Differences To Consider Between Clinical And Home Environments – Industrial Design

Several of our group recently presented at the 2011 Plastics in Medical Devices Conference, in Huron, Ohio. Here’s what Chris Connors had to say on the importance of considering the interaction design of devices as healthcare moves from the clinical environment to home healthcare:

Home healthcare is an industry expanding at a dramatic rate, with both an aging demographic and the possibility that home healthcare can serve to drive down healthcare costs conspiring to drive growth. At the same time, home healthcare capabilities continue to grow; procedures like cholesterol testing that used to require office visits and lab time are now available over the counter at your local CVS. But as these procedures become commoditized, manufacturers are faced with a choice: serve the home healthcare market with “consumer” or “prosumer” versions of their products, or remain in a (possibly shrinking, depending on the treatment) clinical market for those products. How can interaction design ease the transition for companies who chose the former?

In this discussion it’s useful to articulate a common definition of terms, so let’s define interaction design in this context. Initially interaction design was used interchangeably with interface design, or specifically, interfaces on screens, whether that was a desktop, mobile, web, or embedded application. More recently the term has come to embody a more holistic view of product design, encompassing all of the points of interaction between customers and products, the support of those products, and the company itself. It now crosses boundaries to include:

  • industrial design — those functions are accessed with hard buttons; they have this appearance and this feel during engagement and disengagement;
  • packaging design — the presentation of your product to your customers, your last touch-point before they use it;
  • online resources — can customers transact business with your company quickly and easily through a variety of channels and social media? Do you reward customer loyalty with shwag and add-ons through those media?
  • support — how does your company/product make things right when things inevitably go wrong?

Collectively these different factors — interface design, industrial design, packaging design, online presences, and the support experience — make up what we now refer to as interaction design.

In light of that definition, there are three ways interaction design can help manufacturers of healthcare products ease (and even leverage) the transition to home healthcare: by fulfilling the expectations of increasingly more consumer driven purchase decisions, by lowering barriers to data collection for both patient and provider use, and by increasing the duration and quality of patient participation by leveraging social obligation and competition.

When developing and selling clinical equipment, product designers have a phalanx of clinical and regulatory requirements to accommodate, but they also have to win favor with practitioners, insurers, and government agencies who ultimately dictate payment approvals and reimbursement levels. To that list manufacturers must now add consumers, who expect the same design sensibilities that have driven widespread adoption of products like iPod and TiVo, and web services like Twitter, all of whom have made considerable investments in delivering refined interaction design to their customers. Few if any clinical products have taken into consideration questions like “how will this look on my nightstand” or “does the design language confer a level of trust I appreciate/need as a patient” or “can I as a layperson make sense of the product’s purpose and function”.

Along a similar line, most clinical products are designed for experts in the domain rather than home users who are most likely not experts; designing products that can be learned and that minimize errors for patients as their experience grows is a different exercise entirely. However, responding to customer’s design sensibilities, identifying and respecting their needs, creating product interfaces that scale with customer experience are exactly the sort of problems Interaction Designers have grappled with for decades.

Adding to the complexity for the home healthcare arena, patients are often required to log their treatments or some other data as part of their treatment protocol. Diabetes patients are, for example, often encouraged to track both their diet and exercise, as well as their blood glucose levels over time as part of a diabetes management plan. Hypertensive patients are similarly encouraged to keep dietary and weight logs, as are patients attempting to manage their weight. In each of these cases, historically they involved the patient taking a measurement and then transcribing it into some recording format (originally pen and paper notebooks, later maybe an ongoing computer document or spreadsheet). This requires patients to perform two actions: take a measurement and then record it. Why not record the data as the measurement is taken? Modern scales can take a weight and then record the reading by uploading it securely to the internet, track the changes, and illuminate trends, so that the patient only has to worry about taking the measurement. By making the recording step automatic and transparent, not only does the patient have less to worry about, but the data will be more accurate as well. At some point, interaction designers proposed including network communications and multiple personalities for the Withings WiFi Body Scale, and the result of lowering these barriers to data collection is a better experience for the patient, better data for the health care manager, and hopefully better outcomes.

There is also the question of how can we motivate hypertensives, diabetics, or the obese, for whom the actions to outcome time scale may be extended, to continue a treatment when the results of their participation take years to manifest? Web sites like Facebook and Google offer an interesting analog, in that both offer users some utility (the results) in exchange for showing users advertising (the unpleasant stimuli). In Facebook’s case, user engagement is increased as users grow their social network, and in turn, their network of social obligation. As friends and family members post pictures or links or even banal status updates, users feel compelled to read them, comment, or ‘Like’ as real world social obligations are transferred to the digital realm. In effect, users are enduring something potentially unpleasant (viewing ads) in exchange for some utility (social connectedness); the duration of user engagement is extended because they feel socially obligated. One could imagine integrating certain treatment regimens (being careful to respect privacy and allowing users to choose their audience) where the encouragement of friends and family could positively impact outcomes.

Another social mechanism employed by sites like Facebook, Nike +, and Foursquare is competitiveness. People will advertise that they’ve ‘checked in’ to local establishments, or spend real money on virtual gardening implements in exchange for absurdly trivial virtual trinkets, if only to have more of those trinkets than their friends. One could imagine rewarding medical participants for ‘checking in’ at their doctor’s for their annual physical, or public shaming for too many stops at a fast food establishment.

As the transition from clinical to home healthcare products is a relatively new phenomenon, we’ve only scratched the surface as to the ways interaction design can help manufacturers of healthcare products ease the transition to home healthcare. But if manufacturers are willing to make the investment in fulfilling the expectations of increasingly more consumer driven purchase decisions, lowering barriers to data collection for both patient and provider use, and increasing the duration and quality of patient participation by leveraging social obligation and competition, that transition can be a beneficial one for patients, healthcare providers, and manufacturers alike.