OPTIMIZING

AIRWAY CLEARANCE TREATMENTS

In pediatric Cystic Fibrosis patients

Project Brief

For my independent graduate thesis, I chose to explore the pediatric Cystic Fibrosis (CF) experience. Though I began my exploration broadly, trying to understand the CF experience overall, I concentrated my thesis on optimizing the airway clearance treatments that patients must do multiple times each day. The aim of the project was to develop a solution that would both improve treatment outcomes and patient experience.

Overview

I conceptualized a system centered around a Smart Nebulizer that monitors the airway clearance treatment process and provides information to patients, parents, and caregivers in order to improve outcomes. The nebulizer engages children in the treatment experience by interfacing with existing video games, adding additional parameters, controls, and reward systems that correspond with airway clearance treatments and overall cystic fibrosis care.

Roles I Played

  • Conducted contextual interviews and observations

  • Designed prototype testing protocols

  • Prototyped at varying levels of fidelity

  • Conducted prototype testing

  • Generated actionable insights

  • Presented insights and design

Research

Through a combination of in-person and online visits, I was able to gain as close to a firsthand understanding of the cystic fibrosis experience as possible. At first, I interacted with children and parents of children ranging in age from 18 months through 13 years, but later narrowed my focus to children ages 8 and up. 

While engaging with children and families, I was able to observe multiple airway clearance treatments across different families, allowing me to begin to understand how varied the treatment experience is. One family was also able to keep a photo diary that encompassed multiple aspects of the child's daily CF care, extending beyond airway clearance treatments.

Given the highly sensitive and technical nature of the subject, it was crucial that I was in contact with and had the opportunity to learn from three pulmonologists who specialize in Cystic Fibrosis care, two of whom work with pediatric patients.

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Understanding

By constructing multiple journey maps and grouping quotes and observations, I was able to generate actionable insights which helped me understand that in order to have a lasting impact on the child's care and experience, the solution needed to improve medical outcomes rather than merely providing entertainment. Through testing multiple hypotheses as minimum viable prototypes (below), I learned that my design needed to find the sweet spot in the Venn diagram at left - engaging children during their treatment and monitoring treatment in order to improve health outcomes.

Additionally, I found that engaging children during their treatment would likely require the solution to center around screen use. For many families screens during treatment begins as a routine during early toddlerhood and the disruption of this would be likely to lead to a design that would not be viable without drastic behavior changes on the parts of both parents and children.

Iterations

The earliest iterations of concepts for this project were tested as one to two word "seedlings" in a rapid-fire, gut-reaction exercise with parents and children. As these minimum viable prototypes were narrowed down, participants did a card-sort of the concepts as well. Once more developed ideas were prototyped, the two pediatric pulmonologists with whom I had been in contact also participated in prototype testing. The prototypes that rose to the surface were refined and developed into storyboards which were used in the final sessions of prototype testing.

Solution

My final design direction is centered on a nebulizer equipped with wireless communication tools, a microphone, and a differential pressure sensor. The ecosystem I conceptualized is visualized in the first photo at left.

 

The smart nebulizer communicates with existing video game systems through a plug-in, sends all treatment information to a page in the patient's electronic health record, and sends select treatment information to the accompanying app. The gaming plug-in and the app exchange data such that parents are able to reward their child for accomplishing CF-related goals via the game system. Furthermore, parents are able to access their child's electronic health records directly through the app, allowing for faster, more accurate communication between practitioners and families regarding treatment progress. 

Within this ecosystem, children are engaged in meaningful activity without having to change their routine behavior, parents are able to encourage independence in their growing children but still be informed about their child's health, and practitioners are afforded a more accurate picture than before regarding day-to-day health and treatment adherence.