Remedying Error: Addressing Medication Adherence Errors at the Intersection of Healthcare Insights and Industry 4.0

<p dir="ltr">Health is essential to human well-being, with its implications transcending beyond the physical realm. However, it is one of those vital aspects of life that determines overall happiness and quality of life. The persistent nature of chronic conditions impacts daily routines by creating significant challenges for individuals, leading to physical, cognitive, and social consequences that affect the quality of life of those suffering from these conditions. Diabetes is one of the chronic conditions that has become increasingly prevalent across the globe and is adversely impacting the lives of those affected. </p><p dir="ltr">The effective management of diabetes requires individuals to self-manage various aspects of their dietary habits, physical activity, blood sugar, and medication adherence. A person with diabetes must adhere to their medication regimen to control their blood glucose levels and prevent further complications. Better adherence leads to better control of diabetes, preventing diabetes-related health impairments, and saving post-complication costs. However, numerous people with diabetes encounter substantial barriers to medication adherence due to factors that include forgetfulness, misconceptions, and the inherent complexity of treatment protocols. Medication non-adherence has become one of the most critical challenges for the healthcare sector due to its impact on patient outcomes and the substantial increase in financial burden on the healthcare system. </p><p dir="ltr">The concept of agency in healthcare implies the ability of individuals to autonomously make decisions and take actions related to their health and well-being. Healthcare design practitioners are able to enhance the potential of patient agency by designing products and services that offer clear affordances to empower patients to improve health outcomes and enhance their autonomy. </p><p dir="ltr">Situated at the intersection of industrial design and healthcare, my practice-based research focuses on developing prototype-based design propositions aimed at enhancing medication adherence among people with diabetes, drawing insights from the experiences of clinicians treating such patients. This research, being undertaken through creative practice, focuses on exploring the possibilities of using physical computing, hardware devices and sensors to provide a smart medical home environment for people with diabetes. Investigating the area of medication management in the context of people with diabetes highlights a gap between the clinician's expectations regarding the patient's adherence to the prescribed medication regimen and the challenges that the patient faces in following the regimen. The creative practice-based research involves the design of Internet of Things (IoT) based propositional sprints, inspired by the principles of Industry 4.0, that help individuals with diabetes adhere to their medication regimens and empower clinicians with information about it. This research illustrates its novelty through details such as QR-code-enabled prescription refilling, IoT integration, and a clinician-patient interface within a mobile application, which significantly distinguishes it from existing solutions. </p><p dir="ltr">The COVID-19 epidemic limited direct contact with patients in hospitals, necessitating the adoption of different methodologies in my approach to developing design briefs for project sprints. As a result of the limited access to patients, the approach involved a shift to spending more time with the clinician with expertise in diabetes. The clinician provided insights into patient behaviours and medication challenges, which paved the way for potential intervention strategies, culminating in four design propositions. This shift underscored the fact that the clinician's insights could yield substantial and actionable data, often more efficiently than direct patient interviews. </p><p dir="ltr">Employing the laboratory metaphor, the electronic prototype-oriented design sprints conceptualised four design projects as iterative cycles of concept generation, experimentation, and validation. This metaphor served as a structured framework to finally create a patentable medication management system focusing on providing the prescribed medicine in time to relieve the person of the additional burden of keeping track and consequently eliminate errors in medication adherence. Through speculative design methodologies and multi-sensory product experience frameworks, the prototypes explored prospective healthcare scenarios that enhance patient involvement and engagement beyond conventional functional adherence. Building on the principles of error reduction methods used in Lean Manufacturing processes from Industry 4.0, the medicine management project uses the IoT framework to develop a system that engages individuals with diabetes to have more autonomy in defining and following their medical treatments by integrating them within the home environment, as well as empowers the clinician by mapping the errors in the regimen for subsequent consulting visits. </p><p dir="ltr">The approach to integrating IoT and Industry 4.0 error reduction methods in the design propositions has demonstrated the convergence of industrial design, advanced technology, and industry best practices in developing healthcare solutions. Moreover, the close collaboration between the designer and clinician showcases effective ways of developing functional solutions that resonate with users. At every juncture, the designer's tacit knowledge and the clinician's practical expectations came together to create a design intervention that could fulfil the crucial tasks in the day-to-day life of a person with diabetes, which, as the clinician mentioned, "would save lives".</p>