Designing For Better Health Outcomes
Can a combination of smartphone-enabled diagnostics and digital tools change mental models and empower patients to manage and prevent chronic conditions?
It sure can.
Recently, Jana Care partnered with Continuum to improve lives using digital tools for patients in India with Type 2 diabetes. Over 66 million people in the country are diagnosed with diabetes, and another 77 million are at risk of acquiring it. The team felt an immediate need to help this population control a widespread chronic condition and also to focus on preventative care.
Recently, the team launched the Aina device, a matchbox-sized diagnostic sensor that plugs into the headphone jack of a smartphone to perform blood tests. Aina was created as a platform technology and can measure glucose, HbA1c, lipids, hemoglobin, and creatinine from a single drop of blood — making the device a mobile blood lab in the hands of patients and primary health workers to be used both for screening and monitoring of chronic diseases.
In order to increase the effectiveness of Aina and to develop a true digital health solution for people with diabetes, we augmented the diagnostic with the Habits Program, a video-based online coaching program featuring video stories of people choosing healthier lifestyles, a personal coach to offer feedback and answer questions, and reporting capability to track glucose levels, fitness activity, and diet.
We believe strongly in pairing diagnostics with behavioral coaching. One recent study we reference showed enabling patients to modify their lifestyle habits was 27 percent more effective in treating Type 2 diabetes than taking oral drug metformin. While Aina offers an affordable way to measure blood glucose-level data, the Habits Program provides education and engagement via digital coaching and remote support through a community to help patients identify with others and invest themselves in the program. Data from the program produces reports that feed into analytics platform that a patient’s care provider can view and use to offer timely follow ups.
Early results have been positive. Twenty-five providers use Aina and have screened over 3,600 people since the device’s launch. Forty-four percent of these patients have seen significant reduction in their pre-meal glucose and 31 percent report the same reduction post-meal after they have been prescribed the Habits Program post diagnosis.
When designing solutions specifically for emerging markets, it’s important to understand the patients for whom one designs. Don’t take a one-size-fits-all approach to healthcare innovation. Had our team simply chosen to strip features from an existing diabetes treatment on the market in the U.S., we would not have arrived at a meaningful solution for the Indian market.
We saw the transportation challenges India’s emerging middle class faces, as urban travel speeds average less than one mile per hour, and also identified an opportunity in the proliferation of smartphone use in the country. Knowing India is the third-largest smartphone market in the world, we created a diagnostic that works with a mobile device. Patients are engaged via interactive video and audio lessons and exchange text messages with health coaches, offering a convenient way to manage their condition.
It’s important to approach population health problems holistically. Diagnostic tools yield practical results, but are more powerful when additional features can change patient thinking and influence actions. Digital health provides the opportunity to decentralize diagnosis and condition maintenance, build communities, and affect behavior. With over 70 percent of people in the U.S. searching online for health information, and roughly 40 percent joining groups or reading health/medical blogs, American healthcare initiatives should similarly consider bringing people together.
Digital health can benefit populations outside of developing markets, but there are important lessons both providers and designers can learn from this work undertaken in India.
About The Authors
Sidhant Jena is the co-founder and CEO of Jana Care, a company focused on building affordable diagnostics and evidence-based lifestyle coaching programs on mobile phones to make diabetes management cheaper, simpler, and significantly better for the nearly 350 million people worldwide who suffer from this often-fatal disease. LinkedIn: https://www.linkedin.com/in/sidhantjena
Mike Dunkley is SVP, Advanced Systems, at global innovation design consultancy Continuum, where he partners with clients in medical devices, diagnostics, drug delivery, and digital health to improve lives globally. Twitter: @MJDunkley