By Tina Venema
Kelly Grindrod is an Assistant Professor at University of Waterloo’s School of Pharmacy and a practising pharmacist. In her role as pharmacist, Grindrod came across an oversight that could have fatal consequences for elderly patients.
She saw two patients in a row who were not taking their blood-thinning medications correctly. One patient didn’t understand the directions, and the other couldn't read the label due to newly diagnosed vision loss.
Grindrod knew that too little medication increases the risk of blood clots, strokes and internal bleeding. And so, armed with research funding, she wanted to create an app to help people manage their medication, particularly elderly people who live alone.
But, while Grindrod had the pharmaceutical knowledge and expertise, she had no technical development background.
“That is often the difficulty when it comes to health sciences researchers; we have the knowledge but we are not coders," she said. "A critical skill set is missing to transform research into real tools.”
As the UW School of Pharmacy is across the street from the Communitech Hub in downtown Kitchener, the Communitech Apps Factory was a natural choice for Grindrod to seek help.
“The geographical location was perfect," she said. "I loved that they were in the community but I also liked that they include co-op students as part of their development team. As a university we like to support that.”
As a researcher, Grindrod viewed the app as a way to put evidence into practice through technology. She wasn’t interested in creating a fully commercialized product right away; she was interested in taking a concept, building it and testing it to see if it worked.
“I approached Apps Factory from a research angle and they were happy to work with me even though I wasn’t creating a commercialized product per se at the time.”
Due to the Apps Factory team's extensive network and experience, they were able to understand Grindrod's academic thinking and refine the development task quickly. This is a rare skill set and was invaluable in bringing a high-level concept to a practical application that could potentially save lives.
Because she wasn’t working with a development shop preoccupied with getting the product out right away, Grindrod had time to build her understanding of how to take the idea, mock it up and work with the Apps Factory team on development and testing. She was involved in every step, from the staging meeting through wire framing, development and testing.
The result is ClereMed, an application that acts as a research tool to improve labelling of prescriptions. ClereMed tests how people read labels by having patients perform a series of steps that simulate taking their medication.
For example, they may be asked to take two pills at breakfast and one in the afternoon. In the context of the application, "taking a pill” means dragging one or more images of a pill into the correctly labeled box.
If the patient is unable to perform the task, the screen resets with the instructions presented in a larger font. This continues until the patient can carry out the exercise or the maximum possible font size is reached.
In addition to this core game/test component, the system asks the user several questions, such as, Do you normally need glasses? Do you have problems reading glossy magazines?. Based on the combination of game performance and answers to the questions, it presents the pharmacist with recommendations on how best to instruct the patient.
Today, Grindrod has tested the iOS-tablet-compatible app with 45 older adults. She has discovered some important findings and plans to continue research by expanding on ClereMed. She envisions a broader application for pharmacists to use when doing medication reviews.
“So ClereMed becomes an app within an app, a tool to fuel further app development or part of a suite of tools,” she said. At first Grindrod thought it would be a stand-alone app but she now sees that it could become an open source tool for collaborative development.
Grindrod has submitted research abstracts to a few conferences and is waiting to hear if they will be presenting the app and research findings derived from ClereMed's development and testing.
“This was the main goal of the project. The final research paper is being written and it will speak to how older people interact with touchscreen devices for healthcare and how it can be improved. I believe we will be among the first to publish research in this area and we are excited about that,” she said.
Grindrod will also be making use of her Apps Factory experience and Communitech peer-to-peer groups to hold a brainstorming session to improve ClereMed, particularly in the area of user experience. Her dream is to see this type of brainstorming activity have a permanent home at the School of Pharmacy and include Apps Factory developers, UW pharmacy students, pharmacists and patients collaborating to create technology that will improve medication management.
In addition, she has applied for a research grant with support of the Apps Factory team to determine if mobile health applications such as weight management apps are better suited to ‘internal’ social media network components versus the more public Facebook or Twitter platforms.
Grindrod thoroughly enjoyed the experience.
“By working with the Apps Factory I now feel confident that I could handle the process and the knowledge exchange," she said. "I would definitely use the Apps Factory for conceptualizing ideas and creating initial technology around research-based questions."
