Up-and-coming designer Kilian Frieling came out on top in the public vote for the Design Research Award 2020 with his Smart Medication project. Smart Medication focuses on the possibilities of digital transformation in the healthcare sector. Stephan Ott, Director of the Institute for Design Research and Appliance (IfDRA), spoke with the winner.
With his project, Kilian Frieling concentrates on patients who suffer from what is known as multi-morbidity and must take many different medicines daily. Smart Medication uses the possibilities offered by digital transformation in the healthcare sector, equipping a type of 3D printer with medication cartridges to print tailored dosages onto a carrier film. The issue of medication intake plays a large role for a society that is increasingly ageing, the subject is tremendously relevant.
Kilian Frieling completed a master’s degree under Detlef Rhein at Muthesius University of Fine Arts and Design in Kiel and in the medical design section at the National College of Art and Design in Dublin, after which he went freelance in July 2020 to continue developing his project. To celebrate the presentation of the Design Research Award 2020, we spoke with him about the development process behind his project.
Stephan Ott: Kilian, congratulations on your win. I am very happy that we were able to give you the first Design Research Award for your thesis project. How did you come across the idea for Smart Medication?
Kilian Frieling: I worked on various projects during my master’s studies. Although they were not directly connected to my master’s thesis, they could definitely be seen as preparation for it. During my time at the National College of Art and Design in particular, I learned to use a methodical approach and held interviews with users and experts for user-centred research. I found this to be great fun, which is why I also wanted to cast my thesis project in this direction. It is not necessarily very typical for these methods to be covered so intensively during study. In Kiel, for example, there was less of a focus on user-centred design; there were relevant courses, though they were less about the individual users and more about developing a view of society’s needs. It was then that I started researching and looking at what the needs of users actually were.
Were you already sure back then that it would head in the direction of 3D printing and medication?
No, the idea of printing medicines only came about later. Things started with the company Dräger. A staff member doing foundational research there had an idea for a pill dispenser. There are already a number of such pill dispensers on the market, including ones connected to an app, that help remind users about their intake or even count the pills for them. However, my research showed me that that does not solve the actual problem. The actual problem is dosage, and none of these devices take care of this task. This is what drove me to think about how I could use a personalisation process – like 3D printing, for example – to tackle the actual difficulty
So, you started by questioning the scope of tasks and arrived at another issue that was unsolved, primarily from a user’s point of view?
Right. And, relatively speaking, I had a lot of freedom in my actions since it was a degree project and not a job for a client.
How did things go from there?
I wanted to focus above all on design research, which requires a great deal of time, so I continued working alone. Thanks to my research, I then also obtained new findings that led me far beyond the set scope of tasks.
Let us talk about your research process. It incorporates many different subjects, from 3D printing to digital transformation and medication. How did you approach it?
As part of my research, I began with a foundational investigation and studied books to understand how the different processes work. I also interviewed doctors and spoke with the chief physician of the Schleswig-Holstein medical council. I was in contact with a great number of people so that I could build up as extensive a picture as possible. Things went somewhat differently with the patients since the idea of medicine consumption is very general and something that many people have experience with. I then also made contact with the Kiel men’s gymnastics club and spoke with the members of the sports cardiology group there. People with heart problems in particular take numerous medicines, and they were exactly my market: older people who are well connected, are familiar with digital concepts and like making use of such products.
How did you proceed from there?
First I designed various scenarios of how exactly the product could be used, the printing processes that were relevant, how I could combine the various elements, what the patient acceptance was like and so on. After that, I looked at the legal situation in terms of digital transformation in the healthcare sector.
Alongside the various printing processes, I tried to find out how a patient could consume a printed medication. A nurse told me that patients on the ward who have difficulties swallowing often take their medicines with yogurt. This led me from my research to the idea of licking medications. Whether that actually proves to be useful is still undecided, especially in relation to the dosage precision.
That was going to be my next question: is licking somewhat counterproductive if something has to be dosed out precisely?
To understand this better, you should picture how medicines are currently dosed. Tablets, for example, are cut up with a knife and dosed out in a way that is much more uncontrolled and not personalised at all. It is important to understand the so-called therapeutic range that medicines have. This range has a very imprecise definition, and a tall person often receives the same amount as a short person because both might be within the same range due to their weight. My goal is to make this process more precise in order to avoid the large number of side effects and drug interactions. While not everyone may find the action of licking very pleasant, I see it most of all as a relief for people who have difficulties swallowing.
There were critical questions in this context about using medication cartridges, with one remark being that it is too unsafe for patients to handle the device directly. In my opinion, however, it is no different to when a patient has their medication home-delivered from an online or mail-order chemist. Receiving the medicines in no way guarantees that they will be taken.
You designed a printer model for your master’s thesis. How far along are you with the actual medication printing process?
I went through various 3D printing methods and forms of medication for it. In the end, I decided not to mix the medicine with the binding agent shortly before issuing it. Instead, I chose to do it beforehand so that the patient has as little to do with the medicine as possible. The device is even controlled by the doctor; in the end, the patient only needs to take the medicine.
How does the doctor go about controlling the device in your scenario?
The patient collects their body data using self-tracking devices and transfers it to the doctor. The doctor uses a computer program and develops a personalised dose. This could even be connected to the electronic patient record which is supposed to start in 2021. The data needed for printing is sent to the device that the patient has, which then prints out the medicine.
How do you imagine things going from here?
I would like to keep working on it, starting out as a university research project. That would mean thoroughly reviewing all the scenarios and considerations again. Then I would like to build a prototype to test out the principle of its operation. I want to test how I can bring together the medicine and the printing process. If these things work, I could begin thinking about establishing a start-up.
Could you also imagine seeking out an investor with interest in your project?
Here in Schleswig-Holstein there are numerous pharmaceutical companies. I had already made contact with them before my master’s thesis, though as a student you do not receive the attention you need. Maybe that will change now. I need further expertise for the implementation. I need support building the prototypes as well as experts for the 3D printing. Furthermore, I also need experts from the pharmaceuticals industry for the development. I need lots of know-how and, ultimately, financial support as well. That raises the question about whether a start-up grant is enough or whether I will have to collaborate with large companies in the sector in order to actually bring the device to fruition. It could be the case that I become one part of a bigger operation.
You will likely also have to expect developments that you cannot even predict right now.
There was not yet a global healthcare crisis when I came up with the idea of personalised medicines. Right from the outset, I did not rule out the possibility of work on this project potentially turning out to be preparation or specialisation for what I will do afterwards, beyond my degree. After all, the knowledge I have gained means I can also help other companies that have plans for something similar.
Kilian, thank you for this talk. Congratulations once again and we wish you all the best for your future career.
GERMAN DESIGN GRADUATES
German Design Graduates recognises graduates of German colleges and universities for their thesis projects each year. This year, the first-ever Design Research Award was also presented as part of the platform. The award, which comes with EUR 1,000 prize money, is granted by the Institute for Design Research and Appliance (IfDRA). Led by Stephan Ott, IfDRA was established at the start of this year and is part of the German Design Council