Hiboot is an app designed to help over 600 000 chronic disease patients daily. Discover our conference at the International Digital Health Congress Doctors 2.0 explaining our approach to creating relevant and lasting apps by focusing on patients

1. Focusing on patient
to create relevant
and lasting apps.
J.SELLAM & H.JEANTET

2. Jeremie Sellam
Professor of Rheumatology,
AP-HP Saint-Antoine hospital
Pierre & Marie Curie University
Patient care and
clinical/biological research on
rheumatic diseases
Henri Jeantet
Co-founder @ unknowns, an
innovation studio & consultancy
with a strong commitment to
social sciences.
Who we are

3. _Core metrics to look at :
Download
User retention
Usage
Impact on real life !
How to create relevant and lasting apps ?

4. Our vision: from disease to people
There is a gap between the wealth of scientific knowledge about
diseases/treatments and the knowledge of patients’ daily lives,
their issues and behaviors regarding their health.
Technology can bridge this gap, if and only if it is build around and
with people.

5. Rheumatoid arthritis
• 300,000 patients in France
• beginning 40-60 years old
• Auto-immune disease with
joint inflammation
• Progressive joint pain,
destruction and functional
disability
• Chronic disease Þlong term
treatment
Spondyloarthritis
• 300,000 patients in France
• beginning 30-40 years old
• Back pain, arthritis, heel pain
• Association with psoriasis or
colitis
• Chronic disease Þlong term
treatment
What diseases are we talking about ?

6. Rheumatoid arthritis Spondyloarthritis
What diseases are we talking about ?
Early RA Established RA (too) late RA

7. • Specific blockade of
inflammation pathways
(TNF, IL-6, T-cells, B-cells)
• Prevention of joint
destruction
The era of targeted biotherapies since 2000 :
a revolution for the patient and for the rheumatologist
van Vollenhoven, R. F. Nat. Rev. Rheumatol 2009

8. Immunosuppressive drugsÞ­risk of infection

9. Our starting point : safety
Our objective :
How do we enhance biotherapies safety, a self-administred
immunosuppressive drug ?
Our assumption :
Reassuring people through a checklist would increase patient
compliance.

10. #1 Understanding
people.

11. Understanding behaviors : method
Quantitative study (in collaboration with patient’s association) :
- online study, 330 respondents
Ethnography :
- led by a anthropologist, 21 respondents.

12. « It’s not a disease, but a chronic
problem. I have a body with
specific needs »
You don’t catch them,
You can’t really cure them
You have to live with them
through a career.
#1 Chronic diseases are different

13. #2 An ideal of normal life
A desire for normality that relies on autonomy at three levels :
Doctor-patient
relationship
Building a more equal
relationship based
on a common knowledge,
in which the patient is
part of the solution.
Skills and
Knowledge
Coordination
Information
Collaboration
Experimentation
Adaptation
Treatment
appropriation
Managing the treatment
Building habits & rituals
Experience

14. #3 a fundamental tension
Habits and rituals are good for compliance…
…but they lead to trivialization and overconfidence…
...and increases risks of infection.

15. The design challenge :
How do we build a tool that helps people live better, so that they
would integrate the checklist in their ritual and stop being
overconfident ?

16. #2 Here comes
Hiboot.

17. All those insights are the
foundations of the user
experience.
Building from people’s lives.

18. Answer real question in a real
non-medical language : a
situational Q&A built around
daily life (trip, vaccine, fever,
dentist, etc.)
Personalized according to the
treatment of the user
Help patient gain more autonomy

19. Help keep track of life with the
disease (people forget)
Don’t be medical
Help patient get a better life

20. Be a useful companion
Make the checklist part of
the ritual
Integrate the ritual

21. In order to reinforce usages
across different type of users,
we will multiply features that
helps patients daily lives.
And more to come

22. #3 Main learnings.

23. « what do they do/live now ?
what will they do/live
tomorrow? »
Building an app/a website/IOT is
not a goal, it’s a way to help
patients achieve something.
Have a clear objective

24. Doctors and professionals are
irrational people too.
Healthcare is still dominated by
a top-down culture
Engaging patient from the
beginning is key to relevance.
Doctors and pharma don’t always really know
patient’s lives.

25. Go fast for real life, even with an
imperfect product, as this is the
only way to improve it.
Be ready to change everything
from user’s feedback.
And factor it into your financial
approach : the 1-1/2 rule
Getting online is the beginning

26. Put needs first, define what is
your design challenge, and then
decide what kind of technology
you need.
Problem first, technology second

27. Try to avoid it at first, in order to
go fast.
Once tested, tried and proven,
you’ll have the data to justify the
investment.
Medical device regulation are a pain.

28. Rely on existing, verified and
accepted and validated
recommendations (Club
Rhumatismes Inflammation): just
re-write them with people in
mind
Rely on scientific society to be the
product’s face : it helps engage all
stakeholders
Build a neutral ground

29. Gives credibility
Helps acceptance
Generates referrals
Helps with the work
Provide insights
Engaging stakeholders is key to success
Pharma
companies
Patient
Associations
Doctors Hospitals
Scientific
Society
Patients
Scientific board
Pr J. SELLAM
Pr T. PHAM
Dr C. BEAUVAIS
Pr F. TUBACH

30. Thanks !