Supporting better pain management with STAMP.

ADK and Dana-Farber Cancer Institute Bring Human-Centered Design to Cancer Pain Management

Purpose

 

Medical Oncologist and palliative care specialist Andrea Enzinger, MD, and the rest of the cancer care team at Dana-Farber Cancer Institute have built a reputation for world-class care by starting with truly listening to each patient. She and her colleagues work each day to change the lived experience of patients driven by a mission to improve clinical care outcomes, pain management understanding, and care research.

This overarching mission became the impetus to embark on a research study known as STAMP (Smartphone Technology to Alleviate Malignant Pain) focused on developing a mobile application to support pain management and monitoring. But the STAMP research team realized that their expertise in clinical oncology, palliative care and research would only take them so far in making the app a reality. Knowing they would need a digital healthcare development partner dedicated to listening, learning, and sharing to realize their application vision, they turned to ADK as partners. 

The Challenge

Dana-Farber’s STAMP team led by Dr. Enzinger faced the challenge of translating their deep understanding of palliative care and pain management into an application. This included the common research team challenges of limited grant dollars and time frames for reaching goals. They would need a digital realization partner to support development of an app with limited funding and time without compromising quality or efficacy.

As a company dedicated to human-centered design, ADK had become a natural partnership fit for several of Harvard’s 15 affiliate clinical and research hospitals. As timing would have it, their development of the ADK mHealth App Kit had reached a turning point in late 2019. It was now an ideal contender for supporting the STAMP team’s goal of meeting their specific app needs and challenges.

Strategy

A successful STAMP application would provide patients with real-time pain management recommendations based on their survey answers and alert doctors to significant changes in patient pain levels. The long-range goal of the STAMP and ADK teams was creating an app that would meet that criteria for a broad user base as a white label product for healthcare organizations (HCOs). A more immediate goal was developing the STAMP app for further use testing and R&D within a four-month window.

In early 2020, the two teams set project scope by defining the application process requirements and surveys. Collaborative cultures were the root of both teams, so it was easier to develop a holistic approach to sharing knowledge from their respective expertise areas.

Besides the three-person STAMP team’s expertise in clinical oncology and palliative care, Dr. Enzinger is an Assistant Professor of Medicine at Harvard Medical School. Her experience and patient teaching style would prove invaluable in imparting to the ADK team the relevant aspects of:

  • Medical language idioms
  • Medication management
  • Patient communication on pain management in the cancer care journey

These insights broadened ADKs knowledge by fostering a more nuanced understanding of the cancer patient’s daily medical and emotional journey. While the STAMP team guided the survey questions and tips, ADK could bridge their knowledge gap in how it relates to UI/ UX best practices and even algorithm designs.

The goal was to provide response options that fit the known spectrum of patient pain conditions and mindsets within the overall cancer care journey. This would be the foundation for eliciting the most accurate responses that help researchers and clinicians improve outcomes.

ADK determined that bi-weekly sprints with iterations of feature sets that would incorporate feedback from previous session meetings would best propel the project forward with a short timeline of four months. This would ensure development of a single nexus point where: 

  • Application survey questions and tips reflected the deeper nuances of clinical and palliative care
  • The application reflected maximum simplicity and empathy for patients answering the questions
  • Gave providers and researchers the usable data for further research and the ability to improve patient palliative care outcomes

The ADK mHealth App Kit platform would provide the significant building blocks for creating an application design with the highest quality, efficacy, and simplicity for patients, providers, and researchers. ADK's strategy behind the design of the mHealth App Kit was creating a platform capable of broad adaptation within a narrowly defined healthcare research use-case spectrum. These attributes would allow Dana-Farber and other healthcare research teams to start with a strong application platform foundation that:

  • Has core clinical research features pre-built
  • Follows strict HIPAA and regulatory standards
  • Could fit the custom needs of oncology pain management tracking
  • Includes future interoperability features like FIHR compatibility

The project partners determined it would be the ideal foundation for development of the STAMP app on a short timeline with limited budget. Once all features were ready, the STAMP team could start their internal testing via focus groups and research to get testing feedback. 

Impact

The STAMP mHealth App underwent an internal STAMP testing phase by clinical researchers and simulated patient focus groups by the end of Q1 2020. Testing used a digital design mockup of the app with survey simulations to avoid HIPAA related information disclosures while still enabling true feedback scenarios for further adjustment. STAMP and internal Dana-Farber teams are completing internal reviews and approvals for the next phase of an app store launch and future application iterations.

Ongoing Dan-Farber and ADK partnerships show how digital health collaborators can develop mHealth apps that democratize research, development, and treatment applications for teams across the healthcare continuum where budget constraints are universal. A broader long-term relationship with other Harvard Medical school affiliates will also support a body of knowledge and collaborative, human-centered approaches to digital health solutions 

ADK's mHealth App Kit was just one foundational spark of the collaborative work with Dana-Farber that will lead to a cascade of partnerships across healthcare. Each successive digital healthcare tool that emerges from that spark will meet the needs of researchers and clinicians everywhere that are working with limited funding and time. The goal is to serve the broader healthcare continuum in novel ways that encourage digital healthcare possibilities that can transform patient healthcare realities.


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About the study

Dr. Enzinger led a team to see how far an app could go in alleviating pain for people with cancer.

Challenge

Translating a deep understanding of palliative care and pain management into an application under tight timelines and funding.

Solution

An agile approach to design and development built upon the mHealth App Kit as a starting point in order to create a test-able product.

Impact

Within a couple of months, the team had a test-able product ready for R&D. They're now positioning to launch on the app store and explore commercialization.

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