I'm not entirely clear what that interaction would entail, and may require a little more fleshing out. If, as you mention, you lack a general understanding of medical science (and let's face it, none of us are doctors here), perhaps consider narrowing the scope of your design. By focusing on the needs of a particular kind of patient, condition, or use scenario, you may be able to make a more compelling and concrete case for its utility. 

     

  3. Just one question! Does the device have to been plugged in smart phones? It will be a little inconvenient for an user with different kinds of diseases to connect plenty of device with his/her cellphone just to upload data. It will be better If the device can connect with smart phones wirelessly.

  4. Hi Lillian, Caeleigh and Gaoxia, thank you very much for you suggestions for our design. We think your suggestions are very helpful to our design and we have made some adjustments according to your suggestions. Thank you again and good luck with your presentations tomorrow!

     

     

  5. Really nitpicky: "Under the health insurance" - does this include UHIP users, not just OHIP? 

  6. If the data is stored on a cloud based server, what sorts of security and safeguards will be put in place to protect such information? 

    1. Hi Carmine, 

      Thank you for your question. The medical services provided by our design would be covered by the national/provincial health insurance, so the data stored will be part of the provincial /national medical network, which will be protected by the government. The government will be responsible to make sure the data is safe. Hope that might mitigate your concern. 

       

  7. HMOs in the USA would LOVE this device! A great way to connect patient, health care provider and insurer. This connectivity allows for integration of records and updating individuals of your current medical needs (based on feedback). On the other hand, it could be used to collect data on you that could be used against you (HMOs wanting data to prove you have a "pre-existing condition".

  8. From the doctors side of things, how much extra work would this require from them? Since doctors are extremely constrained for time, when would they be able to keep track of their patients? Or would there be a mediator between patient data and alerting doctors that action is needed? 

    1. Hi Minja,

      Thank you for the questions. We are thinking about setting up a data bank with the development of our App. When the user’s data is within the "safe range", it will just be kept in the account record as the medical history. When the data appears abnormal based on the data bank, the alert will be automatically sent to the app and doctor’s account through the system. We believe our design will save patients’ time to go for appointment at the clinic so doctor will have some spare time making responses to the alert case on the app.

      Also, when the physical data is transferred to the user’s electronic devices, say their smart phone, they will be provided with a safe range according to their general information (i.e., gender, age).