Designing better HIV treatment

Digital designer Jepchumba tells us about the making of Aviro, a mobile app for HIV clinicians to accurately prescribe ARV medication.

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What happens when you combine two worlds – when you infuse medicine with technology design? 

I am not a medical professional. I am a designer, curator and digital artist. I have spent the majority of time curating art and artistic practices throughout the continent. I have been passionate about the collaboration between technology and creativity in Africa and have been challenged by the real-life obstacles that many people face on the continent.

We are seeing how Ebola is ravaging Western Africa – and there are many other emerging health crises that highlight critical issues facing the continent. I was provoked to see how creativity can bring about positive change in public health and whether design and medicine could effectively work together to find new approaches surrounding the HIV/TB epidemic. 

A meeting with Dr. Musaed Abrahams, an HIV training coordinator at Medecins Sans Frontiers, introduced me to a prototype of an app that enables HIV clinicians to accurately consult on appropriate treatments. And so began our journey to make the Aviro app a reality and to form a medical design company.

Aviro is the flagship mobile health application for our new start-up, Aviro Health. It is a cell phone-based tool built for HIV clinicians that provides them with real-time, immediate feedback and guidance so that excellent and reliable care can be delivered to every patient.

Based on South African clinical guidelines, Aviro enables HIV clinicians to easily consult on anti-retroviral (ARV) treatment during patient visits. The app came from combining human-centered design principles, mobile technology and proper clinical HIV/TB practices.

It’s a challenge for nurses and clinicians who work in the HIV/TB field to keep up with rapidly changing guidelines.

They often have to refer to confusing charts and inaccurate information pasted on the walls of their clinics. Add to that the long waiting lines and the pressure to make quick decisions affecting the treatment that their patients receive.

We began by examining the daily challenges these nurses face and developed the mobile app alongside them.

The app is a tool that not only serves as a guide for them to properly prescribe ARVs but also gives them confidence in the work that they do. We do not believe that technology will ever be able to replace the care, discernment and expertise that health professionals provide but we can create solutions that make their work easier.

The entire process was a collaborative exercise that pulled different groups together.

We worked with the best medical experts in HIV: Drs Graeme Meintjes and James Nutall (both affiliated with the University of Cape Town) and Dr Ashraf Coovadia (Wits University) to design a set of medical algorithms based on South African HIV guidelines. We used Atul Gawande’s The Checklist Manifesto to crosscheck our process, incorporated design principles into the app’s user interface and got nurses’ input to make the user experience easy and accessible. 

We teamed up with an app developer in Romania who put our wireframes into reality. We then went through a series of iterations where we partnered with the Southern African HIV Clinicians Society and Anova Health Institute to get nurses in Gauteng to use the app and give us their feedback. (We are continuing to work closely with them to ensure that as many nurses as possible download and utilise the app across Southern Africa.) 

We first developed an Android version and an iPhone version will soon be available. The app is available for free download on the app store.

We partnered with great organisations that have helped us with the testing and implementation phase, such as the MTN Foundation that not only gave us funding but provided us with affordable smartphones for the nurses to use during the testing phase.

Why do we not have better designed approaches to health? Africa has more mHealth projects than anywhere else in the world and we have seen an explosion of mobile technology immersion.

We see shining examples such as global design and innovation firm IDEO and other organisations that have injected design thinking into non-traditional spaces. We want to do this for Africa by continuing to bring creatives, technologists and health care professionals together.

I implore designers, artists and creatives to branch out and see how they can collaborate outside their sphere of influence to disrupt spaces and ways of thinking about creating solutions. 

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