Five Questions and an Elevator Pitch: Team Malama
1. What is the need that your project seeks to address?
Mika: We initially focused on helping improve the management of gestational diabetes. The first step in trying to solve for women with this condition is the pain point that stems from the administrative burden and manual load of recording and tracking their blood glucose levels and meals four times a day.
Right now, the patient has to write down the information and manually share it with their provider. We've been shadowing physicians at Stanford Healthcare and in the Maternal Fetal Medicine, or MFM, clinic, where each patient brings in their information in a different way. Some people have it on a notes app; some people write it down, take a picture, and bring the picture in; and some bring their actual glucometer and the provider has to scroll through all the values and write them down.
And, currently, there’s no available product for this population. Existing apps are mainly geared towards managing Type 2 diabetes, which is a very different condition and has different thresholds than what’s appropriate during pregnancy.
With Malama, we're seeking to first address the administrative burden, and second to provide data, insights, and personalized recommendations for patients.
2. How does your solution work?
Orlando: First, you download the Malama Health app. When you open it, it asks you to connect with your glucose meter through Bluetooth. It guides you through the process and starts automatically syncing to download the data and store it. The next time you open the app, it automatically finds the glucose meter and gathers the latest glucose data.
For other important data, like meals, snacks, or activity, you manually input the information. Then the app takes it into account in providing each blood glucose rating and in identifying food triggers that could explain a high blood glucose level. If we cannot automatically find a trigger, we try to connect the user with the nutritionist to help you solve that.
3. What motivated you to take on the project? And what activities have you undertaken?
Shalmali: As an epidemiology PhD student, I’ve found that people don't want to study pregnancy because it's complicated. It's highly regulated; there are additional rules; studies are difficult to conduct; and the data they produce is hard to analyze. The space that we're in is no exception. There's a high level of complexity with GD so you have to go into it with the right mindset. We’re committed to making a difference for patients in this space who have been underserved for too long. We have this as our driving principle and we stick with it, no matter how challenging the project gets. It’s our North Star.
Mika: More specifically, we were motivated by a recent study that showed that black and brown women have three times the maternal mortality rate of white women. We’re passionate about working to reduce that disparity, so we’re especially interested in serving the Medicaid patient population. The most common maternal health conditions among Medicare recipients are gestational diabetes and hypertension, so we focused on GD. After interviewing several providers and patients, we realized that the management of GD is extremely antiquated [as described above], which leads to a poor patient experience.
Since completing the Biodesign for Digital Health course in fall quarter, we’ve dedicated most of our time and energy to prototyping. We started with a basic low-fidelity prototype, through which we would text women relevant information about GD management based on the information and preferences they provided to us. We had about 40 women who signed up to try our beta and share data with us. Then, we began working on a higher-fidelity prototype that will more closely resemble the fully-functional app that we envision, which we'll be testing with Institutional Review Board approval at Stanford Healthcare.
4. What’s the most important thing you learned in advancing your project?
Mika: One thing we’ve learned is to embrace rapid experimentation and getting frequent input from key stakeholders, like the Stanford MFM team, to help drive progress. For us, that meant putting the low fidelity prototypes in front of users—patients, providers, and nutritionists—to make sure that we were developing was aligned with their most compelling needs.
5. What advice do you have for other aspiring health technology innovators?
Mika: Leverage the resources at Stanford. We've learned so much from the Biodesign mentors, as well as the clinical staff, providers, and residents across Stanford, who were all very willing to speak with us and share the problems that they encounter.
Also, I advise developing and nurturing a multidisciplinary team. It takes fresh perspectives as well as a deep knowledge of current clinical practices to solve the most hairy problems in healthcare.
Original Team Members: Shalmali Sunil Bane, Andrew Berneshawi, Cristina Tagle De La Cruz, Mika Eddy, Blynn Shideler
Course: Biodesign for Digital Health
Biodesign NEXT Funding: Awarded for spring quarter 2022