App for Parents of Kids with Severe Allergies

[Jim Sweet]

I'm working on an app for parents of kids with severe allergies and I was hoping I could get some thoughts on the concept.

In an emergency the app lets people alert nearby off-duty EMTs, medical personnel, and other responders who can quickly provide aid.  In addition, this builds a network of people with EpiPens who can be alerted if someone nearby is going into anaphylactic shock. 

I would love to hear your thoughts whenever you have a free moment.

Thanks in advanced everyone!
-Jim

[twinturbo]

How would it work? Even on duty not all EMTs in all municipalities, counties or states are allowed to administer pediatric doses epinephrine. A lot of the trucks carry diphenhydramine IV-only often preferring to wait until a higher threshold or grade of anaphylaxis before administering epinephrine. Heck, a lot of full on critical care doctors wouldn't administer it as a frontline therapy despite NIAID's recommendation.

Municipal police, county, state police or highway patrol? As a general rule they'd have no clue although they could keep their cool and maybe call in with good accuracy. As difficult as it is dealing with school districts sometimes in this regard they're ahead of a lot of first responders.

Now if you could work with MedicAlert and take advantage of their newly released GPS product to autodial emergency dispatch or MedicAlert makes the call for you if you hit the red button on the app you may have a winner.

[rebekahc]

I'm working on an app for parents of kids with severe allergies and I was hoping I could get some thoughts on the concept.

In an emergency the app lets people alert nearby off-duty EMTs, medical personnel, and other responders who can quickly provide aid.  In addition, this builds a network of people with EpiPens who can be alerted if someone nearby is going into anaphylactic shock. 

I would love to hear your thoughts whenever you have a free moment.

Thanks in advanced everyone!
-Jim

People with allergies shouldn't need a network of people with EpiPens, they should have their own.  Plus, why would an off duty EMT/medical personnel/responders carry EpiPens?  And how would I know they had stored them properly?  The allergic (or a caregiver for the very young) should be able to administer epi to themselves - that's kind of the point of an autoinjector.  If they were incapacitated such that they couldn't use the pen, how would they use the app?

[Jim]

Thanks for awesome replies rebekahc and twinturbo!!  Your feedback really helps a lot!

Also sorry for the slow response, I thought that I would be emailed if I got a reply.  I'll check these threads more frequently from now on.

twinturbo
You are 100% right that not all states allow EMTs to administer epinephrine but new legislation in a few states is allowing for any trained person to administer epinephrine.  I'm talking with a few dispatch centers to see if their people would be interested and it is definitely been a mixed response.  2 counties seem interested though so I figure that's a good start.  I'd love to get more questions, suggestions, or concerns from you if you can think of any?  Thanks for letting me know that NIAID recommends using epinephrine as a frontline therapy and how doctors don't like to use it as such.  I didn't know that but that is useful information.  I looked into MedicAlert's gps but I don't think I understand how you were suggesting to work with them.  Any chance you could elaborate on when/how a person would auto-dial 911?  Thanks again!



rebekahc
People should always carry their own epiPens with them but from what I understand there are a fair number of people who frequently forget them and a large number of people who were never prescribed one.  I know not all EMTs carry epiPens (especially while off-duty) but a lot of them (especially in rural areas) carry what they call squirrel bags which contain some basic medical tools, including epinephrine.  I can't think of anyway to verify that a responder's epiPen has been stored properly but I can do a lot to vet the quality of the responders.  If the person was incapacitated and the app gets used I anticipated that it was used by a bystander who may not know how to use an epiPen or does not have one on them.  Does that answer your questions?  I'd love to hear anymore questions, suggestions, or concerns you come up with if you can think of any?  Thanks again!

[twinturbo]

Two things. First is I do know a former combat medic now a civilian full paramedic who owes me a 'solid'. I plan to cash that in for my own purposes at a later date but for the sake of argument how are you engaging EMS personnel? I had to play an insider card and do a solid for him first.

Second what's your plan? Have you ever brought a product or service to market before? With all due respect I'm not seeing a disciplined approach to product development and market research.

Don't shoot the messenger! Remember you asked.  You have my moral support for what it's worth. I may even want to help despite doing R&D through the internets.

[Jim]

Hey twinturbo.  Thanks for all of your support, I really appreciate you taking the time to ask these questions 

I'm reaching out to local EMTs through meetup and other events and frequently by just walking up to local fire stations and saying hi.  There are also some local volunteer groups I'm reaching out to as well. 

You've got a sharp eye to see that I don't have a well defined game plan since I'm learning by doing but I would to love to hear any pro-tips you could share?  I don't like to abuse people's good nature but if you want to help with the R&D research I would love to accept your help    

[twinturbo]

Don't get your hopes up I myself am useless but I know some people who know some people who are.

I still have no idea what your product/service is. What does the app do? How does someone use it? Where does it fit in emergency management? Does it duplicate what an Auvi-q already does with its voice prompt? Do you know if you need FDA approval at any point? Are you registered as a developer? Do you know what's both required of you as a developer and how that registration might allow you access to a target market, and also to test your app in a device simulator or actual device?

Have you ever anaphylaxed yourself? Do you have any EMS background? Usually dispatch is closed off to anyone they haven't performed at least a preliminary background check on. So color me a little surprised they talked to you at all. I'm also not sure where dispatch comes into it knowing fairly well how at least one operates and EMS on duty can stop and assist but can't necessarily assign themselves to run a patient themselves at will without communicating with dispatch.

What does the app do that MedicAlert, a household name service, does not already do with ID?

[Jim]

Sorry of I didn't explain the app well, can you tell me which part of my previous explanation doesn't make sense?

_{In an emergency the app lets people alert nearby off-duty EMTs, medical personnel, and other responders who can quickly provide aid.  In addition, this builds a network of people with EpiPens who can be alerted if someone nearby is going into anaphylactic shock.} 

I don't have a EMS background but I've been doing a lot of personal research for a while.

[rebekahc]

rebekahc
People should always carry their own epiPens with them but from what I understand there are a fair number of people who frequently forget them and a large number of people who were never prescribed one.  I know not all EMTs carry epiPens (especially while off-duty) but a lot of them (especially in rural areas) carry what they call squirrel bags which contain some basic medical tools, including epinephrine.  I can't think of anyway to verify that a responder's epiPen has been stored properly but I can do a lot to vet the quality of the responders.  If the person was incapacitated and the app gets used I anticipated that it was used by a bystander who may not know how to use an epiPen or does not have one on them.  Does that answer your questions?  I'd love to hear anymore questions, suggestions, or concerns you come up with if you can think of any?  Thanks again!

1.  If I was never prescribed an EpiPen or thought it was unimportant enough that I didn't carry it, why would have this app?

2.  If these squirrel bags are left in their vehicle, then the heat would destroy the epi rendering it useless.

3.  If an allergic person is incapacitated, why would a bystander look through that person's phone for an app?  How would a bystander know (or be qualified) to diagnose anaphylaxis?  They should call 911.  If there are EpiPens available, they are almost self-explanatory and surely a bystander who took the time to search a person's phone for an app could read the directions.

[twinturbo]

Jim, how does it alert off duty EMS personnel? Does it ping their phones like a bat signal from the sender's phone? Does it act locally on only that phone in a prerecorded voice that plays in a loop?

Here's how a tactical team forms in counties that do not have their own dedicated team. A rotation are on call, I think during their off duty times so it may be staggered, but they carry dedicated devices that are only when they are called in for that single purpose. Dispatch puts the call out to them they respond.

I take it you also want to build a network of lay individuals volunteering to use their EAI (epinephrine autoinjector including Adrenaclick, Auvi-q and EpiPen brands) at the request of an unknown person to them. How do these individuals know the location of the person requesting assistance to bystanders? Furthermore, where does this belong in the process of epinephrine administration with an immediate call to rescue squad? 911 in USA.

What would be the radius of alert? 500 m? 5 km?

Have you thought about starting with your local small business association to get assistance in drawing up a business plan, and how to do your own market research or seek affordable professional market research?

At the very least you would need one incredibly butt-covering user agreement to limit your liability.

[Jim]

Hi twinturbo
The app alerts responders who also have the app on their phone.  I'm working with just smartphones at the moment but I am looking into ways to work with non-smart phones as well.  The radius may need to be dynamic in the future but for now I'm starting with .5 miles.  I'm currently being advised by my local SBDC so I'm starting to put together a business plan.  I still need to talk with lawyers about how to handle liability but you're very right about needing to pay very close attention to that.


Hey rebekahc
Most deaths from anaphylaxis (at least according to my research) seem to be from people who were never prescribed an epiPen or who didn't have theirs on them at the time.  It feels like a pretty good just-in-case tool to me but of course if people don't want to use it than it doesn't do much good.  I'm actually not sure about how the squirrel bags are stored but that is a great point about the heat from the car. I'll ask some of the EMTs how they store their bags.  I don't anticipate a bystander to launch the app from someone else's phone, my aim is for the bystander to have it on their own phone to look out for their freinds and family who have allergies.  Thanks for taking the time to reply to me, those were some great questions!  Did what I say make sense?  I'd love to keep this conversation going if you have any more thoughts?

Thanks again to both of you guys!!
-Jim

[SilverLining]

I agree with rebekahc.  If a person doesn't have a prescription, or doesn't other carrying it, I doubt they would bother downloading an app instead.  And a concern to me, would this add to the people who should carry an epi but don't bother.  Instead of just thinking I won't need an epi today they will now think I won't need an epi today, but if I do, I'll find someone who has one.

~~~~

One of my son's is a paramedic, and actually does have his own medical supplies including epi.  But I doubt he would want to be on-call 24/7 for people to dumb to carry their own and not willing to all 9-1-1.

And anyway....when you use epi you are always supposed to go the hospital.

[CMdeux]

What rebekah and Silver said.



The people who die from food allergies tend to know that they are allergic-- but to not know how allergic, if you will.  They don't really have a good handle on why they should carry epinephrine, so they don't.  They would NOT download an app about it, either-- because they seriously do not understand that they are at real risk.

[Jim Sweet]

Thanks for the useful feedback SilverLining and CMdeux

I had not considered that this app might cause people to neglect their responsibility to carry their own epi or would make them think that they don't need to go to the hospital.  If thats what people end up thinking then the app is completely counter-productive and beyond useless.  I hadn't gotten that feedback till now but I'm going to look into this a lot more.

It sounds to me like no one who has replied would be interested in using this app to receive help.  Does that mean no one would be interested in using the app to help someone else?  Even a quick "yes" or "no" would be really useful to me 

Also SilverLining, any chance you know how your son stores his medical supplies so that the epinephrine doesn't go bad?  I am a big fan of your son's line of work and I think you made a great point about your son not wanting to be on call 24/7 365 days a year.  I should mention though that they people who download the app can choose when they are available to respond so that they don't have to always be on call.

I really appreciate you guys taking the time to reply to me and if you have anymore suggestions, concerns, or questions I would really love to hear them.  I can't tell you how useful this is to me 

[rebekahc]

Hey rebekahc
Most deaths from anaphylaxis (at least according to my research) seem to be from people who were never prescribed an epiPen or who didn't have theirs on them at the time.  It feels like a pretty good just-in-case tool to me but of course if people don't want to use it than it doesn't do much good.  I'm actually not sure about how the squirrel bags are stored but that is a great point about the heat from the car. I'll ask some of the EMTs how they store their bags. I don't anticipate a bystander to launch the app from someone else's phone, my aim is for the bystander to have it on their own phone to look out for their freinds and family who have allergies.  Thanks for taking the time to reply to me, those were some great questions!  Did what I say make sense?  I'd love to keep this conversation going if you have any more thoughts?

Again, not trying to beat a dead horse, but if someone thinks the allergy is serious enough for them to download an app to try to keep their friends and family safe, wouldn't they just carry the epi?  If they don't think the allergy is serious enough for epi, then they're not gonna think they need the app either.