How to approach product design

Chris:
How did you take the experience of designing the products that Philips was traditionally known for and apply them to healthcare?

Sean:
The last few years Philips has been in a transitional period, moving from a diversified technology conglomerate, into focused health technology company. We've divested ourselves of other industries that made us great, such as lighting and consumer electronics, in order to focus on a continuum of care.

For example, we're working in prevention and precision diagnostics, improving our understanding of why people fall ill for more accurate interpretation of symptoms. This means we can apply medicine in a more precise way and through image-guided minimally invasive procedures.

In the field of patient monitoring, we've developed what we call 'connected care', where we have approximately 275 million patients tracked with our patient monitors each year. We're also managing over 30 petabytes of imaging data for healthcare providers around the world. So if you're a radiographer or cardiologist, you can have real-time access to a wealth of information to guide your decision-making process.

Chris:
How does this translate into hardware? What are some of the material challenges you face in terms of patient experiences?

Sean:
Any clinical environment, hardware needs to be clean, germ-free, low-maintenance, but also robust enough to stand up to everyday wear and tear.

An extreme example of that was when visiting an emergency department in a major US hospital. As the major trauma center for the city, they deal with a lot of gunshot wounds. You're wheeling people in who are in extreme distress into this environment, often they're bleeding out and you're getting them onto a CT machine to determine what the damage is and what interventions they need; and it has to be done quickly and effectively. There's no time to dress up or prepare the area.

Now, when you go back in the cold light of day, and look at this device – which looked beautiful in the catalog and looked amazing in the trade show – when you see it in reality, it's battered, bruised, it's got scuff marks and cracks, and you can see they've hosed it down a million times to keep it clean. We need to make material choices and design with this context of use mind.

Chris:
You've got a complex set of guiding principles because on one hand you've got to have very practical materials for extreme conditions and then you've got to have something that is emotionally reassuring yet durable.

Tell me about the Ambient Experience project, which focused on the emotional needs of the patient.

Sean: 
Having an MRI scan requires a patient to be inside the bore of the scanner for a lengthy amount of time – it's noisy, and for some patients it can be scary, a little claustrophobic – so how do we put them at ease? We designed systems that can project images and we can give patients access to those images in the bore.

But you also have to consider the patient's perception of the room, the materials and the colors we choose, the bed that supports the patient, the mattress that they're lying on. We have to consider, do you design it around clinical efficiency and speed so it can be wiped down quickly, or do you design it so that it's comforting as they're touching it? Of course the answer is both and it's the designers role to figure out how to create a win, win here. We've seen other people come with a pediatric imaging approach, where they've said, 'Well you don't need all these expensive projectors and colored lights; you can put up pictures on the wall, you can put stickers on the machine, you can even put an MDF cover over it and make it look like a fairytale castle' But what they don't take into account is that not all children need that. Pediatrics goes from zero to the age of twenty-one in the US. Imagine an eighteen year old coming into a Disney princess environment – that’s not really going to work.

Equally, there are children suffering from ADHD who get distracted and who will actually become more nervous and agitated if overstimulated. In those situations, you want to cool everything down and neutralize the environment as much as possible. So there is a real need for adaptive environments that can respond to the specific needs of each patient.

Ultimately, we're balancing between addressing needs on functional and emotional levels. On one hand, we design for cleanliness, efficiency and being able to be maintained long term rather than decaying with age. At the same time, we also have to consider the patient’s perception, their experiences, emotive triggers and cues.

Chris:
What's your dream list, wish list, for materials?

Sean:
One that can do everything!

Chris:
Yeah ok, haha, I'll make a quest finding that one!

Sean: 
And be recyclable and knowing what we know now, one of the things that we've pledged is by 2020, we will take back and repurpose all the large medical systems that its customers are prepared to return to us. Ultimately, we are driving towards circularity on everything we do, but right now, it's on the big capital goods. We're looking to take back hardware at the end of life and re-purpose it, re-use it or refresh it, scavenge parts or materials and even up-cycle where possible, which requires a fundamentally different approach to designing it.

This means designing with disassembly in mind, while expecting these devices sit in situ for maybe 10 years, we hope at least. So during its lifetime, can we upgrade it? Can we refresh it in the case of this US based CT? If we know it's going to get beaten and abused on a daily basis, could we design that into the product with materials that are perhaps more attuned to that kind of environment, where it's going to have trolleys running in to it or get blood splatters, detergents and other things in contact with it? In making deliberate choices around the materials, rather than looking at plastics, should we be looking at ceramics or metals? But of course there's a whole host of technical issues around metals in X-Ray, and obviously once you get into MR and you're dealing with powerful magnetic fields, then you have a real set of challenges as well.

Chris:
My philosophy is based-on thinking about materials at the starting point of the design process and then designing out. So, in terms of how Phillips is working with materials, how do you integrate materials within these types of projects?

Sean:
Here’s one example – the neonatal intensive care unit, where you're dealing with premature babies, the most fragile human beings there are – just 26 weeks old. We can now not only keep them alive, but actually help them on their way to being fully functioning adults. But how do you put patient monitoring onto their skin, which is so fragile? Can we look at other ways of applying or picking up their vital signs without applying adhesives and things? That's one extreme example.

Chris:
And you're involved in that level of research?

Sean:
Yes, we work on that primary research level and that's becoming even more relevant as we get into wearables now. We have a big patient monitoring business, and we have approximately 275 million patients tracked with our patient monitors each year around the world right now, hooked up to our devices in ICUs and Acute care settings. What we're doing is leveraging wearable technology, reducing the number of cables on the patient. For example, we've introduced a medical-grade, wearable biosensor that automatically and continuously measures heart rate, respiratory rate, skin temperature, single-lead ECG, posture and activity data for at-risk patients in low acuity settings in the hospital.

This is a great development which will improve the patient experience, but it also requires a lot of thought to be put into the design, from how long it’s going to be worn, to its effect on the patient's skin. We also need to consider the Sustainability angle, since the patch contains technology in it how often should the sensor be replaced? Can we split the patch into a patient interface component and the tech component, allowing for re-use whilst always presenting a fresh patch to the patient. This requires our designers to re-think the fundamentals of monitoring, moving from tech in the bedside box approach to the tech in the patch. The consequent material challenges are also then quite different as we move to this new system.

Chris:
As the market for wearables opens up there is going to give more opportunity for self-diagnosis and self-treatment.

Sean:
I would say Yes, but let's also recognize that we're at the start of a journey here. If our intent is to move into prevention and help people live a healthier life, we have to recognize that we're going to need a lot more than simply counting steps. Of course there are already health benefits in using step counts to get people moving more, but if we really want to help spot early indications of an illness, then we're going to need more than this. We have to look at how this data can help signal when there is a potential health issue. If you can start to measure things like, speed with which you get out of bed, speed with which you stand up, speed with which you move from point A to point B and then analyze that over a period of time, you can start to generate much more meaningful insights. These insights in the future can potentially predict chronic diseases ranging from Cardio-vascular disease right through to cognitive issues. If we can capture these early warning signals and feed them into the medical system then clinicians will be able to start the diagnosis and therapy that much earlier, which will ultimately help drive up the success of treatments leading to better patient outcomes.

Chris:
But those kinds of experiences which are more to do with the emotional experience of materials and being part of a lifestyle – people buy smart watches not because they want to be healthy but because it’s a cool product, a fashion lifestyle accessory. To me that feels like a new type of emerging trend, that in a way is something like sunglasses or prescription glasses, that rather than medical products, they've become fashion accessories.

So do you think that kind of monitoring has an opportunity, because particularly for materials, it's about wearables, trends and fashion, has an opportunity to grow?

Sean:
There's obviously a lifestyle link to this and adding the dimension of fashion and desirability can help drive adoption at scale, as we're already witnessing with the Apple watch. As people then instinctively start to wear these devices everyday we can start to derive a much more holistic view of their activities, their health but in the context of where they were and what they were doing. This is a much richer view than you would be able to obtain for instance if the person was sitting in a Cardiologists consulting room wired up to an ECG. I think there are true health benefits to be derived from it and we're just at the start of that journey. But this isn't just about those who have serious illnesses, it's also about optimizing your health and so increasing your performance, your focus, your productivity, all of those things can all be helped by having access to this data.

I'm working a lot in Japan at the moment, and they've got the problem of an ageing society. We've seen it in other markets as well, and other countries of course, but Japan's a little further up that curve and there's also this stigma about not wanting to be perceived as frail and elderly, not needing help as it were.

So if they have a respiratory problem and they need supplementary oxygen, they don't want to have the stigma of that visible cannula going into their nose because it looks like a medical device and they don’t look particularly attractive. These are people who care about their appearance. What if you could introduce an element of fashion, like sunglasses? So, like you mentioned earlier wearing glasses in the 1950s and 60s wasn't seen as cool, but today, Eyewear is seen as not only a corrective necessity but a fashion accessory. We can de-stigmatize a Cannular by making it more of a fashion statement and introduce materials in there that speak to that as well. Similarly, with things like hearing devices. Hearing aid manufacturers are scaling devices down to be smaller, smaller, smaller, to the point where you can hardly see them. Well, what if you went the other way and actually made it like an accessory made it a piece of ear jewelry? It's those kinds of insights which we’re also interested in exploring.

Chris:
Going back to plastics, does it ever become an issue using recycled materials in health care products?

Sean:
We are doing a lot of work at the moment on wearables around sleep, and not only for OSA (obstructive sleep apnea) sufferers where we need to have devices to keep a constant positive airway. These products blow air into your nose and keep your airways open to avoid a drop in oxygen through the night. Traditionally they looked a little like Pilots masks and wearing them wasn’t always comfortable. You got sweaty, maybe skin irritations, so people would take them off in the night or brush them off because they were so uncomfortable, which of course defeats the whole purpose. So we created one called Dream Wear, which is using the lightest possible combination of silicone that you can hardly feel touching it, and then minimizing the touch points while still providing a seal because you've got to get an air seal in there. We're moving beyond pure silicone, looking at new material technologies to make the fit even more comfortable.

Chris:
What is crucial for the success of a designer?

Sean:
A crucial aspect of being designer is getting as close to the action as you can. I encourage designers to embrace what we call 'radical empathy' – immersing themselves in the reality of user experiences. That's the way we think, 'get the designers in there, understand the context' and this is the way you build empathy with the user, with the patient, with the clinician. You've got to do that, you've got to get in and get your hands dirty. Otherwise, we're destined to design only beautiful concepts, have great coffee table books, amazing visions of the future. These things pay a role of course, but working in the field of Health I believe we need ensure our vision become reality and we ensure our designs have impact which results in driving better outcomes for patients and better experiences for them, and the clinical staff.