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Web-Based PAH Risk Calculators

United Therapeutics

Challenge: Pulmonary Arterial Hypertension (PAH) is a rare, life threatening disease that has no known cure and few treatment options. Historically, physicians have had a difficult time diagnosing and treating PAH patients, and they’ve struggled with finding reliable tools for characterizing the extent of disease. As part of their work to provide tools and resources to help physicians manage PAH in patients, biotech company United Therapeutics created paper worksheets for physicians to facilitate the PAH risk assessment process. While these worksheets have proved to be an invaluable tool, there are drawbacks, including the need for physicians to carry a physical copy of the worksheet with them, and reliance of physicians to do math on the spot. Gilero was asked to help United Therapeutics turn these paper worksheets into online automated calculator tools that physicians could easily access and use.

Approach: A few constraints dictated the boundaries of our development.

1. Calculator web pages needed to integrate with the corporate website. This required us to collaborate with the client’s website vendor to ensure a seamless user interface and consistent user experience, as well as the client’s IT department for hosting and deployment logistics.
2. There must be a consistent look and feel between the electronic calculators and the paper worksheets so that physician experiences would be the same no matter which tool they used.  This included  mirroring existing design elements, placement of selection options, and rules for generating results.
3. Physicians needed to be able to access and use these calculator webpages on a desktop, tablet, or mobile device, without creating a true mobile app. This required two webpages to be developed for each calculator where the device selects the appropriate page to load.
4. To protect patient privacy, no data or results from the calculators could be stored.  Once the calculation was complete, the data had to be cleared.
5. Physicians needed the ability to print results in a format that resembled the paper worksheet.

To meet these needs, the Gilero team deployed a reactive design methodology enabling each calculator to fit on a variety of devices and screen aspect ratios. We used a combination of HTML, CSS, and JavaScript to build and implement these calculators. JavaScript was used to create a novel PDF print function, allowing calculator results to be saved or printed in a format that resembles the original paper worksheets.

Outcome: In just a few short months, Gilero’s team of software and product development engineers turned the paper-based calculation worksheets into electronic versions, delivering four web-based PAH risk calculators that are accessible from the PAHI health care provider website. Each calculator represents one of four different methodologies for calculating risk status in patients with PAH – REVEAL 2.0, REVEAL Lite 2, ESC/ERS Guidelines, and Non-Invasive French  in two form factors – one optimized for a computer and one for a mobile device. A physician can simply click to select the calculator of interest and is immediately presented with a user-friendly interface for selecting the parameter values associated with patient test results. The tool does the math in real time, and when the physician is done entering the data, the risk status is presented. The electronic worksheet can then be printed or saved as a PDF and added to the patient’s medical record.

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