Chapter 3

Chapter 3: A design case study

Now, too much of time traveling. Let’s go back to the year 2014, where two Biodesign students are talking about Proteus Digital’s Health smart pill. Since they are biodesign students they are talking about the design of this particular product. Of course, one doesn’t have to be a design student to talk about design; you can also be a medical student, or biologist but anyway, let’s hear what they have to say, since there is no-one around besides them.

Design student X: Oh, I am already tired of hearing about this Proteus Digital Health’s smart pills time and again. They seem to be everywhere.

Design student Y: (in a slower pace) Are you now?

Design student X: Ya, I am. I would rather go home and sleep.

Design student Y: Would you now? (slower and louder than before)

Design student X: I would rather do that.

Design student Y: Well, would you now? (just as loud as the last time)

Design student X: Yes, I would rather do that than read this shit. (pointing to his laptop)

Design student Y: Well, would you now? (louder again)

Design student X: Stop saying that. I don’t even understand why this is such a big deal. I think I would have to call Z now.

Design student Y: Would you now?

Design student X: Stop saying that. I am going to call Z. He is usually always near us. Hey, Z.

Design student Z: Yo, what’s up X? What’s up Y?

Design student X: How are you Z?

Design student Y: Are you Z, now? (to Z)

Design student X: Just ignore him. Do you know anything about Proteus Digital Health’s smart pills? Do you know why it’s a big deal?

Design student Z: You know what, I was just reading a paper about it written by Kiran, which he is going to write in the near future. Or something like that. Anyway, let’s not digress into that time paradox, but what do you want to know?

Design student X: Just want to know, why it’s actually a big thing? If it’s actually something that’s needed or people are just trying to do something cool shit with technology?

Design student Y: Would you now?

Design student X: Oh, shut up.

Design student Z: Yes, of course I can. So, why this kind of technology is necessary? That’s your question, right? So, first of all, you probably already know that the market is full of wearable devices. As of 30^th September of this year 266 wearable devices, of which 118 were fitness wearables. (6) So, you can see that the market is saturated with these devices, but most of them are just tracking fitness data, and sleep patterns without really much purpose. Most of the companies are “interested in helping the affluent and tech-savvy” (6) to help them run more, make their bodies look better and not so much in chronically ill patients. “According to a Pew Foundations survey, 45 percent of US adults are dealing with at least one chronic condition.” (6) That’s a very large number that needs to be helped. And then, 42 percent of adults with one chronic condition and 62 percent of adults with two chronic conditions track their health indicators as opposed to 19 percent of people with no chronic conditions (6) and yet no companies want to work on making wearables for people with chronic conditions.

Design student Z: “Besides that, readmissions of patients through the emergency department cost the health care system billions of dollars per year.” (7) So, monitoring things like blood pressure, blood glucose, and oxygen saturation can help improve outcomes for the patients as well as reduce the costs of the US health care services. If you can carefully monitor the patient’s activities and health indicators, you can help them a lot as well. So you can see, that there is a need to develop technology for people with chronic conditions.

Design student Z: Next source of need is the pharmaceutical company. They are always looking for a breakthrough in drugs. But this depends on a "non-scientific variable: whether patients take their meds." (8) The experimental drugs have to be tested through a five-phase process from phase 0 to phase 4, and “hundreds of thousands of patients participate in clinical trials, often to treat life-threatening conditions or to get a better understanding of how to improve treatments for chronic disease, which accounts for more than half of healthcare spending.” (8) However, the patient adherence to drugs is as low as 50 %. This is a big hindrance to the research and development of the drugs as this undermines the statistical analysis and may lead to inaccurate failure of the drugs.

Design student X: And Proteus Digital Health addresses all of that?

Design student Z: Well, it does.

Design student Y: Does it now? (both stare at him)

Design student Z: So, if you look at the local context of the pharmaceutical industry and that of the medical field, you can see that there are these two severe needs that this “smart pill” addresses. If you just think generally, you might think that not taking medicines routinely is not really a problem, but if you look at it closely in the chronic conditions field, it is actually a problem and Proteus works toward with its medication adherence pill - Helius.

Design student X: So, is that why this startup is so successful and popular than any other wearable device companies?

Design student Y: Well, is it now? Aye?

Design student Z: What’s wrong with him?

Design student X: Just ignore him.

Design student Z: So, couple of reasons behind that. Okay, so first of all, as already stated earlier, it is a company that has actually embraced the actual need for people affected with chronic diseases, and also for the pharmaceutical companies. People with chronic diseases can keep track of their own health indicators, and similarly, the doctors and the patient’s relatives can keep know about patient’s medication adherence and indicators. This is going to help improve the condition of the patient, and if the patient needs close attention, then the doctors can be alerted by the insights they might gain by looking at the patient’s data. (1) Doing this is not just going to help the people, it’s also going to help the nation’s health care system, as this can reduce the cost of US health care system. And on the other hand, pharmaceutical companies will be very happy to work with them because now by using these ingestible sensors they can get a detailed record of what medications were taken and when. Now, the research won’t be affected by the patients’ non-adherence. These sensors can bring increased precision and consistency to drug tracking during clinical trials. (8) So, this is a great tool to be not just on the patients and clinicians side but also for stakeholders like the national health care and the pharmaceutical industry side.

Design student Z: I think one of the reasons it has been so successful is that it has put the users in the center. The fact that the FDA has approved it proves that Proteus seriously cares about its users. While most of the other companies tries not to deal with FDA regulations and try to take much simpler path Proteus Health “ has gone through vigorous approval processes by multiple agencies, addresses real clinical concerns, and may have a major impact on patient outcomes.” (9) Due to this fact it not only appeals to costumers but to clinicians as well. This is very important in health sector as we have to think not just about the patients but also about the health care providers, whether they too are willing to adopt this technology.

Design student Z: Another important thing about a product is the user's experience with it. I think this technology is really appealing because to reiterate again, it puts the users and their experiences at its center. Proteus Digital Health chief product office has said, “Part of the challenge is you have to have the technology disappear and you have to focus on something else. We feel strongly you have to focus on the consumer.” (10) And I think they have done it very well through this technology. Because the focus of their technology is not their product itself but the network or connection between the people involved. The connection between the patient and his/her family members, the connection between the doctor or caregiver and the patient these are the main focus of the product. Similarly, it has really empathized with its costumers as well. For instance, Laura is always worried about her aging mother who lives an hour away, and wishes she could do more for her mother, and make sure if she’s taking her meds or assist in her care. “This is a common problem for many families, in which elderly parents live just far enough away that their adult children can’t help them with their day-to-day care.” (11) Proteus Digital Health has really empathized with them and thus provided them the way to stay connected with their parents and help them in her care. I think this is what makes this product so great.

Design student Y: Well, is it now?

Design student Z: What's wrong with him?

Design student X: Just ignore him.