INTRODUCTION
Nearly 2.4 million patients who live in Canada can not afford their prescribed medications, including life-saving and essential ones for managing chronic illness. The purpose of the CLEAN Meds project is to make progress towards providing medicines for patients who can't afford them free of charge across Canada. CLEAN Meds ensures that patients can receive their medication on time by delivering them right to their doorsteps.
COLLABORATION
The CLEAN Meds Team at St. Michael's Hospital and the Health Design Studio at OCAD University have collaborated to achieve the purpose of the CLEAN Meds delivery service. Due to this collaboration, a team with various design and healthcare backgrounds was created in the studio and known as the Essential Medication team (design team). All meetings took place online, as the project started during the first wave of the COVID-19 pandemic.
RESULTS + OUTCOMES
The Essential Medication team has gone through an iterative design process, which resulted with a brand profile, packaging design and production techniques. Within the process several other considerations have taken place such as verifying if the brand name resembles with the indigenous communities of Canada; address stigma; ensure privacy; and highlight approachability and patients' accessibility.
DESIGN PROCESS
The iterative design process took a public health lens and a value-informed design approach. Moreover, local context and engaging patients with real lived experiences through the community guidance panel (CGP) were crucial to the design process. Applying both approaches ensured to put the patients' needs as a central priority and discover lived experience challenges, which won't be found in secondary research only. Additionally, close and continuous collaboration with members of the CGP and CLEAN Meds team helped in determining the design values. During the process, two key feedback workshops were conducted to solidified and validated the design direction. These approaches align with the principles of Value Sensitive Design (VSD). The design process necessitated the adaptation of engagement techniques to online interactions and platforms due to the constraints of the COVID-19 pandemic.
THE CHALLENGES
The essential medication team has been challenged to design within the context of a free medication service while alleviating or at least not contributing to the potential additional stigma of receiving CLEAN Meds. Additionally, the need to encourage awareness and access to the service is a connected need we refer to as approachability.
THE GOAL
The goal was to design a brand identity and packaging for CLEAN Meds service that is professional, inspires confidence in the recipient, addresses stigma, protects privacy, and is highly accessible, while engaging closely with stakeholders.
Several design criteria were identified through CLEAN Meds team feedback, and insights from iterative testing with the CGP; this guided the design process to reach the goal. The criteria were divided into two categories: packaging and branding.
BRAND DIRECTION
The brand was driven by the five values created, which are: equity, accessibility, community, humanity and quality. Every design choice was tailored with clarity in mind, hoping to make every aspect of the brand as effortless and intuitive as possible. Combining the five values and the consideration of tailoring the design with a minimalist visual style added a professional look and quality to the brand and medication. Such combination was well received by the CGP, who found the brand visually appealing, easy to understand, and professional. Furthermore, the CGP valued simplicity in the brand, regarding it as more genuine and helpful than a brand using design trends that they remarked having “seen around”.
BRAND IDENTITY CONSIDERATIONS
In order to meet the brand direction vision, several considerations has been pinned to the design criteria. The brand should:
- Should demonstrate CLEAN Meds’ values.
- Should not represent a certain population or create stigma (gender, social standards, race etc.)
- Should appear professional and encourage confidence in patients.
- Should be trend neutral.
- Should consider visual-related challenges (i.e. colour vision deficiency).
BUILDING THE BRAND
To create a brand that will fit with the CLEAN Meds vision and be verified by the CGP, the design team had to first establish design brand values, create archetypes and profiles by using tools such as journey mapping etc. The team had to also reflect on the sense-making results process, understanding the problem, needs and wants of members of CGP as representatives of future service users. The process was aligned with thematic analysis techniques, where the design team was involved in several online meetings to synthesize data collected, code and identify major themes. Three different brand archetypes, values and identities were created and tested. The Kanoe brand profile was chosen by the CLEAN Meds team and the CGP; all feedback was taken into consideration and applied to the final design.
THE CONCEPT
Upon the data collected from the CLEAN Meds team, primary and secondary research, several concepts and prototypes have been made in order to reach the final outcome. Concepts were later combined into one concept to achieve the package's considerations. Three different package sizes were created to accommodate the amount of pill bottles that the patients' needs. All package were created in a way for the users to have the same private content system, experience and learning curve that they have gained from other kinds of packages. This promotes to help reduce trust between the brand and the users.
PACKAGES' CHALLENGES + CONSIDERATIONS
Designing a package that reflects on the CLEAN Meds' values while keeping it accessible to all users' physical conditions, considering the packages' durability, being environmentally friendly, stabilizing pill bottles, retaining the users' privacy, and emphasizing the users' journey were very challenging. The practicality of keeping the pill bottles in a high condition during shipping required several prototypes and experimenting with different materials. Other considerations that have been taken to cautious are the pharmaceutical working and storage space, and the ease of assembly and packaging for the pharmacists.
THE PACKAGING CONSIDERATIONS
General features:
- Should have different sizes according to the average amount of pill bottles delivered.
- Should maintain the high quality and safety of medication during mailing/shipping.
- Should use recyclable materials with a friendly budget.
- Should not create more challenges besides the minimum storage space, while the pharmacist is assembling it.
Interactive features:
- The package should have its own folding and assembly techniques; ease and flexibility of package assembly in a pharmacy setting; a design that is not time-consuming to assemble, respecting the busy environment, and heavy workload.
- Ease of storage in the pharmacy setting in case of limited storage space.
- Be easy to interact with (considering physical illnesses such as Parkinson's or arthritis)
- Maintain personal content security/privacy.
Package Design Production
- Materials should maintain the high quality and safety of medication during mailing.
- Use recyclable and environmentally friendly materials.
- The production budget should find a balance between the production of the packages and the medications.
All packages comes inside of a shipping box to protect the user's privacy while being delivered. Three different package sizes were created with the same features and design elements. The smallest size accommodates 3 pill bottles; the medium size accommodates 6 pill bottles, while the largest accommodates 12 pill bottles. A seal is added to promote privacy by ensuring that the user is the first one to open the package. The package only shows the brand name Kanoe and its graphic element to help reduce stereotyping or other possible identifying of private information.
After the users tear off the seal, they open the flap, which holds their personal paperwork and medication information. This is considered to be the first thing that is visible when the users open the package. This helps users to take the time to read what's in the packages, especially if the user has any kind of motor condition that may cause the pill bottles to drop out of the package. The quote printed inside of the package was tested with the CGP, and they found it to be relatable to CLEAN Meds service users.
The 4 figures above show the pill bottles under the flap that holds the paperwork. The pill bottles are held by a stabilizing mechanism; each package size has its tailored stabilizing mechanism to ensure that the. pill bottles won't move or be damaged while shipping. The smallest size (A-B) packages could only carry from 1 to 3 pill bottles, while the medium size (A-B) is designed to intentionally carry between 4 to 6 pill bottles. This system is created to reduce waste and promote sustainability. Versions A and B show different ways of accessing the pill bottles. In version A, the user can easily pull out the pill bottles while the stabilizing mechanism is still in the package. In version B, the stabilizing mechanism could be taken out, then the pill bottles could be removed. Such option makes the user feel that the packages are flexible to be personalized according to their preferences. According to the feedback testing with the CGP, the ability to take the packages apart and collapsing them made it easier for them to recycle them. Moreover, reassemble the packages helped in reducing the storage space in the pharmacy.
Other interactive and visual design features have been implemented in all of the three identical design packages with different sizes to maintain the same experiences between users' journeys. All features were tested with the CLEAN Meds team and the CGP; adjustments and verifications have been applied.
OTHER INTERACTIVE FEATURES
The users' interactions experience with the packages is considered to be the first impression that will make them rebel against the service or develop emotional connection and trust. Stating from the seal, it is easy to tear off and not required a sharp object to cut through it. The gaps on the flap edges are added to make the process of accessing the bottles easier, especially for those who have Parkinson's or shaky hand movements. Other features that the CGP were appreciated, such as that the packages are not cluttered with unnecessary materials, and they are 100% recyclable, even the seal. The package is made of sugarcane material. Moreover, no glue or any other attachments is used to assemble the package, which helps the pharmacists and reduces the time spent on putting the packages together.
OTHER VISUAL FEATURES
One of the visual design features is applying different shades of teal from the branding color palette. This feature symbolizes going deeply into the healing process as the lightest shade is the first thing the users see while the darkest/strongest shade is the last interaction point of the users. An additional rationale behind keeping the light shade of teal as the packages' exterior color is that lighter colors tend to not attract curiosity, as darker colors. This helps to retain the users' privacy as much as possible after they remove the Kanoe package from the shipping box. Besides the color theories, the perforated guidelines on the mechanism stabilizer, reduces the amount of errors, time and effort pharmacists might make in order to cut out the specific pill bottle size slot. They can simply tear out the slot they want to use.
Since the team was working online and not in a studio, there were some latenesses with producing the package due to the pandemic restrictions, and a tight budget to complete this project, which allowed for only one of the team members to get and interact with the unbranded packages before sending them to the CLEAN Meds team and the CGP for testing. The design team had to adapt to such changes of work patterns and were exchanging notes and remarks through video making, sketches and photo editing techniques, then sharing the on Miro board.
(Video on the left: Assembling The Smallest Package Size)
Both of the videos show how to assemble the unbranded packages step by step. These videos were also used as a guide for the CLEAN Meds team (pharmacists) to experience how to interact with the unassembled packages. The first video demonstrates the smallest package size, while the second video shows the medium package size. The technique used to assemble both the packages was exactly the same, which means that the learning curve to the newly introduced systematic technique is fairly low and quick to adopt.
(Video on the right: Assembling The Medium Package Size)
THE PROCESS REFLECTION
Working on this project during the time of the COVID-19 pandemic has definitely influenced the team’s critical thinking and problem-solving skills throughout the design process, and approaches toward the final design outcome. The COVID-19 challenges helped to scope the project from both a funding perspective and public health lens. One major decision influenced by this was to reduce the material used to produce the package while maintaining high quality. This allowed the team to reduce and save on the production budget, reduce waste, and created an easier packaging interaction for both the patients and the pharmacists.
TESTING REFLECTIONS
Due to COVID-19 restrictions, the team had to adapt the testing and feedback sessions format. The changes were largely informed by digital access and equity considerations, where the focus was to ensure that every member of CGP can participate. Therefore the team adapted the feedback sessions to a teleconference rather than an online video co-design session. The experience of testing a physical package using a teleconference led to be precise in the language use and questions, create tools to allow for more engagement and manage the session time effectively to ensure all participants' opinions were heard.
THE FUTURISTIC REFLECTION
Acting as representatives of their community, the CGP’s opinions and knowledge were central to the team’s understanding of the community’s values and needs. However, for this service to move forward, the packaging and branding created need to hear from the wider community. There are big questions that remain that the team is curious about. How will the community react to the newly designed packages and branding? Will the new design have any unforeseen psychological or social impacts especially in addressing stigma? What other factors or future innovations can contribute to making this service as tailored as possible to a wider community? With this project, our team hopes to contribute to the conversation around the importance of essential medication and universal pharmacare in Canada.
PUBLISHING AN ARTICLE
The design team has been writing a paper that will be submitted to the Journal of Health Design; however, the paper is currently being reviewed. The paper focuses on the design process and what directions did the team take and why to end up with this specific outcome. The paper also discusses the primary and secondary research data collected in depth, which provides solid rationals through the process phases.
(The article's link will be added as soon as it is published online.)
(Team-Work-Project)
Personal Role: the Essential Medication team was made up of 3 undergrads and 3 graduates students from OCAD University. As one of the graduate students, my personal role was to make sure that the transition of the collected data is implemented correctly with the design concepts and applications; giving feedbacks and remarks on proposed designs; creating prototypes; collecting and analyzing primary and secondary research; adapting to new situations by critically thinking; designing the testing process and experience; searching for materials that the undergraduates hadn't been exposed to and introducing it to them; planing and managing meetings' content; following up with other team members on their tasks; connecting with other members involved in this project; and writing the article.