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What Happens When You Combine…

                       Patient
                     Engagement
                      Company




         Participatory
                                      Mobile
            Design                    Health
           Research                   Study
          Approach




                   Kevin A. Clauson
                    Dana M. Lewis
                     Boris Glants
Mobile
Health
Study




         Kevin A. Clauson, PharmD
              @kevinclauson
Resolving
Medication
Issues for
Non-adherence in
Diabetes
Help our patients with type 2 diabetes put themselves
     in a better position to manage their disease
Target low-
hanging fruit
oot
                 causes of
                medication
                   non-
                adherence


forgetfulness
The most
ubiquitous
   device
on the planet
Textus interruptus



                     Retrevo Gadgetology Report 2010
Adhere to me.
Not the other way around.
The most accessible
healthcare professional
Actual patient perspective




  Means to engage patients




Missing pieces of the puzzle
Groups in the
ReMIND study




        N=162
The control group does not
receive any short message service (SMS)




              (aka text messages)
The passive group receives
unidirectional SMS (uSMS)
The active group participates via
   bidirectional SMS (bSMS)
Measuring our outcomes of interest

   Knowledge of disease
   Health literacy
   Engagement
   Medication adherence
   Clinical marker
RESEARCH STUDY FOR PATIENTS WITH DIABETES
                             Nova Southeastern University is conducting
                                   research to see if texting can help people
                                  remember to take their diabetes medicine

                                             Who can participate?
                                             If you are an adult diagnosed with
                                             type 2 diabetes mellitus and:
                                              Read English
                                              Take diabetic medications by
                                                 mouth or injection (like insulin)
                                              Own a cell phone that can send and
                                                 receive text messages

                                             What would I receive if I
                                             was in the research study?
                                              Free blood glucose (Hemoglobin
                                               A1C) testing
                                              $20 worth of Publix gift cards



      If you are interested in learning more about this 6 month study, please
      contact Dr. Kevin Clauson at 754-300-TEXT (8398)
Lessons learned
 1. Impact of involvement of
    patient on front end on
    ethics/IRB/IC
 2. Research participants
    versus research subjects
 3. Technology has potential
    to reduce clinician and
    patient burden



     IRB=institutional review board, IC= informed consent
Participatory Design Approach
    (Integrating a patient perspective)

             @DanaMLewis
Patient perspective: snapshots
(Other background: @DanaMLewis)



#hcsm
Approached to
participate…..
“Non-compliant diabetic”
The future is
 bright for
participatory
   design
The elephant in the room (the patient)
Researchers: remember
patients are new to this.
Lessons Learned

 1. As patients,
    we have a
 valuable role,
     but it is
    different.

   2. Don’t let
   yourself be
 inhibited from
       fully
  participating
  in the design
    process.
Patient Engagement Company




           @BorisGlants
What is Tonic?
Role in ReMIND Study


    Engage the patient
    Simplify data
     collection
    Easily extract
     insights
The Art of Engaging Patients

 Contextually relevant
  images boost
  understanding and
  meaning
 Patients can’t wait to
  see what we are
  going to ask them
  next
The Art of Engaging Patients


Only serve up one
question per page
to sharpen
respondent focus
The Art of Engaging Patients

Increase perceived
— and actual —
speed by providing
robust skip logic
and broad range of
“tapable” answer
constructs (rather
than free text)
A picture is worth… 40% more data




                Boris Glants
Lessons Learned
1. Engagement is iterative

2. There are many
   opportunities to
   leverage patient
   engagement
   technology in research
It’s time to work
    together to
 improve patient
     outcomes
Acknowledgments

  Alexandra Perez, PharmD
  Goar Alvarez, PharmD
  Naushira Pandya, MD
  Joshua Caballero, PharmD
  Andrea Fass, PharmD
  Sydney Kchao, PharmDCand
Images
•   http://www.flickr.com/photos/santheo/5074032126/sizes/o/




•   http://anewscafe.com/wp-content/uploads/2009/10/root-1.jpg




•   http://2.bp.blogspot.com/-H51sJ8-jkP0/TyLXw-UWRBI/AAAAAAAABRY/_ZtBLF296No/s1600/ROOTS.jpg



•   http://memotext.com


•   http://www.flickr.com/photos/jimsawthat/4682146054/sizes/o/




•   http://www.friendship-quotes.info/wp-content/uploads/2010/05/1_-_Gotham.jpg




                                   Images without citations are
                                 licensed and/or rights are held
                                        by the presenter
Questions?
 Kevin Clauson, PharmD
   clauson@nova.edu
     @kevinclauson
    www.CCHIR.org

      Dana M. Lewis
      @danamlewis
     www.swedish.org

       Boris Glants
 boris@tonicforhealth.com
 www.tonicforhealth.com

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What happens when you combine the participatory design research approach and a patient engagement company for a mHealth study?

  • 1. What Happens When You Combine… Patient Engagement Company Participatory Mobile Design Health Research Study Approach Kevin A. Clauson Dana M. Lewis Boris Glants
  • 2. Mobile Health Study Kevin A. Clauson, PharmD @kevinclauson
  • 4. Help our patients with type 2 diabetes put themselves in a better position to manage their disease
  • 6. oot causes of medication non- adherence forgetfulness
  • 7. The most ubiquitous device on the planet
  • 8. Textus interruptus Retrevo Gadgetology Report 2010
  • 9. Adhere to me. Not the other way around.
  • 11. Actual patient perspective Means to engage patients Missing pieces of the puzzle
  • 12. Groups in the ReMIND study N=162
  • 13. The control group does not receive any short message service (SMS) (aka text messages)
  • 14. The passive group receives unidirectional SMS (uSMS)
  • 15. The active group participates via bidirectional SMS (bSMS)
  • 16. Measuring our outcomes of interest  Knowledge of disease  Health literacy  Engagement  Medication adherence  Clinical marker
  • 17. RESEARCH STUDY FOR PATIENTS WITH DIABETES Nova Southeastern University is conducting research to see if texting can help people remember to take their diabetes medicine Who can participate? If you are an adult diagnosed with type 2 diabetes mellitus and:  Read English  Take diabetic medications by mouth or injection (like insulin)  Own a cell phone that can send and receive text messages What would I receive if I was in the research study?  Free blood glucose (Hemoglobin A1C) testing  $20 worth of Publix gift cards If you are interested in learning more about this 6 month study, please contact Dr. Kevin Clauson at 754-300-TEXT (8398)
  • 18. Lessons learned 1. Impact of involvement of patient on front end on ethics/IRB/IC 2. Research participants versus research subjects 3. Technology has potential to reduce clinician and patient burden IRB=institutional review board, IC= informed consent
  • 19. Participatory Design Approach (Integrating a patient perspective) @DanaMLewis
  • 24.
  • 25. The future is bright for participatory design
  • 26. The elephant in the room (the patient)
  • 28. Lessons Learned 1. As patients, we have a valuable role, but it is different. 2. Don’t let yourself be inhibited from fully participating in the design process.
  • 31. Role in ReMIND Study  Engage the patient  Simplify data collection  Easily extract insights
  • 32. The Art of Engaging Patients  Contextually relevant images boost understanding and meaning  Patients can’t wait to see what we are going to ask them next
  • 33. The Art of Engaging Patients Only serve up one question per page to sharpen respondent focus
  • 34. The Art of Engaging Patients Increase perceived — and actual — speed by providing robust skip logic and broad range of “tapable” answer constructs (rather than free text)
  • 35. A picture is worth… 40% more data Boris Glants
  • 36. Lessons Learned 1. Engagement is iterative 2. There are many opportunities to leverage patient engagement technology in research
  • 37. It’s time to work together to improve patient outcomes
  • 38. Acknowledgments Alexandra Perez, PharmD Goar Alvarez, PharmD Naushira Pandya, MD Joshua Caballero, PharmD Andrea Fass, PharmD Sydney Kchao, PharmDCand
  • 39. Images • http://www.flickr.com/photos/santheo/5074032126/sizes/o/ • http://anewscafe.com/wp-content/uploads/2009/10/root-1.jpg • http://2.bp.blogspot.com/-H51sJ8-jkP0/TyLXw-UWRBI/AAAAAAAABRY/_ZtBLF296No/s1600/ROOTS.jpg • http://memotext.com • http://www.flickr.com/photos/jimsawthat/4682146054/sizes/o/ • http://www.friendship-quotes.info/wp-content/uploads/2010/05/1_-_Gotham.jpg Images without citations are licensed and/or rights are held by the presenter
  • 40. Questions? Kevin Clauson, PharmD clauson@nova.edu @kevinclauson www.CCHIR.org Dana M. Lewis @danamlewis www.swedish.org Boris Glants boris@tonicforhealth.com www.tonicforhealth.com