Xueping Li, an industrial engineer at the University of Tennessee who has spent two decades solving complex health care puzzles, saw a stubborn problem staring back at him: one of every four Tennessee children under two years old was missing their CDC-recommended vaccines. Tennessee's immunization rates were falling behind other states, and the barriers keeping families from vaccinating weren't simple. They were systemic—tangled across geography, information, trust, and logistics. So Li and his team built an app.
SmartSHOTS emerged from a collaboration that spanned the university's engineering, nursing, design, and communications departments, all working with Tennessee's Department of Health and County Health Councils—the local volunteers, teachers, doctors, and parents who know their communities inside out. The insight was crucial: you cannot solve a health problem by looking at only one piece. The team conducted statewide surveys to map out exactly what was stopping families from vaccinating their youngest children, then designed the app to address each barrier head-on.
What they discovered mattered. Families struggled to locate vaccine clinics, especially those who moved frequently. Transportation to clinics was another hurdle. But beyond logistics lay deeper concerns: caregivers worried about vaccine safety, and misinformation flourished—some believed homeschooled children didn't need vaccinations at all. The app's response was comprehensive. It includes a GPS-enabled tool that shows caregivers exactly where nearby vaccine clinics are located and how to reach them by public transportation. Just as importantly, SmartSHOTS offers evidence-based animations about each CDC-recommended vaccine and the disease it prevents, delivered in both English and Spanish, the two most-spoken languages in Tennessee.
The numbers behind this work are significant. Over the past three decades, routine childhood immunizations have prevented more than 1.1 million child deaths across the United States, according to the CDC's 2024 estimate. Yet Tennessee's vaccination gap showed there was urgent room for improvement. When the SmartSHOTS team tested their app with real families, the response was unmistakable. Beta testers offered enthusiastic feedback, and their results were published in the international Health Informatics Journal in January—validation that the problem was real and the solution was working.
"The beta tester feedback was incredibly rewarding," Li reflected. "SmartSHOTS was built through close collaboration with nurses, engineers, public health experts, designers, and community partners, so seeing such strong validation from users affirmed both our approach and the real need for this solution."
The app represents a lesson in systemic thinking applied to everyday health care. A professor accustomed to modeling complex systems recognized that vaccine hesitation and low immunization rates couldn't be blamed on a single cause or solved with a single intervention. By bringing together expertise across disciplines—from user interface designers in the College of Architecture to linguistics experts in the College of Media and Communication—the team built something that meets families where they are, in their language, with the information they actually need.
As SmartSHOTS moves from beta testing into broader use, it offers a blueprint: listen to communities, understand their barriers, and design solutions that treat health care not as isolated transactions but as a connected system where every detail matters.