July 29, 2015

How to Change a Life with Service Design [Cross-post]

This a cross-post from a blog post I wrote for Cambridge Consultants during my internship there.

Lizzie is a 12 year old with type 1 diabetes. As she gets older she is becoming more responsible for managing her disease. Her doctor has prescribed her with KiCo. KiCo is a secure online service which provides a hands-off way to keep everyone in the loop with Lizzie’s health.

Lizzie wakes up. It’s 6.30 AM – a school day. Daily routine for Lizzie is different to that of her classmates: type 1 diabetes has disrupted the homeostatic rhythm of her pancreas. This means that she needs to actively keep her blood sugar levels at a healthy level, balancing her eating, exercise and insulin dosages to avoid serious health problems. Lizzie must consider carefully a trip to the sweet shop; even a quick game of football with her friends is an event that needs to be carefully managed.

Lizzie sits up in bed, pricks her thumb with a needle and drops a sample onto her blood sugar measurement device. On her bedside table, her phone glows briefly as the reading is transferred automatically over a Bluetooth connection. Lizzie feels safe knowing that this reading has already been sent securely over the internet and software ‘workers’ are drilling into the information to check for warning signs. Is her blood sugar dangerously low for a morning reading? Does this represent a concerning trend in her health? Is she following her doctor’s advice? The tattered paper book that Lizzie used to use to record her readings is lying on the top shelf above her desk.

As Lizzie sits down to breakfast, the KiCo app sends a notification to her phone recommending her a pre-breakfast insulin dose quantity and type. She now uses her KiCo insulin pen to inject herself. The pen does not need batteries because it harvests the energy required to take its cap on and off to produce a Bluetooth signal to Lizzie’s phone. This means that she will never be stuck with a pen without power and the KiCo app will always be aware of her dosage.

When Lizzie is ready for school, Laura, her mother, walks with her and they talk about her 13th birthday party, taking place that weekend. After dropping Lizzie off and returning home, Laura turns on her iPad and logs in to the KiCo Parent app. She can see Lizzie’s readings from this morning and is reassured that today is going well so far. She adds a meal reminder to help her plan for supper. The KiCo app observes that Lizzie is playing basketball this afternoon and would benefit from an above average amount of carbohydrates in her evening meal. Laura makes a note of the Victoria Sponge cake that she will make for Lizzie’s birthday. KiCo recommends a dose of 8 IU of insulin before the partygoers arrive.

On the way back from school, Lizzie pays a routine visit to her doctor’s office. Leticia – a diabetes specialist – has known Lizzie since her diagnosis and Lizzie has built up a trust in her to help her keep her blood sugar at a comfortable level. This trust is preserved by Leticia’s ability to stay up to date with Lizzie’s latest readings. 10 minutes before Lizzie’s appointment, Leticia browses Lizzie’s patient profile using her KiCo app. The profile shows the good consistent HbA1c level that Lizzie has kept up since being diagnosed. Leticia noticed that Lizzie’s pre-meal blood glucose reading has been low in recent weeks. This is normal for child diabetics who are learning to manage themselves through their busy school days. When Lizzie and Laura arrive, Leticia is able to communicate this information to Lizzie using her up-to-the-minute view of Lizzie’s health.

‘Today you had a medium-sized meal for lunch, try taking some extra food at the school canteen or grab a pudding. It’ll carry you through sport in the afternoon and you’ll feel better towards the end of the day.’ Laura thanks Leticia and Lizzie picks up an ‘I’m a star’ sticker. With time-honoured satisfaction, she wears it over her school uniform on the drive home.

Leticia ends a busy day of talking to patients and checks her current progress. Her skill as a doctor is quantified by key performance indicators. KiCo helps diabetics maintain healthy long term blood glucose levels and consistently good HbA1c readings and marked improvements in the health of her patients means that Leticia is due for her performance-based bonus.

KiCo makes daily life easier for patients, carers and doctors in the world of diabetes. It is one of the many examples where services can enhance products in people’s lives.