Insightfil

Insightfil is a new health-care initiative from Artaic, a mosaic tile manufacturer, whose goal is to revolutionize the experience of using prescription pills. While it may initially seem odd for a mosaic manufacturer to make the leap to health care, when you consider that the core of their expertise is custom software development and robotics manufacturing, it begins to make more sense. The same robots and software that create beautiful mosaics by placing thousands of tiny tiles are also ideally suited to placing pills in a custom pill pack.

The Initial Strategy

When I first started working with Insightfil, the go-to-market strategy was business-to-business. They envisioned a robotics workstation that would fill customizable pill packs both more efficiently and more accurately than a person could. The robotics would reduce errors, and a unique pill packet design would reduce dosage and timing errors.

As part of our design research, we visited central-fill pharmacies to observe and interview the pharmacists and pharmacy techs. This helped us understand the design requirements for the robotics workstation. We also visited nursing homes (customers of the central-fill pharmacies) to understand how pills were currently distributed, and identify opportunities where Insightfil's approach could make a difference. This contextual research was invaluable as a starting point.

Working with Insightfil and Boston Device (who were responsible for prototyping the robot itself), we began to explore possible designs, starting with paper prototypes. Several iterative rounds of design and testing led to an approach we thought would work.

Because many central-fill pharmacies operate with limited space, the design of the workstation had to be compact. And because their margins are tight, the workstation would be built with commodity hardware, such as Dell monitors (at the time, a touch UI was considered, but proved too costly).

From the paper prototypes I designed a prototype UI/UX using Keynote, to display on a vertically oriented Dell monitor as it would at the final workstation, and used this for testing and design iterations. I envisioned that the software would intelligently batch orders so pharmacy techs could more efficiently gather medication, reducing the number of runs from the workstation to the shelves. To bring in a human element, I placed the faces of the patients along the top menu bar, as the visual indicator for each order. People naturally relate to faces, and we had observed it was all too easy to get caught up in the rush to meet package quotas, loosing sight of the fact that this medication was for specific individuals.

A Shift to Consumers

While this work was underway, Insightfil's market research indicated two things: that central-fill pharmacies' incentive to differentiate their offerings was low; and that the regulatory hurdles to introduce a new package were high. At this stage, the go-to-market strategy changed from business-to-business to consumer, with a shift from pharmaceuticals to nutraceuticals, or what you might think of as "supplements."

Through a second round of site visits to pharmacy-grade nutraceuticals manufacturers, we learned that there's a world of difference between the supplements at the CVS, and those that have the highest quality control and research to back their efficacy. Our introduction to this world came through the Sloan-Kettering Cancer Center at Hartford Hospital. We learned that integrative medicine takes nutraceuticals seriously. Yet, as with pharmaceuticals, adherence can be a challenge. Indeed, the World Health Organization has compared adherence to a "blockbuster drug" in its effect on outcomes.

The question we needed to ask was: what problem are we trying to solve? It seemed the issue was less about package design and robotics fulfillment (though these promised to reduce medical errors), and more about changing patient behavior. If adherence was the challenge, we needed to understand the lived contexts of the people for whom we were designing.

Our work began with a visit to the integrative cancer center at Hartford Hospital. There, we interviewed doctors, receptionists, and observed patient behavior. At this point, we realized we were dealing with a service design challenge. Service design concerns itself with understanding and visualizing the experiences a person has with an organization from their perspective. To visualize each step of the patient's path, and shift our collective understanding of the total experience to that of the patient, we created a patient journey map.

The Patient Journey Map

When we created a Patient Journey Map, it proved to have a profound influence on Insightfil's approach to their purpose. It became clear how each step in the patient journey compared to the next. And from here, we could agree on which areas to "target" for design, knowing that the highest value experiences would be at the top of the list.

Using this visualization tool made clear that initial engagement, the first clinical visit, the first order, and the package experience in the home were key steps that merited design consideration. In addition, we envisioned an iPad app to engage patients in their own health plan while visiting their clinician, followed by a consistent experience using an iPhone app to track adherence and report back to their physician. We created initial digital iPhone prototypes apps based on a set of rewards and prompts to encourage patients to both record and adhere to their medical regimen. 

Mike Trachtman, Insightfil's CTO, said that the Patient Journey Map has transformed how his organization understands its purpose and has helped prioritize both design and technology efforts beyond our engagement.