Shouldn’t we be blaming the design instead of blaming the patient?

Patient Problems are really Design Problems

This is the post that inspired part of my talk at the Cusp Design Conference 2013, which was first published Feb 14, 2013 on my previous blog.

I posted last week about the revolutionary design of the Auvi-Q epi injector. I could personally attest to the design flaws of the Epi-Pen Jr, bit I was wondering what the scientific literature had to say about them. As I read through the papers, what struck me was the one-sided medical view of the problem.

I read statements like “patients often do not understand when to use the device, how to use it, often forget it, [and] allow it to expire.” (Sicherer SH. Self-injectable epinephrine: no size fits all! Ann Allergy Asthma Immunol. Jun 2001;86(6):597-598.)

But is it the fault of the patient or the fault of the design?

If you think about the new improved design of the Auvi-Q a lot of these “patient” problems are really “design” problems.

-Is it a patient problem (lack of patient understanding) or a design problem (Epi-Pens have a confusing design with a cap that comes off the opposite side as the needle)?

The design solution: Device talks to you and tells you what to do!

-Is it a patient problem (patients often forget the device) or a design problem (who has pockets that can fit 2 Epi-Pens the size of large Sharpie markers)?

The design solution: Device is the size of a cellphone and fits in your pockets!

-Is it a patient problem (patients allow the device to expire) or a design problem (it requires work to find the expiration date on the pen and who has time to remember the expiration dates on all their medications anyway)?

The design solution: You can record the expiration date in an accompanying mobile app for Auvi-Q and the app will send you a reminder when it expires!

This to me is a prime example of how better design can lead to higher levels of patient adherence.