Early, Iterative, Functional: How to develop the right medical device to actually help people.

The world doesn’t need more gadgets, it needs better ways of thinking, of Design Thinking. Of working with the people it affects, and helping them to get what they can actually use, especially when it comes to healthcare and medical devices.

The world of healthcare is exploding. A swarm of buzzwords have emerged, healthcare, connected device, IoT, medical devices, smart-things. And while every company clambers to create the next smartest thing, the next wearable, the next clever watch that tells you the time, and does 15 other things, people continue in their daily struggles, with everything from the increasingly more common issue of obesity, to the more serious, Diabetes, to the more debilitating, COPD, and other chronic diseases which render people unable to participate in the world around them; regardless of their age or social status, and also certainly worsening due to their age and social status. A thousand pilot projects, and uncountable smart devices (check out http://vandrico.com/wearables for a database of all the existing wearables) aim to help existing conditions or prevent new ones. I applaud each of them, whether the creators are trying to actually help people or just make a buck, it’s good work to help people. What I’m missing… is what works. And I haven’t found it. Yet.

Without launching into a long debate about all the available devices, I’ll focus on the process which I believe could help these developers to help the people their product is aimed at. It’s an open discussion, I invite debate, and I hope that through this debate, better methodologies of design thinking, engineering, and development result.

The Process

The process is relatively simple. It’s iteration, and it’s functionality. Here’s what it looks like:

Get an idea. No, not you. Your stakeholders. The patients, doctors, clinicians, nurses, engage them. This is the part commonly known as Participatory Design. Any one of you (you the inventor, you the patient, you the doctor, the nurse, etc) might have a great idea; but it’s the collaborative debate about this idea, about the situation, the problem domain, the actual what-do-we-do-every-day, and how do I design for that, that is interesting. So in this “Get an idea” phase, there’s a lot of things involved. I won’t explain them here, but I will give you a brief outline. Where I work, we call it Context Validation, it’s basically Design Thinking, but just in the first stages. It can involve:

1. Learning about your user group (Let’s say it’s COPD patients: In what stage? At home, in the hospital, at a community center, where are they? What do they do each day? What is their daily routine, down to the most silly detail, WHEN in their routine can you design for?)

2. Exploring the context (Okay, COPD patients, mid-range development of COPD—they can walk, but not far, and they’re doing okay, with the help of their spouse/caretaker). Go visit their homes, find out how they live, pay attention to the things they do to make their lives a bit easier (at one place I visited, a gentleman with COPD put a key on a long piece of string and then when people knocked on the door, he pushed the key out the window in his kitchen, so people could let themselves in, walk up the four stairs and come to visit him, so he wouldn’t have to navigate the stairs).

3. Exploring the problem, which you think you know, but you’ll soon find out that you don’t. Not really. (Talk with the COPD patients, take a walk in their shoes, try to understand at what moments you could make their life a bit easier.)

4. Explore it with others (Talk to their caregiver, their doctor, their nurse, their family and friends, get different perspectives on the problem, on the person, on what other people think the problem might be).

Then we get to the fun part. Build.

In IdemoLab, we create functional, early prototypes. We specialize in electronics and energy harvesting and for us, building means making something that people can use, right away, in context. Sometimes we build a first model WITH our users. We sit down in a room with patients, nurses, and family and build together. An example of this was in building a pill dispenser for the home, we brought a bunch of stuff from the dollar store and let people talk, with their hands, by building their concepts. In the photos you can see the early mockup, and then one functional prototype later on, that we tested in people’s homes, and a ‘final prototype’ we brought to the same people’s homes to show them how we had addressed the issues they had pointed out.

Here we had 3 iterations, each building upon the last, each built and evaluated, with the people who will eventually use them, alongside nurses, and collaborators, such as the municipality who would sell the devices, the pharmacy that would give people their medication, and the private company whose name it would sell under.

So back to the process.

First we explore, we do Context Validation.

Then we build, we build our ideas alongside all the stakeholders who will be involved in the end product. We then take these mockups into our own hands and build functional prototypes. They’re not pretty, and that’s the point. People should be able to critique them. To pick them up without fear of mishandling them. To be honest in their criticism. They don’t do that if something’s shiny.

Once we have built something, we take it into context, and test it out. We get people to try it, to role play, in context, and show us how they might use it, and we observe, and listen and gain insights. Our insights do not depend on what they SAY, but rather what they DO. Old news to many of you, but a good reminder nonetheless. People tell you what they think you want to hear, it’s what they do that’s really interesting.

And that brings us full circle. I could go on for another 12 pages. You could also just read this amazing guide from Ideo, a free resource on Design Thinking that I highly recommend: http://www.designkit.org/

What’s most important is to try it out, find out what works, and what doesn’t. Your great idea might not be the best solution. Surely in this list of wearables by Vandrico, there’s more than a few that are, in the least, questionable if not downright unusable and silly. (On that note, do use Vandrico to go and click on some of the wearables in their database, they do a great job of breaking down all the important things, like compatibility, features, price, etc. What they don’t mention is how well it actually works).

Working in IdemoLab, DELTA where we do everything from the initial concept development to developing the technology and testing it in context, with users, to utilizing the rest of DELTA (see www.madebydelta.com) to do things like EMC tests and CE marking. I have seen a lot of products fail, 80% of all products launched don’t make it to market, and of the 20% that do, very few are actually adopted after purchase as a regular use item. (How many of you have bought a gadget, used it twice and it’s now hiding in that junk drawer in the kitchen that you and your spouse swear you’ll clean out one day?). The point is to make things that people need. Things that people value. Things that actually make living with a chronic disease less difficult, less painful, and just plain easier.

The world doesn’t need more gadgets, it needs better ways of thinking, of Design Thinking. Of working with the people it affects, and helping them to get what they can actually use, especially when it comes to healthcare and medical devices.

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