GeneFlow - Research, Strategy and Design

World Day for Cultural Diversity for Dialogue and Development

GeneFlow:

Bio-Cultural, Environmental Pollution Exposure & DNA Analytics Application

Problem

Racial Social Constructs & Health Disparities

Healthcare disparities exist due to racial models used in studies of human genetics, biodiversity, disease susceptibility patterns, public health, epidemiology, and biomedicine. Historically, these archaic morphological and typological "racial" approaches have defined human populations without understanding clinal-variation, population genetics, or environment. More accurate, detailed, and integrated database information on relevant geographic, environmental, cultural, genetic, historical, and demographic variables is needed to understand local group expressions of disease inequities.

[Jackson, F. 2006 Illuminating Cancer Health Disparities Using Ethnogenetic Layering (EL) and Phenotype Segregation Network Analysis (PSNA). J Cancer Education 21(1):69-79.]

Overview

Problem Statement: How might we create a platform for people to access information about their genetic profile, while incorporating accurate bio-cultural data, and empower physicians to better prevent, treat, diagnose, and cure chronic diseases.

Branding:

Visual and user interface design, navigational structure, typography, color pallet, and photography.

Account Set-up: Client statistics ( name, address, D.O.B.), insurance information, primary care physician, consent authorization, user name selection and password, account confirmation, and order DNA test kit.

DNA Test Kit Registration: Test kit verification bar-code and patient confirmation, instructional prompt on how to use prepaid package for returning saliva sample.

Target Audience: Patients and Physicians

Scope: GeneFlow as a trusted resource in the analysis and interpretation of genetic material, will provide a database accessible to physicians that can be used to treat their patients.

Project Management Tool: Trello by Atlassian because it integrates with Jira and Confluence.

ABIOTIC, BIOTIC & SOCIAL CULTURAL ENVIRONMENTAL FILTERS WITH GENE MODIFYING EFFECTS

Epigenetic Filtering Influence on the Genotype as Expressed in the Phenotype:

The expression of the genetic background (= genome) is modified as it passes through the various filters resulting in an expressed genotype ( = phenotype) that differs from that predicted solely by the genome. Redrawn from Jackson (2004).

Typical Modifying Variables

PHENOTYPE (Expressed Genotype)

▶

Diet Subsistence

Occupation

Body Form Metabolic Profile

Toxicity

Humidity Altitude Radiation Precipitation

Language

Religion

Ethnic Identity

Socialization

Class Structure

Genetic Background (Genotype)

Ethnogenetic Layering and Phenotype Segregation Network Analysis (PSNA)

Ethnogenetic Layering (EL) and Phenotype Segregation Network Analysis (PSNA) focuses on micro-ethnic groups (MEGs) using GIS-facilitated maps to reveal variations and causes of health disparities. This helps in creating bio culturally effective interventions. It uses digital maps to detail local geographic variations in historical demography, genetic diversity, cultural patterns, and specific chronic disease risks, like diet and toxicological exposures.

EL relies on technology by using GIS-facilitated maps to produce horizontally stratified geographic regional profiles which are then superimposed and evaluated vertically. Each horizontal digital map details local geographic variation in the attributes of a particular database; usually this includes data on local historical demography, genetic diversity, cultural patterns, and specific chronic disease risks (e.g. dietary and toxicological exposures). Horizontal visual display of these layered maps permits vertical analysis at various geographic hot spots. From these analyses, comprehensive patient gene panels and DNA testing, geographical areas and their associated MEGs with highly correlated chronic disease risk factors can be identified and targeted for applicable treatments.

Biological Lineage Coalescence: A powerful mathematical and conceptual tool for studying the evolutionary processes that have shaped the genetic makeup of populations over time.

Dr. Fatimah Jackson, Howard University [F. L. C. Jackson (2008) Ethnogenetic Layering (EL): an alternative to the traditional race model in human variation and health disparity studies, Annals of Human Biology, 35:2, 121-144, DOI: 10.1080/03014460801941752.]

Competitive Analysis Report

Upon evaluation of competitive analysis, companies in the remote health and gene therapeutic sector have continued to rely on:

Racial and topological models that have shaped western medicine since its inception
A limited multi-ethnic DNA analysis research database
Platforms designed for profit health care systems and European descent Americans with disposable income
Reliance on short-read DNA sequencing technology that is prone to error

Long and short term trends illustrate a future convergence of almost equal daily search engine interest. This may indicate that people are becoming more aware of the importance of remote healthcare, individual DNA profiles and gene therapeutics in their own lives. Furthermore, a novel platform that revolutionizes similar services, and incorporates many of their features into one application, demonstrates proof of concept and scalability for GeneFlow. At the same time such a platform would offer a more refined genetic analysis of user DNA, based on human biological evolutionary diversification and history.

Research Plan

Design Project: Exploration of GeneFlow Registration, DNA Analysis Interface with Results Interface

Research Cycle: Phase One: Oct. 13 - 18, 2020

Objective: To provide patients and their physicians with a precise and accessible genetic profile. Identify current pain points due to limited DNA sample sizes available in world wide databases. GeneFlow passes an individuals genetic information through a number of local and regional biotic/abiotic filters, in contrast with the current topological model that predominates genetic science. Validate opportunities for technological development.

Hypothesis: By creating a novel scientific tool for genetic analysis, we will: (1) Expand the world wide DNA sample database; (2) Introduce non topological, phenotype centered models into genetic science; (3) Provide patients and their physicians with readily available genetic profile information; (4) Empower gene therapeutic companies to better target remedies for specific, multi-regional ethnic groups.

GeneFlow will reduce rates of chronic diseases.
Lower medical health care costs.
Increase accessibility to preventative medicine.

Approach

Resources

Deliverables

Key Assets and Tools

Timing

Six (6) Remote 30-45 minute research interviews.

Exploratory, cause and effect research protocol.
Otter Voice Recording

October 13 - 18,

45 minute interviews.

Research Analysis

Report

Six (6) Remote interviews.

Research Goals

Research Goals: Give patients the tools they need to empower their physicians with better ways to treat and prevent diseases.

Project Goals: What is the main value that Geneflow brings to the DNA analysis market?

To do this we examined:

Patients: What are their preexisting conditions? What exposure they’ve have to environmental pollutions?

Medical Professionals: How they envision EL/PNSA would have on the care they provide their patients?
Insurance Companies: How this information may used for increasing premiums and denial?
Pollution: Thoughts about environmental pollution impact of health and well being?
Diet: What impact does diet and exercise have on health?
Access: How one might obtain quality healthcare?

Research Goals: Understand how patients and physicians feel about genetic information being used?

Project Goals: What advantages and disadvantages exist having genetic information added to your medical records?

To do this we examined:

GeneFlow’s potential: How does EL/PSNA provide better DNA analysis than traditional methods?
Insurance companies: How would GeneFlow effect health care costs and underwriting of insurance policies?

Research Goals: Understand how patients and physicians could use the GeneFlow platform?

Project Goals: Who do we approach and what qualitative/ quantitative data is necessary to generate interest?

To do this we examined:

Patient introduction: How would GeneFlow be discovered?
Medical Professional instruction How would we compose a demo for physician? And what would it look like?

Research Findings

The GeneFlow interview process consisted of two user groups, comprised of three test subjects per group.

Group one were healthcare professionals who work in nursing and research demonstrated a better understanding of the factors presented to them. Group two was made up of individuals with preexisting health conditions, such as, diabetes, lupus, COPD, high blood pressure, and obesity expressed a lower level of comprehension concerning some of the factors introduced to them,

In contrast, the second group had comparable levels of comprehension for the other factors presented to them. All participants agreed that they would benefit from an interactive digital platform that analyzed, interpreted, and charted their genetic data. In a for-profit health care system, test participants pointed out the obvious disadvantages of their genetic profile being added to medical records. Specifically, increased insurance premiums for preexisting or predicted future health conditions, unnecessary therapeutic treatments or medications, and denial of life/health insurance.

UX Strategy: Insight One

Better Information with More Advanced Tools

A contextualized interpretation of an individual's DNA analysis is necessary, leveraging biotic and abiotic filters. This will equip patients and healthcare providers with more valuable data to implement preventive measures and identify disease vulnerabilities.

Key Finding

There is a gap in medical research regarding the impact of regional environmental pollution on micro ethnic groups living in specific geographic areas. These groups make up a significant portion of the patient population served by healthcare providers.

Supporting Data

• Both patients and medical professionals acknowledge the harmful effects of environmental pollution on health.

•Both patients and medical professionals have shown interest in a product that analyzes an individual's genetic profile in relation to their local exposure to toxicity.

Strategic Implications

Connect local environmental pollution, historical records, EPA reports, water, soil, and air quality as they pertain to gene expression.

UX Strategy: Insight Two

Cures Based on Phenotype

Medical Professionals are still relying on racial models for the interpretation of biological diversity.

This leads to disparities in the development of medicines, therapeutics and cures.

Key Finding

Racial models predominate the landscape for the development of therapeutics medicines and cures to illnesses. Adverse reactions include: allergies, failed immunological response, rejection, and altered biochemistry.

Supporting Data

• Patients and medical professionals are unaware of the lack of scientific data supporting racial models.

• Patients and medical professionals are in doubt as to whether fully evolved modern man migrated out of Africa.

• Lack of information about the Human Genome Project.

Strategic Implications

GeneFlow’s platform provides appropriate experience design to educate people. Make complex scientific concepts easily understood.

UX Strategy: Insight Three

Modern Technological Tools that Change Lives

Patients believe that they’re physicians already utilize the latest in medical technology, therefore they may not seek out better informed alternatives.

Key Finding

People who were without health insurance the majority of their lives, under the Affordable Healthcare Act, now have employer based insurance. With no prior base comparison, these individuals are convinced that they are receiving top quality healthcare that utilizes the latest technological tools.

Supporting Data

Some people with chronic illnesses express great satisfaction with the level of healthcare they receive.
Many patients lack the foresight to explore alternative ways of understanding their health conditions.
Many patients confuse access to healthcare as having a high quality of life despite obesity, high blood pressure, poor diet, and sedentary living.
Recognition of existing toxicity in local tap water. Yet, a behavioral conditioned reliance on consuming tap water since childhood.
No control over pollutants in the environment.

Strategic Implications

GeneFlow using design to present easily understood concepts as it relates to the impact environmental pollutions

and toxicity on gene expression and overall health

UX Strategy: Insight Four

Problems Within a For-Profit Healthcare System

Patients and medical professionals are award of the advantages and disadvantages of having genetic information made a part of their medical record.

Key Finding

Both patients and medical professionals realize the potential for their unique genetic profile to be used in positive ways. Also, they are concerned about the possible drawbacks of readily accessible genetic information in medical records being misused.

Supporting Data

• Patients and medical professionals

• expressed their concerns for the misuse of genetic information and the excitement of potential cures, therapeutics, and preventative healthcare that could result.

• The possibility of lower healthcare costs.

Strategic Implications

The creation of a secure, confidential, and accessible platform not open to insurance companies.

UX Strategy: Opportunity for Innovation

Observation

Insight

Implications

Opportunity

Patients believe that they’re physicians already utilize the latest in medical technology.

Patients are not going to investigate alternative medicine or question the care that they are receiving.

Patients and medical professional education.

N/A

Both groups have a good idea of the advantages and disadvan tages of having genetic information made a part of their medical record.

Patients are unaware of the bias that has predominated the medical sciences, and as a result, therapeutics medicine,

and access to healthcare.

Make patient and medical professionals aware of the subconscious bias that exists

in science.

Medical Professional are

still relying on racial models for the interpretation of biological diversity.

Benefits include better healthcare tools. Insurance companies can use genetic susceptibility to chronic illness and disease susceptibility patterns to raise premiums, deny life insurance, and refuse coverage.

Move away from a for-profit healthcare system to one that looks out for the health and well being of the patient by using the most modern technologies in providing care.

Both groups recognize that en- vironmental pollutions has an impact on health as does quality of water and air.

People are more willing than ever before to embrace science as it relates to studies of the impact that environmental pollution, water, and air quality have on gene expression.

To introduce GeneFlow

Value Proposition

What is the main value that GeneFlow brings to patients and physicians?

A more contextualized interpretation of an individuals DNA analysis passed through a number of biotic and abiotic filters. This approach provides patients and physicians with better information for implementing strategies related to preventative healthcare.

Customer Engagement Principles: What guidelines do we use when interacting with physicians patients, and insurance companies?

The protocols regarding patient privacy and physicians' confidentiality oaths. Develop a database accessible only to physicians and their patients. Insurance companies would be unable to access this database.

Touch Points and Campaigns: What are the tools we can leverage to market?

DNA test kits and My Exposure (EL/PSNA)

Assumptions

• Patients will lower their overall annual cost for healthcare.

• Physicians will be able to better treat, diagnose, and cure chronic health conditions.

• GeneFlow’s catalyst capacity for breakthroughs in targeted phenotypic gene therapeutics is unprecedented.

• GeneFlow can exponentially increase the delivery of preventative medicine.

• GeneFlow can introduce a more sophisticated model for the interpretation of human biodi-

versity to the medical sciences.

• GeneFlow innovative solutions can potentially disrupt Teladoc Health, Livongo, 23andme, Ancestry.com, Crispr Therapeutics and others.

• The product is scalable.

Product Features

Branding: Interface design, navigational structure, typography, color pallet, and photography.

Account Set-up: Client statistics (name, address, D.O.B.), insurance information, primary care physician, consent authorization, user name selection and pass- word, account confirmation, and order DNA test kit.

DNA Test Kit Registration: Test kit verification, barcode and patient confirmation, instructional prompt on how to use prepaid package for returning saliva sample.

Key Performance Indicators (KPIs)

• Time-On-Task rate: The amount of time it takes to set up an account and register a DNA test kit.

• User error rate: The amount of errors encountered when setting up an account and registering a DNA test kit.

• Navigability: Measuring how efficiently the user is able to locate information and move throughout the application.

• Customer Satisfaction Score (CSAT) survey.

• System Usability Scale (SUS) questionnaire.

Outcomes

GeneFlow will create a novel interactive web-based application product for patients to manage their health care needs. The platform database will interface with primary care physicians, specialists, epidemiologists, geneticists and pharmacologists. GeneFlow will use: (1) EL / PSNA ; (2) Comprehensive genetic test panels; (3) DNA testing & analysis, and; (4) AI algorithms.

Physicians will be able to treat, diagnose, cure and pre- vent many genetically inherited diseases.

Human Benefit

Lower costs of long read DNA sequencing
Dramatically increase the global research sample DNA database
Increase the number of multi-cultural, multi-ethnic, and multi-regional samples of DNA profiles thereby allowing a more precise interpretation of ancestry, migration, and gene Improve accessibility to preventative healthcare and gene therapeutics, and
With this expanded DNA database, gene therapeutics can be specifically targeted for the approximate 10,000 Homo-sapien phenotypes that currently exist in the human race