SAGE IN ACTION

Introducing our Cast of Characters

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How Sage Can Change Lives

SCENARIO 1

John uses Sage to help new and old members of his care team embrace his whole story.

John, 87, juggles multiple specialists and medications. To simplify his care, he is considering switching to a Geriatrician as his Primary Care Provider. Before John’s first visit, he gets a call from the Geriatrician’s office encouraging him to set up a Sage account so the doctor can learn about him in advance. Beth, his wife, thinks it’s a good idea — he has struggled to connect with new doctors. She helps him get started on their computer.

After creating a Sage account, they are able to link John’s Patient Profile with his existing EHR. His medical history, existing conditions, and prescriptions populate automatically. Sage then prompts him to create a Care Story using the Sage app. Beth enters her mobile number and receives a unique pin. When they open the app on her smartphone and enter the pin, it picks up right where they left off on the Sage website.

They build John’s Care Story by answering a short series of questions. They can choose to type the answers, dictate by voice, or save for later. John narrates his answers while Beth types them into the app. One prompt reads, “Show us your living environment…” John takes the phone from his wife and uses the video function to record their bedroom, kitchen — including the drawer where they keep his pills — and even family photos.

As they build John’s Care Story, surfaces a list of possible discussion points for his first visit with the Geriatrician. Beth adds one about his rapid decline in coordination and mobility. They select “finish,” sending his newly created Patient Profile, Care Story and Visit Agenda to the Geriatrician. They also send his Patient Profile to the Cardiologist whom John is not quite comfortable with yet.

On John’s first, he is initially skeptical because the Geriatrician seems young. But, because the doctor has reviewed John's Patient Profile beforehand, it doesn’t take them long to connect. He asks John some clarifying questions about his living situation, pill routine, and the mobility issues that Beth added to the Visit Agenda. Both John and his wife leave with a sense that this new doctor really cares.

Over the following month, John and his wife occasionally update his Patient Profile, noting two consecutive falls in their home. She writes that he is starting to need more physical assistance than she can provide. Sage begins surfacing topical resources, and a caregiving service called Honor stands out. Together, they check out the Honor website and add it to the Visit Agenda for their upcoming appointment with the Geriatrician.

SCENARIO 2

Lisa taps Sage to coordinate her mom's entire care team and avoid crisis.

Elizabeth, 70, is in a constant battle with severe COPD, arthritis and heart disease. Plus, her memory simply isn’t what is used to be. She relies heavily on her youngest daughter, Sophie, with help from her other two kids, for everything from transportation to dealing with doctors. As the Team Captain, Sophie uses the Sage app to stay on top of her mom’s health and rally other family members as needed.

The day before a visit to Elizabeth’s Pulmonologist, Sophie sends a private Caregiver’s Note to the doctor. She is frustrated that her mother is being guarded about changes in her health, like a worsening nasal drip. She’s worried that Elizabeth won’t be honest in the appointment, but doesn’t want to embarrass her by confronting her in front of the doctor.

At the appointment, Sophie uses the Sage app to take notes — it automatically transcribes the conversation to text and saves it to her mom’s patient profile. This visit is particularly important, so she “star’s” the note and sends it to her siblings. As they leave the office, she sees that her sister has already opened it, so she posts a short Care Team Message: “The doc says to keep a close watch on mom and look out for a dry cough with phlegm.”

20 minutes later, the Sage app indicates that the Pulmonologist has prescribed new meds via Elizabeth’s EHR. As the drugs are added to her Medication List, Sage looks for potential interactions. It flagged a possible Medication Conflict. Opening the alert, Sophie reads a description of the problem and some suggested next steps. She clicks the “share” button to push the alert to the Pulmonologist, her mother’s PCP, and her siblings.

Her brother, Antonio, responds with a worried message. She assures him that Sage has flagged the issue and the doctors are discussing how to reconcile it. Later that afternoon, Elizabeth’s PCP sends a message: she should hold off on the new meds until she can do some blood work. The PCP adds appointment to the Shared Calendar for the end of the week. Sophie has a conflict at the time and declines the invitation, which immediately alerts her siblings. Antonio accepts and the appointment is confirmed.

SCENARIO 3

Sage helps Jasmine manage her severe Lupus and find ways to expand her care options.

Jasmine was diagnosed with Lupus a year ago. For months she struggled with the nuances of her disease and the resulting depression. Recently, she downloaded Sage, which in addition to helping her build stronger relationships with doctors and manage her mood, also provides instant access to helpful services, information, and advice.

Jasmine receives a text from a friend about a Lupus clinical trial at Johns Hopkins — she’s curious. Via her Amazon Echo, she asks Sage, “Can I participate in a clinical trial for Lupus.” Sage responds, “You can, and there are some happening locally. Would you like to learn more?” Jasmine agrees and Sage provides an overview on Lupus clinical trials.

Jasmine asks Sage to show her the local trials. Sage responds with, “I’ve pulled up a few local Lupus clinical trials, you can view them on any of your devices now.” She opens Sage on her laptop and scroll through the options. The Care Bot appears in the corner, and asks if she has any questions. Jasmine asks a few specific questions and the bot answers them, referencing her medical history and compatibility for certain trials.

That night, Jasmine is feeling rotten. She has a bad migraine and thinks it might be a Lupus flare-up. She’s worried and scared, but doesn’t want to drive to the E.R. Using her smartphone, she tells Sage, “I think I’m having a flare up.” Sage immediately pings her sister, her appointed Team Captain, and starts a video call with a Care Counselor. He is a trained RN familiar with her condition.

The Care Counselor notes that he can see swelling around Jasmine’s eyes and asks her a few questions. He explains that she doesn't need to go to the ER, but should take an additional half-dose of her prescription migraine medication and an anti-inflammatory pill. The recommends that she try to rest calmly, and walks her through a breathing exercise to help her relax.

Jasmine is already starting to feel better. They end the call and she gets a text from her sister — “you ok?” — Jasmine responds, “Sorry, false alarm. Sage took care of me!” The Care Counselor follows up with a message, suggesting she ask her doctor about how to manage swelling. She continues to practice the breathing exercise, feeling calmer and more in control.

SCENARIO 4

Karen uses Sage to master her health and understand the progress she is making.

Karen prides herself on her ability to manage her own health and is wary of burdening her kids. At 65, it’s harder to keep up with the changes in her body, and she’s contending with diabetes, arthritis, and asthma. Her insurance company suggests that she download the Sage app. She isn’t the most tech-savvy person, but decides to give it a try.

After creating her Patient Profile, Sage recommends the Metrics Package she should start tracking: blood sugar, weight, and blood pressure. Karen then selects a wearable fitness band and connected scale, available for free through her insurance company, and sets a Check-In Reminder for 6:00pm daily.

Over the next month, Karen logs her blood sugar nearly every day, while her fitness band and scale collect data automatically. Sage regularly emails her Smart Summaries and she checks the Metrics Dashboard often. The interface is simple and is full of tailored recommendations. Sage celebrates her stabilized blood sugar levels with a Goal Badge.

At her next appointment, Karen's PCP applauds her diligent tracking as they review her progress on his tablet. They decide to change her blood sugar reporting from daily to twice weekly, and she'll now track her mood because he would like a better sense of how she is feeling in between visits. Karen feels like she is the master of her health!

Experience Principles

It’s not hard to engage people who are already highly engaged or interested in self-care. But how can we help those who aren’t?

MINIMUM EFFORT, MAXIMUM HELP

Already so busy managing their health and personal life, the last thing Sage users want is a tool that is time consuming and exhausting to use. Sage should require minimal input and maintenance from users, while maximizing unprompted value to them.

Ways of bringing this principle to life:

Effortless interoperability: automatically connect smart devices to make data integration invisible
Proactive surfacing: track device usage to measure engagement and induce prompts accordingly
Emergency preparedness: use gps and patient profile data to locate contextually relevant care facilities

NO WAY TO FAIL

Sensitive to their failing health or feeling less capable than they want to be, Sage users crave moments of being in control. Sage should be supportive of their inquiries and forgiving of their mishaps, leaving no room for interpretation or frustrating dead ends.

Ways of bringing this principle to life:

Consistent navigation: maintain clear and consistent features throughout to create a “home base”
Unprompted tasks: provide easy to find suggested fast tracks to complete common actions
Guided learning: accompany users through the interface so they learn by doing

AMPLIFIED HUMAN SUPPORT

Sage may be a digital tool, but not all of its functions are 100% digital. Sage users are more engaged knowing there is someone human on the other side who cares for them. Sage should guarantee voice or video communication assistance as a backup method for getting help.

Ways of bringing this principle to life:

Made by real people: highlight content is defined by humans so users know that it’s made with care
Transparent data channels: showcase where health data is going to so users understand the purpose
Approachable tone: use a friendly human tone that communicates in plain language to foster conversation
Human presence: emphasize there is always a live human to talk to via voice/video so users feel supported

UPLIFT SENSE OF SELF

Balancing health and life issues can be difficult, but patients are people before anything else. Sage users crave outlets for them to contribute value as individuals. Sage should provide opportunities that give purpose to their efforts and focus on what can be done, instead of what can’t.

Ways of bringing this principle to life:

Visualize progress: show users where they are during any given process so they know what to expect
Utility that is inviting: create an interface that anyone is able to use so they can comprehend quickly
Positive Framing: communicate the value of caregiving and managing their care to encourage engagement
Behavioral trends: demonstrate the value of achievements to help users recognize patterns over time

SEE PROTOTYPE