A Smart Asthma Inhaler and Companion App for Teens
March 2019 - May 2019
OVERVIEW
Prepaired is a smart inhaler and companion app system that allows teenagers with asthma to take control of their treatment. Its seamlessly integrated digital and physical interfaces prevent inhaler misuse and remedy communication gaps between the patient and their parents, doctors, and school nurses. My role was to research user needs and develop a digital prototype of the smart inhaler. I collaborated with a project manager (Ben Michel), a human factors researcher (Mary Kate Kelley), and a UI designer (Zack Nassar) to launch this project.
MY ROLE
Manufacturing Manager
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Lead brainstorm sessions
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Designed inhaler prototype using AutoDesk Inventor
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Created infographics to present the final design to stakeholders
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Assisted with user research, prototype fabrication, and mobile interface design
Background
Design Science, a product design firm based in Philadelphia, challenged our team to design a smart inhaler and companion app prototype that could help improve treatment outcomes for children and teenagers with asthma. We used the four-phase iterative design process outlined below:
Research: Understanding the Problem
What do current asthma treatment systems look like?
The first step in our research process was to familiarize ourselves with current asthma treatment systems. We learned that the typical asthma treatment plan for young adults involves three main pieces of equipment: the inhaler, which dispenses medication; the spacer, which sits between the inhaler and the patient's mouth to ensure that the patient inhales all of the medication; and the peak flow meter, which indicates condition severity by measuring the strength of a patient's exhale.
Asthma Treatment Equipment (left to right): inhaler, spacer, peak flow meter. © Lydia Heely 2019
Who else is involved in the treatment plan?
How do teens feel about their asthma treatment?
In order to understand how our target user group feels about they way they manage their asthma, my team and I created and distributed a questionnaire using Qualtrics. We asked them about how confident they are in using their devices, how they track their doses, the things that frustrate them about their treatment system, and the things they would change about asthma treatment, if they could.
Next, we interviewed a parent of a child with asthma in order to more deeply understand the challenges of coordinating asthma care. We learned that the treatment ecosystem involves many parties beyond the child, parent/guardian and physician– school nurses, teachers, and pharmacists also need to be informed about treatment changes– and that lapses in communication among these people can be frustrating and even dangerous for the patient. We also learned about the Asthma Action Plan (AAP), a crucial document that contains information that providers must know about a child's condition. It is vital that this document be up-to-date and accessible to all relevant parties. For example, an out-of-date or missing AAP could render a school nurse unable to give emergency treatment to a student having a severe asthma attack at school.
After this conversation with our interviewee, we added versions of the questionnaire for three other important stakeholders: parents of children with asthma, medical providers who treat young adults with asthma, and school nurses.
Research Takeaways
The good and the bad: the main points we noted art our research review session
We collected many valuable insights from our preliminary user research. We learned that the main things that our user group appreciated about their inhalers was that they were portable, fostered independence, and counted remaining doses. However, our users found it difficult to remember to take their medication, were anxious about using their inhalers in a social setting, and were sometimes unsure that they were using their devices correctly.
Research: Understanding the Problem
What do current asthma treatment systems look like?
The first step in our research process was to familiarize ourselves with current asthma treatment systems. We learned that the typical asthma treatment plan for young adults involves three main pieces of equipment: the inhaler, which dispenses medication; the spacer, which sits between the inhaler and the patient's mouth to ensure that the patient inhales all of the medication; and the peak flow meter, which indicates condition severity by measuring the strength of a patient's exhale.
Asthma Treatment Equipment (left to right): inhaler, spacer, peak flow meter. © Lydia Heely 2019
Who else is involved in the treatment plan?
How do teens feel about their asthma treatment?
In order to understand how our target user group feels about they way they manage their asthma, my team and I created and distributed a questionnaire using Qualtrics. We asked them about how confident they are in using their devices, how they track their doses, the things that frustrate them about their treatment system, and the things they would change about asthma treatment, if they could.
Next, we interviewed a parent of a child with asthma in order to more deeply understand the challenges of coordinating asthma care. We learned that the treatment ecosystem involves many parties beyond the child, parent/guardian and physician– school nurses, teachers, and pharmacists also need to be informed about treatment changes– and that lapses in communication among these people can be frustrating and even dangerous for the patient. We also learned about the Asthma Action Plan (AAP), a crucial document that contains information that providers must know about a child's condition. It is vital that this document be up-to-date and accessible to all relevant parties. For example, an out-of-date or missing AAP could render a school nurse unable to give emergency treatment to a student having a severe asthma attack at school.
After this conversation with our interviewee, we added versions of the questionnaire for three other important stakeholders: parents of children with asthma, medical providers who treat young adults with asthma, and school nurses.
Research Takeaways
The good and the bad: the main points we noted art our research review session
We collected many valuable insights from our preliminary user research. We learned that the main things that our user group appreciated about their inhalers was that they were portable, fostered independence, and counted remaining doses. However, our users found it difficult to remember to take their medication, were anxious about using their inhalers in a social setting, and were sometimes unsure that they were using their devices correctly.
The current treatment ecosystem: the patient (left) struggles to manage his treatment as the necessary equipment is bulky, inconvenient, and easy to misuse. Other stakeholders including family, doctors, and school nurses (right) may run into technical difficulties updating and accessing the AAP, and can't support the patient in a coordinated manner. © Lydia Heely 2019
The caregivers' biggest collective concern was that the patients were using their equipment improperly (or not at all), followed by concerns about coordination of care. The patients themselves agreed that inhalers are easy to misuse and misplace, and spacers and peak flow meters are bulky, expensive, and hard to use discreetly. Many patients reported leaving their spacers at home to avoid drawing extra attention to their condition, even though healthcare providers strongly recommend that patients use a spacer with their inhaler every time they take medication. Some patients also mentioned that it was emotionally stressful to have their families constantly concerned about their course of treatment, and wished that they could manage their condition more independently while giving their families peace of mind.
Ideation
Main Design Goals
We used our findings from the questionnaire, interviews, and initial research to come up with four main design goals:
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Promote proper dose administration & adherence to asthma action plan, including use of a spacer and peak flow meter
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Lower the social stigma of using inhalers
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Increase communication amongst doctors, patients, nurses, and other caregivers
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Reduce negative transfer of skills by keeping the size and shape of the inhaler similar to existing designs
We also created a risk assessment so that we could incorporate risk-mitigation strategies into our design where applicable.
Specific Product Requirements
We used our data from the discovery phase to generate a list of specifications for the the smart inhaler and companion app. In some cases, like in the example below, the user need that we identified was best realized through a combination of features on both the physical device and the companion app.
Pain Points/
Comments
User Need
Product Requirement(s)
"It's hard to coordinate my breathing so that I can inhale all of my medication at once. I don't always know if I'm getting my full dose."
The user needs feedback on their technique in order to feel confident that they are using their device correctly and receiving the proper amount of medication.
The companion app shall provide tutorials that guide the patient through administering a dose. The audio and video of the tutorial shall be synched to audio-visual-haptic indicators on the device itself, allowing the patient to correct their technique in real time.
Sketching the Inhaler
We created low fidelity sketches of both devices using the crazy eights method in order to iterate through design options that met our requirements. One of our objectives for the physical device was to decrease the stigma of using it in a social setting, so we aimed to make the design as compact as possible. However, we also needed to ensure that the design encourages the user to take their medication with a spacer, so we decided on a modular design that incorporates a spacer. See below our early ideas about a spacer (represented by a collapsible silicone water bottle) that can be stowed when not in use.
Inhaler sketches: After each group member completed their independent brainstorm session, I distilled our ideas into a basic sketch of the prototype (left). In our design, the spacer expands for use (right), and collapses when not in use to save space. The spacer can also be detached and stowed on top of the device (not shown). We imagined reducing the peak flow meter to its most essential component (the fan-shaped device that measures exhale strength) and making it a removable component of the inhaler body. In order to take a reading, the patient attaches the peak flow device to the mouthpiece of the inhaler and exhales into the device. To administer medication, the patient removes the peak flow device and inhales as they would with a traditional inhaler.
Sketching the App Interface
We ran another brainstorming session for the companion app interface. (We focused on the patient version of the app in this exercise, but the entire system will include versions for parents, doctors, and school nurses.) We made a priority list of information to display on the home screen, which includes number of doses remaining, medication refill alerts, risk (calculated based on weather and air quality index), and an easy way to access the AAP. The design also includes dose and peak flow data tracking, and a messaging platform that the patient can use to contact their healthcare providers.
Interface sketches: a draft of the home screen, data tracking, and AAP pages.
Prototyping the Inhaler
Foam prototype: adding a drawer for the peak flow device to the design.
We began the prototyping process by hot wire cutting pieces of foam board to represent the inhaler and peak flow meter. Our major design constraint was the size of our model spacer. We scaled all of our elements accordingly, rendering our overall design about 15% larger than we thought was ideal based on the anthropometric data of our target user.
We realized during this process that we needed to create a docking station for recharging the inhaler. We decided to add a drawer to the dock so that the peak flow meter could be store securely when not in use.
Medicine Canister
Inhaler
Dock
Peak Flow Device
Building the first printed prototype: (from left to right) A rendering of the 3D modeled components; print-in-progress; a close-up of the peak flow device suspended in the storage drawer with magnets.
I then used the rough dimensions of the foam prototype to create a mockup of each piece using AutoDesk Inventor. We 3D printed the design and attached magnets that allow the user to attach the peak flow device to the inhaler body and to the drawer.
Prototyping the App
UX designer Zach Nassar used Sketch to create mockups of the interface based on the product requirements that we developed as a team, and assembled them into an interactive prototype that we used for testing.
Testing
Methods
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We evaluated the efficacy of our designs by asking five users to perform a series of tasks with our prototypes. For the inhaler, we most wanted to assess how ergonomic the device was and how easy it was to simulate proper use. For the app, we wanted to determine whether or not we had correctly prioritized information on the home screen, and how quickly users could locate the AAP. (You can find our full list of user testing questions for the inhaler and the app here.)
Results
We gathered many valuable (and surprising!) insights from user testing. First, we found that even though the inhaler was oversized and the magnet placement for the attachments was not optimal, our users had little difficulty using it to simulate taking their medication. We predicted that the size of the device would be an issue during testing, and were glad that it did not appear to cause problems. Users liked the collapsable spacer, and confirmed that they would be more likely to a take space like this one with them when they go out. We were happy to hear that our design would encourage users to use their spacer more often, as improper spacer use was a top concern for healthcare providers. However, some users thought that the dock was bulky and wished that it could be more streamlined.
Users were able to assemble the inhaler without any instruction, though none of the users could identify the functionality of the peak flow meter. We predicted that this would be the case, as traditional peak flow meters look much different. Additionally, a few of our users had never heard of peak flow meters, as the severity of their asthma doesn't require using one.
The app was very well received. Users had an easy time accessing critical information and performing basic tasks such as messaging their doctors. However, some users were questioned the relevance of the live weather display on the home screen. One user with severe asthma suggested that we expand our logging system to accodate other medications that people with severe asthma use regularly.
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Because Prepaired was an on-campus project, we unfortunately didn't have the resources to recruit users who exactly fit our target demographic (young teenagers with asthma). We instead worked with college students with asthma who had the condition as teenagers. We made sure to emphasize the intended target demographic when we introduced our users to the product, and asked them to evaluate the design from the perspective of their younger selves.
Redesign
Inhaler Tweaks
We printed a third iteration of the inhaler prototype and developed some supplementary materials in order to address some of the issues that our users identified during testing. The new design features different magnet placement that solves the issue of the attachments sliding off the inhaler during simulated use. Although we would have liked to change the design of the peak flow device to make its functionality more discoverable, we decided that due to time constraints the best course of action was to design a supplementary pamphlet that indicates the functionality of this component.
Inhaler prototype progression: (from left to right)
initial; version 2; version 3.
I designed this infographic using original illustrations to communicate how the Prepaired asthma treatment system improves the flow of information between all parties.
The third version of the inhaler prototype: (from left to right) With the spacer extended for use; with the peak flow device attached for use; in the storage position.
App Tweaks
The final app prototype incorporates our branding and addresses users' concerns about adding multiple medications to the logbook. Since the weather display on the home screen was intended to help inform users of their asthma attack risk based on environmental conditions, we added other data points like pollen count and air quality index for context. You can take a look at the final prototype here.
Final Ecosystem Overview
The prepaired ecosystem: the patient (left) safely and independently manages his treatment with a sleek, modular inhaler that includes a collapsible spacer and attachment to measure peak flow. LED indicators on the device guide proper use while the app tracks long term treatment progress. Other stakeholders including family, doctors, and school nurses (right) can also access versions of the app where they can view the AAP and send the patient messages. © Lydia Heely 2019
Feedback & Takeaways
It was incredibly rewarding to present our concept to Design Science and our peers at the end of the semester. Although some aspects of our concept were purely theoretical, our audience commended us on how we developed our devices not just to support the patient but to support the entire network of stakeholders.
The biggest challenge of this project was the compressed timeline. We had roughly three months to research, design, build and test our product, make refinements, develop branding, and present our final design. Thankfully, I worked with amazing teammates who were all willing to wear multiple hats and make sacrifices in order to meet the deadline.
I am so grateful to have had this opportunity to work on this project. I grew immensely as a UX researcher and designer. I learned how to identify user needs by asking the right questions during interviews. I learned how to translate those needs into requirements for a prototype. I built on my previous AutoDesk Inventor experience and gained new skills in 3D printing. My favorite aspect was defining the product requirements and using them to sketch possible concepts. I loved working around pain points and turning users’ wishes into features.
Building the first prototype: teammate Ben Michel and me working out the product dimensions in the machine lab.