MICONationwide Children's Hospital

The Problem

Pediatric oncology care has a blind spot. Clinical decisions happen in hospitals, but day-to-day medication administration, symptom recognition, side-effect response and caregiver coordination happen at home.

Current approaches are often reactive, fragmented and paper-based. Care teams may only learn of problems after outcomes deteriorate, adherence drops, symptoms worsen or protocol deviations appear.

What MICO Does

MICO pairs a caregiver-facing medication management experience with a role-based monitoring portal. It supports families directly while converting at-home treatment activity into structured, actionable visibility for clinicians, coordinators, research staff and trial teams.

1. Guided medication execution
   • Configurable schedules, multimodal reminders, dose confirmation, missed/late dose capture and medication-change workflows.
2. Barrier + symptom insight
   • Captures why breakdowns happen: side effects, refills, schedule disruption, caregiver handoffs, symptoms and treatment burden.
3. Monitoring portal
   • Role-based visibility into adherence patterns, symptoms, engagement, medication changes and emerging risk.
4. Conversational support
   • Relevant education, prompts and guidance at the right moments through a supportive, low-burden experience
5. Companion engagement
   • A clinically safe, lightly playful character layer designed to support trust, agency and sustained use.
6. Trials + care delivery
   • Designed for protocol execution, data fidelity, retention, care coordination and real-time treatment visibility

Who It Supports

• Patients & Families
  • Peace of mind, understandable guidance, caregiver coordination, medication support and low-burden connection to care.
• Care Teams
  • Earlier visibility into adherence, symptoms, medication changes, engagement patterns and escalation needs between visits.
• Research Teams/ CROs/Sponsors
  • Improved protocol execution, higher-fidelity data, earlier safety signals and better trial traceability.

Evidence & Validation

MICO builds on the BMT4ME / CareSync development pathway, including caregiver and multistakeholder co-design, high-fidelity usability testing, NIH-funded randomized feasibility work and Spanish-language transcreation.

• 86.5
  • SUS / usability signal in current deck materials
• 85%+
  • engagement in initial pilots across pediatric hospitals
• 70%
  • second iteration RCT usage over three months
• $949K+
  • grant-supported development and testing to date

Commercial Use Cases

• Care Delivery
  • Guided medication administration
  • Symptom escalation pathways
  • Reduced caregiver cognitive overload
  • Visibility into adherence between visits
  • Standardized at-home oncology workflows
• Clinical Trials
  • Protocol adherence and traceability
  • Earlier detection of safety and symptom indicators
  • Structured medication and symptom data
  • Reduced protocol deviation risk
  • Improved trial retention and data integrity

Deployment Model

MICO can be deployed as a MEMOTEXT-supported marketplace intervention for pediatric oncology, transplant and complex medication-management programs. The intervention can be configured for bilingual content, caregiver/patient workflows, site-specific reporting, clinical trial workflows and future EHR or trial-system integration.