Designing a better world – For people with diabetes
At the end of last year, we launched our Designing a Better World Competition. The challenge to our clients was to propose a project, on which we could work together. KD would gift £50,000 worth of our time and energy to the proposed idea or project that we felt would have the most positive, meaningful impact toward our purpose of designing a better world.
The proposal we chose, from the many we received, was from the R&D Innovation team at Roche Diabetes Care. Their ambition was to find new ways to tackle the growing epidemic of type 2 diabetes. As a challenge with purpose and opportunity for impact, this is as big as they come.
Addressing the challenge of Type 2 Diabetes
According to 2019 figures from the international Diabetes Federation, 463 million adults are living with diabetes – 9.3% of the world’s population and predicted to rise to 700 million adults by 2045. Type 2 diabetes accounts for over 90% of this total and, estimates suggest that an additional 50% of this total represents adults who are undiagnosed.
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Annual global health expenditure on diabetes is estimated to be USD 760 billion being driven by growth in Type 2 diabetes in particular and with prevalence rising more rapidly in low and middle-income countries than in high-income countries, the health impact is even more challenging and acute.
The big idea
Not unsurprisingly, there are no easy answers. However, in many cases, the causes and progression of type 2 diabetes can be attributed to lifestyle factors such as diet, exercise, sleep, and stress management. The challenge for many people diagnosed with type 2 diabetes is that they did not see it coming, and once diagnosed, they receive very little support advice or information about it and consequently, feel unable to control, manage or improve their condition.
Roche’s idea was to develop a tool, powered by AI and datasets, for use by people with diabetes and their healthcare professionals, to enable them to predict the progression of their condition, and empower them to identify achievable changes to their lifestyle that will slow down or stop that progression – potentially even achieving remission.
We could see that the impact of providing a snapshot of people’s diabetes future could be a powerful trigger but making changes to lifestyle behaviours that may have become habitualised over many years is hard for people to do. We knew we had to get inside the heads of the people we were designing for, so proposed to Roche that we spent the majority of our budget on empathic research and co-creation, rather than jumping to solutions too quickly.
We recruited patients ranging from those recently diagnosed to those who had lived with type 2 diabetes for 10 years. Despite initially feeling hampered by undertaking the research during COVID-19 lockdown, we turned that to our advantage using video diary techniques, and informal interviews to build rapport and create a picture of how people felt about their condition. We talked to them individually and in pairs to allow them to swap and share their experiences and feelings.
We also recruited diabetes healthcare professionals – diabetes specialist nurses and diabetes dieticians – used to advising and supporting people with diabetes. As well as validating approaches from the perspective of clinical practice, this gave us an experienced view of what these professionals had seen succeed and where they had seen patients struggle.
As our work progressed, we co-created potential solutions with them, using online whiteboard tools to capture thoughts and build ideas with direct input from our sample of end users.
Amongst our findings, key takeouts included:
Personalisation: Everyone is different – making solutions as personalised as possible is vital.
Simplicity: Make it easy and quick to enter data, particularly around diet and exercise
Maximising touchpoints: Interactions with healthcare professionals are precious and rare, typically 15 minutes every 3 or 6 months. Tools which work with, and maximise the value of that touchpoint, are essential if they are to be adopted in healthcare practice.
Visualising the future: Predicting disease progression can be a powerful motivator confronting the reality of long-term health impact.
Goals: Setting goals that are realistic and measurable is expected by patients and part of therapy support from healthcare professionals.
Smartphone activation: Using technology via peoples’ smartphones to support achievement of goals is an expected part of a solution – but the tone of interaction needs to be authentic and personalised
Peer support: Whether in the form of forums or real-life story-sharing, this can be just as effective as professional advice
Building a solution
Taking reactions and ideas from the co-creation sessions, we built a prototype of a diabetes management tool for people with type 2 diabetes and their healthcare professionals. This built on work previously developed by the Roche team and comprises a web-based tool used in patient / professional consultations and a patient diabetes App that embodies the following key elements:
● Prediction of the patient’s progression
● Suggested lifestyle changes with illustrations of the potential impact on progression
● Personalised information and advice on diet, exercise, sleep and medications
● Realistic goal-setting to be created and owned by each patient
● Motivation and support provided by features in the App and access to peer support and tailored educational materials
● Virtuous cycle created between consultations encouraging positive habit-forming over the long term
With further testing and development, the goal is that tools based on the work done to date will be adopted by healthcare systems and people with diabetes to make a difference to many individual peoples’ lives and to play a meaningful part in addressing the damaging growth in diabetes.
Commenting on the work, Roche’s Jenny Fisher said: “Having the opportunity to work with KD on this innovative project helped us to better understand the needs of people with living with type 2 diabetes. We enjoyed having the fresh perspective of KD to uncover new insights.”