Control = Freedom = Happiness

The Power of Community-led System Design

The stories that were shared last week were the complexity and stress of managing chronic conditions.  Many of our friends, family members, clients, patients,  neighbors live this struggle everyday.

This week we reviewed our 'Draw How To Take Medication' and the nodes that emerged from the activity.  

Our review of these nodes and the patterns that emerged inspired a rich dialogue that further deepened our understanding of the complexity and patterns in managing chronic conditions and the medications that are a part of this fight.

We shared laughs about the importance of place (using a different bathroom = a smell from not wearing deodorant) and a story about Moses (not to be confused with Charlton Heston/10 commandments Moses - ask Kathi to tell you the hilarious story)

We started by exploring the connection between Routine -> Place -> Remembering.  Bev told how important in her work, as an occupational therapist (OT), that she learn her client's, with traumatic brain industry, previous routine.  Because everything new needs to fit into an existing routine or else the change would be too great for the client to adopt.  

Routine (including Place) and Habit Are Critical 

We talked deeper about keystone habits, from Charles Duhigg's book, the Power of Habit, and how an association to habit is a powerful way to form new or strengthen existing habits especially taking medication as prescribed.  This included the power of place that in inextricably linked to habit.  Much like the Japanese Kanban that transformed Japanese manufacturing place and routine our powerful.  How does routine become part of this system?     

Medication History Helps at Doctors and In Emergencies

Sue discussed the importance of having medical history along with medication information. She includes; past surgeries or episodes, conditions, doctors names and phone numbers, next appointments, medical power of attorney. advance directives, DNR (Do Not Resuscitate) and ICE (in case of emergency) contacts.  There are tools out there like St. Mary Mercy's Plan In A Can  and File of Life and Advance Directives.  How would a system work that integrates medication with medical history?

Take or Not Taken = Important

Remembering whether or not we took our medication was an unanimous challenge when taking medication, vitamins or supplements.  A little bit of a stretch but we made a connection to the movie Inception, because Leonardo DiCaprio's character had a Totem to tell what world he was in. Sue has a totem to tell where or not she took one important medication she takes seperately on an empty stomach. 

After taking this critical medication, Sue turns the bottle over as the indicator that she took her pill that day.  Bev added "it could be like an airplane toilet, Occupied or Vacant".  Could we design a totem that is familiar, integrated and becomes part of a routine?

Control = Freedom = Happiness

A deep, human and emotional theme seems to be control.  If a person feels controlled by their medication, their mental health wanes (meds (can) = depression) and the physical health follows.  But if a person can gain control over their medication, condition and health they have the freedom to live life.  Our quick with a quip, Ed Marsh declared "Control Frees Us To Live Life".  Freedom is Happiness.  How does this system give people control and the ability to experience freedom?

Five Senses To Freedom

Finally, we talked about the importance of using all our senses.  Touch, Taste, Sight, Smell, Sound.  Color to indicate morning and night.  Braille or texture for low visibility.  Background color (black, blue, red) to maximize contrast with each pill.  Bracelet or Watch as a wearable accessory that goes with us everywhere.  A magnifying glass to see details on each pill.  A gumball machine with the sound and visual of the gumball rolling down.  How do we engage all our senses in the design?  

Next week we will explore these five questions.  

How To Draw Taking Meds?

Last week performed a community design activity called 'Draw Toast?'.  If you are interested in learning more check out this TEDx video.

It is a fun way to visualize each participants perspective and easily see patterns emerge.  Below is what emerged during our activity.  There were five interesting themes that we will explore more deeply.

The five themes that became more obvious once we performed this activity were:

1. Importance of Remembering Take or Not Taken

We had had a few solutions suggested during the activity like; documenting in a log or having a family member call to check in. 

2. Distractions Are Barriers

Distractions included a pet, busy schedule, how chores, and a phone call that can get us out of our routine and prohibit us from taking our medication.

3. Taking Medication Correctly Becomes Part of A Routine or Associated with an Activity

A new insight that was identified in few community members' drawings was associating medication to an activity or routine like teeth brushing or coffee making was a helpful.  

 4. Time and Information Have A Critical Relationship To Medication

Timing and other information are an important part of taking medication as prescribed.

 5. Water or A Beverage Were Always Associate With Taking Medication

It might seem obvious but taking medication is most often linked with drinking a beverage or water.  This could be something that is explored to further strengthen or create a deeper connection between the two.  

Finally, below is the summary of the nodes clustered together.  

Check out the Draw Toast website to learn more about this fun and helpful team centered activity to move your organization closer to its goals.  

Community Design A New Way To Innovation

The Pill Pouch has entered a phase.  A phase rooted in community design.  After almost 6 years from prototype to today the Pill Pouch is helping many that share a similar story to Kathi and Stella.  Just like living organisms grow, evolve and adapt so too the Pill Pouch is entering a stage of growth and evolution.  We are doing this in the context of community.

We invited mothers, fathers, sons, daughters, grandmothers, grandfathers, designers, refiners, nurses, pharmacists to work together, in community, and we asked them to share their experience, creativity and ingenuity to come up with the next adaption of the Pill Pouch.

We started by sharing stories of health stress and success. We then used these to together define the opportunities we are working toward.

 Two themes emerged.

1. A way to talk about taboo topics with family (aging, death, living situation, driving, advance directives, making decisions, etc.) 
2. Getting control and changing our relationship to medication

 We used these two themes, put on our designer hats and came up with ways we can use our individual experiences and talents to collectively solve these challenges.

Our journey has begun, in community, with individuals sharing their gifts and experiences together to create something new.  Now that we embarked on this journey we can't wait to experience what emerges.  

Tissue Box Innovation Recognized In The Ocean of Healthcare

Pill Pouch is plankton in the sea of healthcare but this family-owned Detroit, Michigan-based and made business, was nominated as one of five finalists at this year’s 2015 Eye For Pharma "Most Valuable Patient Initiative" in Philadelphia, PA on April 8, 2015. The other finalists (“the Whales”) were mega pharmaceuticals Roche, Bristol-Myers Squibb, Novartis and UCB. Although the Pill Pouch family didn’t win, their story and the Pill Pouch were an audience favorite. The winner was Novartis for their Helio App, “a lifestyle and disease management app.”

In 2008, Kathi Sitek and her 90 year old mother Stella came up with a daily companion, formed out of a tissue box, to help Stella gain confidence in her medication and assist her when taking them daily. Stella’s confidence grew, she stayed healthy and out of the emergency room.

In fighting chronic conditions such as diabetes and hypertension, pharmaceuticals are one important part of maintaining health and quality of life. And for the medications to be effective, taking them as prescribed is a significant part of the battle (adherence). Individuals can forget or misunderstand; they can become overwhelmed, intimidated, or disorganized. Because of these challenges, it is important to meet the individual where he or she is with the information that is relevant in a usable way.

Patient centricity was the talk of this year’s conference and the Pill Pouch’s special recognition was due to its focus on patient adherence to their medication that grew out of Kathi and Stella’s story. Together they were able to change Stella’s relationship to and confidence in her medication, thus improving her adherence and keeping her out of the ER.

The Pill Pouch is such a companion. It is an accessible tool that facilitates conversation with medical professionals, coordinates care with family, friends and medical community, and strengthens an individual’s understanding of and confidence in taking his or her medication as prescribed. This Pill Pouch is low cost, simple and a durable update to the original tissue box version. This simplicity, with a pocket for each sample of medication (visual) and the information about each medication, serves as an accessible daily guide to fight chronic conditions, stay healthy and maintain control over one’s health.

Although the Pill Pouch did not win, the recognition among such whales of competition is an affirmation that even their story, a seeming drop in the ocean, can have a meaningful impact in healthcare.

Eye For Pharma http://www.eyeforpharma.com/philadelphia/awards-finalists.php

Growing A New Companion For Healthy Daily Living - Strengths

The Pill Pouch grew out of our story, the story of our matriarch Stella Mazur. Together Stella and her daughter Kathi, looked to their own gifts, ingenuity and creativity to strengthen their relationship to each other, their medical community and to Stella’s medication.

Their simple, visual way helped Stella change her relationships to the ambiguous pills in her pill box. With the change in relationship came a growth in confidence, communication and her health.

Now that the Pill Pouch has been used by a lot of people that share a  similar story to Kathi and Stella including nurses, doctors and pharmacists, Pill Pouch is beginning our next phase of growth. We started by convening a community of daughters, sons, mothers, fathers, grandmothers, grandfathers, caregivers, nurses, pharmacists and students.

We focused on the strengths of the Pill Pouch and the opportunities the Pill Pouch has to help even more people that share the story of Stella and Kathi.

The strengths that were listed by the community are:

• Simple
• Unassuming
• Familiar
• Visual
• Organized
• Personalizable 
• Accessible
• Made In The USA
• Facilitates Communication
• Coordinates Care
• Our Story - the story of Kathi and Stella

We want to take the gardening approach that is rooted in the strengths that already exist and now grow to meet the identified opportunities.  Next post will focus on the opportunities that the next adaptation of the Pill Pouch could grow to meet.   Please share your comments and experiences.