We were not prepared for this.

Never imagined I’d one day fill my plant mister with 96% alcohol to use as a disinfectant spray.

Never imagined asking my parents to leave Jakarta to take shelter in another country where they’d be more likely to survive this COVID-19 pandemic.

Who would’ve thought that just as we thought the world was smaller, more accessible, that it’d be a vehicle for disease to spread faster.

As of today, Indonesia has one of the highest COVID-19 death rate in the world.

Given the population density of the country, lack of proper hygiene, and many other problems (like how I can’t find a single smoke-free restaurant in this city), the exponentially growing incidence rate will:

• Overwhelm our medical infrastructure, including hospitals and medical professionals
• Increase patient medical bills that may not be covered by insurance (or if it is, will be a pain to get reimbursed)
• Inevitably impact vulnerable populations the hardest, further widening economic inequality across income brackets

Short-term efforts such as social distancing, giving free food to Gojek drivers and staying home are all temporary bandaids that we can do right now, but what should we do about it moving forward? How can we learn from this?

In an empty house coupled with the complete depletion of social activities, I’ve made a conscious decision to take a step back from news channels and social media to refocus my energy on precious thinking time.

“Celebrating” my quarter-century of life in the midst of this healthcare crisis got me jotting notes, writing on windows and flipping through past mental notes and I keep returning back to the same question:

How will the healthcare ecosystem evolve after COVID-19?

The tragic 9/11 attack on the US World Trade Center in 2001 completely transformed traveling as the world knew it. Will this COVID-19 outbreak do the same for the healthcare industry? We’ve already reached 102,734 deaths around the world and climbing. Would this be the wake-up call that would finally spark an industry transformation?

My idealistic millennial voice says:

“Yes, of course!”

But upon pondering on this question more, it didn’t take long for my optimistic self to be hit with the reality of the lack of proactivity of our friends in the public health sector — the critical driving force with the power to stimulate country-wide change.

Similar to how a country prepares itself for war, preparing our body to defend itself from illnesses is something that does not happen overnight.

Building a strong immune system takes time, and it is not a one-man job. There are no shortcuts.

Back in the day, I used to mindlessly eat and take part in not-so-healthy lifestyle habits, until I entered a long streak of seemingly never-ending illnesses that persisted for weeks at a time. I felt horrible.

Eating well-balanced meals, exercising routinely and mastering the skill of delayed gratification is a struggle — a true real life example of the Marshmallow Test for grownups.

It wasn’t until I started surrounding myself with coworkers, friends and a partner who cared enough about being thoughtful and responsible did I see a change in the way I was treating my body. Having that community support is so important.

After the pace of life returns back to normal, as new businesses are born and existing ones recover and restructure from the downfall, I’d really like to see:

• More smoke-free hangout spots because secondhand smoke can exacerbate future respiratory damage and infections (like COVID-19!)
• More restaurants following proper food safety and handling guidelines because the food consumed enters the bodies of hundreds every day
• Equal healthcare coverage amongst employees because your title and seniority should not determine how much you should pay to care for your wellbeing

A note to my millennial friends. Yes, you.

Many of you reading this may be new business owners, taking over your family business or even moving up the corporate ladder. Wherever you are now and whatever you’ll be doing, you are a part of this rising generation of thought leaders and game changers.

As we’re also the most likely group to survive this COVID-19 pandemic, home quarantine presents itself as the perfect time to rethink the way we view community health and how it impacts our own health. I know that I need to make changes within my own household — like investing more time and resources to educate my employees on basic nutrition and hygiene.

This year on my 25th birthday, there are no candles or confetti.

But I do have my health, and I couldn’t be happier.

“We need to take him to the hospital,” my mom said.

I woke up to her shouting my name from the hallway. It was 2AM on New Year’s Eve. I jumped out of bed and saw my dad vomiting profusely. He could barely open his eyes as he complains of extreme vertigo. He couldn’t even sit up without falling. He could barely talk as he was gasping for air.

I took out the blood pressure cuff for a reading. It read 149/92. His BP was way too high. We had to go now.

We went straight to the emergency room. As he was wheeled through the double doors of the hospital, I told the doctor about his history of high cholesterol and heart attack a few years back.

“What medication is he on?”, the doctor asked as he checked my dad’s vitals.

“Lipitor and baby aspirin, and uh…”

“What dosage?”

Shit. I froze. I didn’t know.

I stepped back to let the nurses get to him. They proceeded to insert a line to give him something to stop his head spinning. It was the first time I was in the emergency room since the incident a few years ago. I had no idea how accurate my recollection of my father’s past medical condition was. I felt useless as the curtains closed in front of me.

I’m extremely grateful my dad was able to fully recover in the next few days. I applaud the care team for making the right judgement with the information that they were presented with.

But thoughts of what could have happened kept lingering in my head.

What if the doctor made the wrong call? What if the drugs he gave had complications with the meds he was taking? How could we have reduced the risk of complications?

Defining The Problem

If you are in the top 2% of the population living in Indonesia, you probably receive regular health services in neighboring countries such as Singapore and Australia. Why?

These doctors:

1. have better resources and access to the best medical equipment,
2. receive a much higher quality of medical training, and
3. held more accountable due to a stricter regulation of laws around medical practice

Thus, the standard of receiving medical care outside of Indonesia is substantially higher.

But what about the other 98% of the Indonesian population who seeks care locally?

I have heard horrific stories of doctors making the wrong disease diagnosis, prescribe “quick fix” drugs and unnecessary procedures that all contribute to the pile of medical expenses.

Like in anywhere in the world, but especially in Indonesia, these decisions involve monetary incentives from big pharma, through insurance companies and private institutions, who have a much stronger grip on the industry than the law or medical board regulations.

What do doctors have to say about this?

I interviewed a dozen doctors from various fields, both in an inpatient and outpatient setting. We had discussions about the challenges of being a medical professional today.

I found that a common barrier that is preventing doctors to be confident in providing the right care is the lack of patient context.

I learned that in Indonesia:

• No two hospitals have the same electronic health record system
• More than 50% of private practices and community clinics are still using handwritten paper records

So what happens if we seek care with multiple doctors at different clinics? It would typically take days or weeks to get these records mailed over.

Do we provide doctors with enough information to make the right call? How can we collect all the puzzle pieces to represent one’s health status?

Retrospectives from my dad’s hospital encounter is why I started Project Syna.

Presenting Syna. Your health records in your hands.

Syna [sea-nah] is a SaaS platform to help keep all your medical records in one place that is accessible by you, the patient, anytime and anywhere.

The word Syna comes from the Greek word ‘symfrazómena’; meaning “context”.

The Syna platform:

• Transforms paper-based medical records to a digitized format
• Securely stores your information in a heavily protected data center
• Allows you to organize and visualize your health data

Objectives for this project

1. Critically think about why the problem exists
2. Communicate my thinking and design process
3. Implement design on the front end using skills learned from my coding bootcamp (ongoing)
4. Identify potential limitations of the product

User Personas

Mr. Traveller

“I have multiple chronic conditions and I spend 50% of my time traveling for work. I want to have peace of mind and know that if something happens, I would be able to give the doctor a complete picture of my history.”

Ms. Super Mom

“I have 3 kids and 4 grandparents to manage. I want to see all my family’s health information compiled in one place.”

Ms. Ownership

“I want to make sure that my records are complete. I can’t rely on the administration to keep track of all my records. Records get lost all the time. I want to be able to leave the doctor’s office with all the notes to look over in my own time so I can understand my health better.”

Inspiration and Feel

Going to the doctor’s office is stressful. I’m a huge believer in that we absorb the energy around us and with the things we interact with.

I noticed a huge difference in the aura of my apartment space when I added succulents and hanging plants. Plants help reduce stress and create a feeling of well-being.

As plants are often looked as a symbol of growth and livelihood, I wanted Syna to have the same vibe. I was aiming for an interface that is clean and minimalistic while having tones of garden plants to stimulate a feeling of calmness. I used Coolors.co to generate these color schemes.

Information Architecture

I worked very closely with electronic health records during my time as a health coach at a Stanford preventive cardiology clinic called SSATHI (short for Stanford South Asian Translational Heart Initiative).

From that experience, I was able to break down and highlight the relevant information typically used in a clinical setting.

Wireframes

I went through almost a dozen pages sketching out different versions of all the screens before I used Sketch to create high def wireframes.

The Designs

After weeks of iterations, going through user flows and working with web designers, I present to you a glimpse of Syna.

Product Limitations and Improvements

Accessibility. When I first started this project, it occurred to me that the due to the large amount of complex health information and short visit time of a doctor visit, using Syna would be most efficient on a large screen, like on a computer or tablet.

A huge chunk of the Indonesian population are at or below the poverty line and will not have access to such devices.

Navigation and digestion of information. Although the complete patient data will be present on the platform, Syna will only be beneficial if doctors can easily navigate and filter to get relevant patient information upon first exposure to the interface.

Doctor-patient interaction. Syna would prompt more screen time and reduce the face time between the doctor and the patient. Imagine the change in dynamic when a doctor asks, “Tell me about your history” and you just hand him an iPad with Syna loaded on it. Nothing can replace the value of human interaction.

Final Thoughts

Healthcare has become a team effort; no discipline works independently. Doctors all rely on one another for expertise that exists outside of their scope of practice. It is clear that there needs to be a better way to make continuity of care across multiple physicians easy and efficient. As family members, we play a crucial role in providing doctors the tools and information to make the right decisions, because after all, healthcare is a team sport where lives are on the line.

Thanks for stopping by and reading :) Do clap if you enjoyed my story!

A big shoutout to Jenna Gassier for working with me on the designs.

If you’re passionate about anything healthcare, medical innovations and accessibility and want to have a conversation, do shoot me an email at tiara.hudyana@gmail.com — I’d love to hear from you! ❤

If you’re a millennial health nut living in the Bay Area, you’ve probably been bombarded with ads from this New York-based startup, Daily Harvest, offering their frozen superfoods home delivery subscription boxes.

Each cup contains farm-frozen ingredients — vegetables, fruits, nuts, etc. — that can be stored in the freezer, poured into the blender when desired and poured back in the cup for enjoyment.

Since launching 2015, Daily Harvest recently picked up some high profile board members like Oscar-winning actress Gwyneth Paltrow and tennis champion Serena Williams. They even debuted a fresh new look! Let’s look at the before and after shot.

The New Look

I have to admit, I often give into the elegant typography, aesthetics, and overall craftsmanship of food products so when I saw the Daily Harvest ad, I knew I had to try it out.

Daily Harvest’s visual transformation is fairly similar to RXBAR’s recent revamp led by the amazing McQuades designers — which many say is the driving force of their 700% growth and $600M acquisition by Kellogg.

Just like a new hair cut, a makeover can work wonder$!

The domination of white space*.

Food brands often package products in different colors to represent the flavors but the key here is to balance all the elements.

The Proxima Nova font exclaims “BERRY BRIGHTENER” so overwhelmingly that it takes away the elegance of the cherries. The oversized picture along with the large text crowd the eyes, leaving no breathing room for them to wander to what is relevant.

The eyes need to breathe.

In the new design, I love how they stripped away the overlapping jargon and simply scattered the fruits on a plain white canvas. The fruit colors are enhanced by plenty of white space yet tempered by the lower opacity patterns on the rim of the cup. You can almost feel the fruit as they pop against the clean backdrop while enhancing the flavor profile.

Ingredients front and center.

Larger distance forces attention and leads users eye’s towards relevant content.

The addition of the ingredient list encourages consumers to read every ingredient while the simplicity is intended to encourage people to focus 100% on what’s inside: the superfoods.

I like how Daily Harvest uses an asterisk to indicate which ingredient is organic. With this list in place, there is no need to rummage through the Ingredients List in the teeny tiny Nutrition Facts panel they print vertically (but if you are highly skeptical about false food labeling like me, you never skip the Nutritional Facts label!).

The Lid: Points for Functionality

One feature that Daily Harvest added to their new packaging was the straw insert. The lid’s laser cutout straw insertion reinforces the dual purpose paper cup not only packages the frozen ingredients, but is designed to be its own carrier.

You still have to wash the blender, but having this “to go” disposable cup means that you lazy, I mean, busy people will have one less item to clean.

However, a flaw that I found with Daily Harvest’s subscription box is that they did not include the one thing that ties the experience together— the straw**.

Conclusion

With so much misleading advertising and false labeling in the food industry, Daily Harvest and RXBAR brand embeds the one thing that health conscious individuals really want — transparency. They promote not only a brand, but the lifestyle of healthy eating while on the run.

PS. If you’re a sucker for aesthetically pleasing food packaging, I would highly recommend checking out bpando.org curated by British designer Richard Baird, where he analyzes the world’s food brand identities from wine subscriptions to artisanal muesli mix. My current favorite is Volcano At Home, an ethically traded coffee made in 100% compostable Nespresso-compatible pods!

*The term “white space” can refer to any blank space, regardless of the color white, that isn’t competing with another element.

**Side note — did you know McDonald hired designers from Google’s Project Ara to reinvent their straws?).

Thanks for reading! If you’d like to talk food, health, or design, hit me up at tiarahudyana@gmail.com or LinkedIn.

I came across a quote from Leonard D’Avolio, PhD, Assistant Professor at Harvard Medical School, who states:

“In healthcare, policy eats culture and strategy for breakfast.”

What does this mean exactly?

This means that, for any restructuring of the healthcare system, no matter how well the intentions and purpose are, effective actionable change can only happen if it originates from the policy level. Thanks to the past presidential administration, who started Center of Medicare and Medicaid Services’ Quality Payment Program and funded the Precision Medicine Initiative, there has been an explosion of research in these areas. We can truly feel the strong support to shift towards providing personalized quality care with 359,000 clinicians ready to participate in the MACRA implementation.

Today, much of the current focus of precision medicine involves developing new drugs and therapies for personalized treatment of a specific type of cancer and disease. The focus on genomics over the past 5–10 years have shifted from interest in uncommon single gene abnormalities to conditions that are more prevalent in the general population says Gregory Feero, a primary care physician with a PhD in genomics.

Millions of dollars are getting poured into these areas of research, with the first FDA-approved gene therapy treatment to just hit the market this month, but how much will genomic research affect the general population? A valid case can be argued that the public will benefit much more on early detection and prevention — precision prevention. Personalized treatments can help save the lives of the sick, but prevention applies to everybody.

“ By focusing on the health of a broad population, we can eventually have a meaningful impact on the well-being of patients around the world.”

— Sanjiv Sam Gambhir, MD, PhD, Chair of Radiology at Stanford and Director of the Canary Center Early Detection.

For precision medicine to succeed, a population perspective is needed. The key to disease prevention has a tendency to be overshadowed by the hype of new technologies in genetics and media representation of the promises of precision medicine. However, we must not forget what we already know about the simple yet powerful prevention habits that revolve around a balanced diet, adequate exercise and not smoking. After all, these modifiable risk factors could prevent one third of deaths in the US.

As we wait patiently for clinical trial results to ripen, data science companies are racing to decode the population health data that already exists; buried in EHR’s free-text form and private patient socioeconomic data.

But what we do know is that we need to do better at fixing the problems that exist in healthcare today.

We need to focus on precision prevention. was originally published in {Data, Value} driven Medicine on Medium, where people are continuing the conversation by highlighting and responding to this story.