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Follow up testing with Dr Ranjita

Top Doc feedback

She felt that some senior doctors would not like the introduction of this tool, as they are used to being the 'fountain of knowledge'

“Senior doctors would feel intimidated by this - they come from the old school, they’re used to being the authority"

It's interesting that in her eyes this would impact the traditional dynamic of junior and senior doctors - right now, senior ones with years of experience are the most valuable resource for advice, and they enjoy that position. We also found this in our first round interviews, that a very senior doctor was not open to new ways of learning. HMW design this tool in a way that feels non-threatening - or would be accepted by the medical community at large? Many doctors have suggested that linking it to CME points would work.

“If it was from an authority like WHO it would work also”

She is in a Whatsapp group with GP's from the AFPI (Association Familiy Practitioners of India) and shares best practice and case studies with them. She also takes content from WHO and is putting it into Whatsapp groups with patients, as well as directions on things like vaccines.

“We will help each other learn how to tell patients things in layman's language, in a non medical way”

This was one of the key elements of Top Doc that we'd anticipated would be great for more experienced doctors (vs the basics of bacterial infections).

Remote Doc Booth feedback

She felt that although this idea is good in theory for patients - it might be difficult to pull off, partly because many pharmacies are already affiliated with doctors - officially or unofficially.

“It needs accreditation that only trustworthy doctors are able to be on this.”
“70-80% of all pharmacies are directly or indirectly linked to doctors already, so you might find this gard”
“It would only work if its completely unbiased”

Visual aids feedback

“I would have to give a prelude to the picture. I would not use this” (The shapes one)
"The two words catch the eye, and it’s clearly saying it's 'inappropriate'” (The Petrol vs Diesel one)
“Success depends on time with these. Learned patients would think it was innovative. Less educated patients just want the medication and magic to be done in a day”

We've heard a few times that the more educated patients are interested to be taught about medications and when to use them, less educated do not want a conversation - they simply want to be in and out of the doctor with their medications. HMW design solutions that encourage people no matter how educated, to take more of an active role in their healthcare?

Smart Prescription

“It’s very useful for your thought process - it makes it faster. It comes up with these things on its own. It's like a double check”
“It would be great if it can cross check if the patient has a certain condition, for example gastritis. If you’re giving amoxicillin you should check if people have bowel problems”
“(Reminders) - This is all good. I am completely in with this. It’s perfect, it also works with chronic diseases”
"I don't want to read that this antibiotic is overprescribed and a leading cause of AMR, no. I want to know if it might present a problem for this patient right here"

Great builds from Dr Ranjita. She would want the alert in the tool to be highlighting any potential issues of giving medicines to a specific patient, based on what they're already taking or if they have allergies. Something we've heard from other docs too.

She would also want to have guidelines and protocols that are contextually relevant to India.

"I would prefer Indian guidelines on AB, but currently they’re not consolidated (i.e. state to state)"

We have heard from other doctors that when guidelines are too broad they are easy to ignore. (for example when they say AB's should only be given after a test - many patients can't afford tests so docs override this guideline in order to 'help out' the patient.) If this concept is chosen to prototype, it will be great to see what kinds of guidelines make most difference to doctor's behaviour.


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