After AthenaHealth acquired Epocrates in early 2013, the Epocrates design team was tasked with creating an impactful product that demonstrated the power of combining the ‘big-data’ capabilities of AthenaHealth with the mobile expertise of our design team at Epocrates.
Introduce AthenaHealth to the 1.5 million medical professionals that use Epocrates products.
Expand relationship between Apple, Epocrates and AthenaHealth. With the announcement of iOS7 and Apple’s movement away from the skeuomorphic approach to UI from previous versions, we had an opportunity to create something that adopted the iOS7 design philosophy and rekindle the relationship between the two companies while bringing AthenaHealth into the mobile app space in a big way.
I participated in a brainstorming session with the Principal Architect, VP of Medical Information, a Physician Informaticist, and VP of Design using the following as high-level goals:
The top idea became Bugs & Drugs, addressing a common issue that doctors in medical facilities face: understanding the local resistance of bacteria to commonly prescribed drugs.
Understanding the physician experience
In order to build an effective tool, we needed to better understand the issues physicians grapple with when making a prescription decision—so we spoke to physicians working at Epocrates as well as Epocrates and AthenaHealth users.
This experience map shows the decision flow of physicians diagnosing and providing treatment to patients with a probable bacterial infection.
To confirm a bacterial infection in a patient, a sample from the patient must be taken and then cultured. This typically takes a few days. As a result, physicians must make a tentative diagnosis and write a prescription prior to confirming the specific pathogen—or “Bug.”
When deciding which drug to prescribe, physicians must consider many factors including:
What are the most impactful drugs for this bacteria?
Are there any known resistances to this drug in my area? Many physicians want to limit the prescribing of drugs for which bacteria have grown resistant as, as pathogen resistance to drugs grows within communities due to over prescribing.
While physicians in an in-patient setting typically have access to semi-recent infection & antibiogram data from their health system, many physicians who practice in rural areas or smaller towns practitioners do not.
Oftentimes, antibiogram information is typically distributed in the form of cards or sheets (example below), oftentimes carried by physicians in their coats. This resistance data comes from lab samples taken within a given health system or when the results are added to patient charts.
Antibiogram charts typically look like this and include the relevant drug/bug resistance information for the most common pathogens and drugs prescribed within that health system.
Our data-driven solution
Because AthenaHealth has millions of antibiogram data points regularly added to its network from labs nation-wide, we wondered if we could combine these data points with a mobile app that would use the physician’s location to check a specific drug against a specific bug’s resistance in their area. Thus, allowing a physician to make a more informed and up-to-date decision at the time of prescribing.
Now that we better understood the problem and the data we had to work with, we set out to design an app that would give physicians access to the latest resistance data.
A photo from our brainstorming session. We landed on the basic concept, but still had open questions about the navigation, essential information to display and the visual approach.
I created this wireframe after our brainstorming session to think through the functionality and propose a visual concept that came up as part of our discussion—to use imagery of the actual pathogens in the app. Because iOS7’s move away from the skeuomorphic UI approach of the past, we took inspiration from Apple’s weather app, which had been redesigned with the new OS release. Upon launch of the app, the physician’s location would be used to show them a list of bugs sorted by the number of isolates (i.e. cultures) taken in their area (they could also change location as needed). Tapping on a bug would show the physician a list of drugs that could be prescribed and the relevant resistance information. Because lab results are regularly added to the AthenaHealth system, the app would reflect this and essentially always be up-to-date.
Our visual design team took the concept from the wireframe and ran with it, working through the new “flat UI” approach dictated by iOS7 and using macro photography as background.
Results
Our small skunk-works team of designers, developers, and physicians created this app in about 4 weeks. It was released to a groundswell of support from physicians and Apple alike and generated dozens of leads for the AthenaHealth suite of products, delivering on both of our high-level goals from the project’s start.
Bugs + Drugs was promoted heavily in the app store in the weeks after its release. App downloads exceeded 100,000 in the first 2 months.
The core team working on this project were named inventors on the patent for this app:
Methods and apparatus for geography-based antimicrobial resistance tracking (US20160092657A1)
Eventually Bugs & Drugs was added to the Epocrates main app, which is still available for download.