Group Presentation Schedule

1. Group Presentation Schedule 5:30: Katia, Kim, Liz 6:05: Ana, Joan, Hubert 6:40: Sue, Sami, Joelle, Toby

2. VisitAssist Mobile Health Design | Katia, Liz, Kim

3. Goals Goal: To improve communication between doctor and patient. Organization: A student (high school or college) health center What does it do: Allows patients to engage with their doctor by proactivley suggesting question topics and grouping common symptoms. The app also provides answers to FAQs or tailored questions for the patient's visit. Allows them to ask their own questions. Who benefits: Doctor, patient and administrative staff How do they benefit: The patient received specific, valuable information, the physician's face-time is efficiently used to review, and administrative and non-physician clinical staff answer and ask fewer routine questions.

4. Target audience Target audience: Students, less-engaged patients, those with chronic conditions, also your average person who may have questions but not necessarily be likely to ask them in person. Target audience needs: Suggestions about what questions would be helpful to ask. Barrier is - don’t know where to begin with questions. Not time intensive, part of the waiting room routine. How app addresses needs: Familiarizes patients with their symptoms and what helpful information they should seek -- and how -- from their provider Works seamlessly with the waiting room routine and can integrate with the EHR.

5. Personas • Kayla • Young black college student • Chronic illness • Wants app to help with asthma questions • Melissa • Young white high school student • Currently ill with mono • Needs to know the "right" questions to ask • Joab • Young latino college student • Undiagnosed anxiety/depression • Won't discuss emotional issues unless prompted by his Doctor

6. Competitive Analysis • PingMD • Pro: HIPAA privacy guidelines • Con: Glitches • MyChart • Pro: Sync with web profile for easy sharing • Con: Not widely available to everyone • MeVisit • Pro: 24/7 provider access; database "suggestion" for symptoms • Con: Discourages patient/provider communication beyond what patient generates

7. Using our app Three main areas: • (1) View/Update Personal History • (2) Ask Questions • (3) Account Settings

8. Using our app (1) Personal History • Medical/Personal history, goals • FAQ’s

9. Using our app (2) Questions • Your Physician/PCP • Experts • Patient can filter experts • Sourced from database

10. Using our app (3) Account settings • Basics & Clinical • Guardian name if requested by school • GPS predicts local hospital and leaves option for user input • Option to link insurance information to guardian or emergency contact

11. Evidence-based guidelines • The most popular apps have these things in common: • Easy access • No unnecessary features • Flexible design • Attention to detail • Well tested • Free • Teenagers and millennials: • Like an app that establishes their independence • Have limited spending power • Prefer to interact via email/messaging

12. Evidence-based guidelines • Approach to doctor-patient communication • Patients want more meaningful discussions with their care provider when making health care decisions. • Want to know the latest medical evidence. • Want their provider to ask about their goals and concerns for their health and health care • Want to be told the truth about their diagnosis

13. Successful usage • By using their main form of communication - texts and email • Modern design • Provides them independence from their family

14. Improves on existing apps • Ask an "expert" • FAQs are created based on modeling of symptoms

15. Uses smartphone capabilities • Contains a notification system • Uses GPS to find local hospital(s) • Syncs with EMHR of doctor's office • Both iPhone/Android capable

16. Evaluation plan • Planning the Sessions • Scripted • Beta test with colorful, modern, fully-interactive interface • Prompts assigned to users • Mock search results • Conducting the Sessions • 2 moderators: one to conduct, one to assist; scribe • Collect demographics • Each user given a mock health situation; search • Ask before, during, after questions • Moderators prompted to ask counter questions

17. Evaluation plan • Compiling Results • Notes from assigned scribe • 1 -2 observers will watch moderator performance and offer suggestions on script • Prioritize and Report • Include all positive and negative feedback • Reaction, criticism, praise, problems, suggestions • Shared with all teams (development,design, technical) • Conclusion • Moderator's report • Plans for moving forward

18. Development plan • 1. Functionality: • Check every single screen and test every button • Figure out how different sections of the app work with each other • Work closely with a developer • This could take months and cost about $50,000 after all the revisions ($100 per hr) • 2. Design: • Make it look modern and attractive to our audience • Hiring a designer for this would run around $10,000

19. Development plan • 3. Going live: • iTunes connect account ($99 a year); pricing; description; marketing ($1000) • Cost of entire process: At least $61,000 but because we want to connect to EMHR and specific school networks it will probably cost much more. • Timeline: The first step will take at least six weeks to complete, and another two weeks with the designer. The hardest part will be trying to sync this app with school health systems and electronic health records

20. Marketing plan • Partner with ACHA and ASHA • Will ensure proper marketing to target audience • Improve visibility and credibility • Promote to health prof. associate, hospitals, small clinics in areas with large student population (e.g. Boston); large regional and inner city high schools • Platforms • iOS and Android • "Health and Fitness"; "Education"; "Medical" categories • Immediate launch • Possible Blackberry AppWorld launch with good response

21. Marketing plan • Price • Free • Small advertisement bars at bottom • If affiliation becomes costly - will suggest that app cost $1.99 to cover costs • Not ideal - high school and college students not inclined to pay for apps

22. Limitations • Linking with EHRs is logistically difficult because of interoperability issues and HIPAA privacy concerns. • Suggest partnering with major EHR vendor to ensure interoperability, sustainability, and expertise • The "use-case" is limited; students may be unlikely to download the app without first being prompted by a clinician • Emphasize marketing campaign and awareness, rewards during roll-out, etc. • Grouping symptoms and suggesting questions may contribute to psychosomatic perception of conditions and self-misdiagnosis

23. MYndMeds MYndMedsMisMedMent(Spanish)MYndMeds: the app that mindful keeps me on track Mobile Health Design 2013 Online Course Tufts UniversityMedicalSchool Final Presentation GroupThree: Hubert Park, Joan Storey& Ana Villanueva

24. MOBILE HEALTH DESIGN

25. MYndMeds • Organization: Psychiatry Clinic • Goals for app: 1. Increase effectiveness of 20 minute medication visits, for patients with depression, in waiting room and seamlessly transfer data to MD. • 2. Improve and make more efficient data collecting, regarding satisfaction with medication. • 3. Increaseadherencetotreatment.

26. Target Population • Both men and women • All age groups • Bilingual or monolingual • Different levels of depression • Patients with low literacy and low health knowledge, and low technological knowledge and platforms

27. Target Audience’sneeds Patients need to know a) Easy technology to answer questions -a small training before they have the app on their hands- b) Treatment c) Drug’s Frequency d) They’re important to their physician e) Follow up tips

28. MYndMeds • Concept Statement: : • 1) Assess patients’ knowledge about their medication (s). • 2) Formulate and coach patient to ask personalized question. • How app addresses needs: • 1) Patients will satisfy their need of communication • 2) Doctors will satisfy their need of information to evaluate the medication effectiveness and follow up on it. • 3) Both will save time and we’ll avoid to be too impersonal.

29. A Review of Personas • Persona#1 Belkis Rosario • Working mom in early 40’s • History of abuse • Suffers from depression • Originally from Dominican Republic • Limited English • She lives with her mother, grandmother, and five kids. One kid with ADD. • CC: “I forget to take my medications and I suffer from bouts of severe depression”

30. A Review of Personas • Persona#2 Carolyn • Walker • 24yo African-American female. • Attends city college and lives in inner city. • Boyfriend who’s not always faithful. • Individual therapy for 2 years for depression. • Low self-esteem and “moody”. • Rx: Celexa to some improvement • Patient’s Chief Concern: “Wondering if I should stop the medication”

31. A Review of Personas • Persona#3 • Irving Johnson • African-American gay male • in his early 30’s; • Dx with HIV+ in 1990 • Rx: Combivir, Prozac (80mg). • Marijuana and ecstasy on weekends. • Depression, anxiety; HTN and hypercholesteremia due to HIV meds. • Anonymous sex but wishes for a long-term partner. • Very active in pro-gay movement. • Likes to look “buff”, worried about weight gain. • CC: “80mg Prozac is beyond FDA recommendations”

32. Lessons on Personas & Scenarios for our app’s design • They need: • Easy, comfortable, and relaxing app • Something appealing to maintain her interest in future visits –music- • Ensure privacy/confidentiality • Information on current medications: risk, benefits, and alternatives • Facilitate efficiency in time spent with MDs • A “fear free to technology” environment

33. COMPETITIVE ANAYLISIS

34. CompetitiveAnalysis • After reviewing several apps that might compete with ours, we conclude: • Market offers “psychmeds”, “dosecasts”& “doctors’ notes”, among others, but they not put together all our goals.

35. CompetitiveAnalysis • Borrow • Multiple language • Simple lines • Easy download • Avoid • Poor instructions • Lack of empirical research/data • Lack of expert advisory board • Lack of data Security • Lack of personalization/customization

36. Formative evaluation plans

37. Actual Formative Evaluation • Consent to video record • Evaluator/interviewer and a scribe • Ana and Joan will interview because they are warm and friendly • Hubert will transcribe because he types fast

38. Formative Evaluation • Goals: • Appeal • Usability • Effectiveness

39. Questions to Ask on Appeal • - Do you find the colors easy to look at? • Did the logo reveal its purpose? • What was the first thing to look at when you found this app? (I don’t get this question)

40. Questions to Ask on Usability (1) • Did the name of the app reveal its use? • What would you like to know that you did not know before? • Do you find the app easy to navigate ? • What do you know about your medications? (e.g. name, appearance)

41. Questions to Ask on Usability (2) • Did the name of the app reveal its use? • Have you used a smartphone or iPad before? How comfortable are you using those devices? • Would you prefer to talk or type? • Does “X” persona seem like anybody you know?

42. Questions to Ask on Usability (3) • Would you use this app if the receptionist asked you to use it upon your arrival? • Would you use this app if the doctor asked you to use it upon your arrival? • Do you think you need a training session to use it?

43. Questions to Ask on Effectiveness (1) • Does this app help you know more about your treatment/medication? • Are there any health issues that are missing in this app? • What are your primary sources of information about health issues? • What else do you want to know about depression and its treatment?

44. Questions to Ask on Effectiveness (2) • MCQ: When did you last take your medication? (Today/yesterday/last week/last month/ don’t remember) • How well do you think the medication is working? • What side effects do you have? • How worried are you about becoming addicted to this medication? • How worried are you about others knowing about your medications?

45. Questions to Ask on Effectiveness (3) • What other things do you think help with your depression: “Botanica”, exercise, prayer, etc. • Would you like to see a short video on your medication? • Would you like to know why this medication was chosen instead of another one? • If we had a website, would you have access at home or at a library?

46. OUR APP DESIGN

47. Name:MYndMeds/MisMedMent(Spanish) MYndMeds Logo: Slogan:MYndMeds: the app that mindful keeps me on track

48. MYndMeds • Check-in app at a psychiatrist’s office • Provide relaxation via music • Review of Rx meds • Facilitate efficiency in patient-provider interaction

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