Posted September 21, 2008 by Lygeia Ricciardi
At last week’s Project HealthDesign Expo, Amy Tenderich of the blog DiabetesMine gave the keynote address. Amy is known in part for her April, 2007 open letter to Steve Jobs, in which she challenged the gurus of consumer product design to make medical and health management devices more livable.
After her talk I asked Amy whether she’d ever heard back directly from Steve Jobs or Apple. Nope. Perhaps he was too busy working on the iPhone. And it’s not as if there’s a lack of products out there that would benefit from better design (for example, could someone please move the alarm buttons in elevators out of reach of my three-year-old?!).
What are the main reasons for the gap between the (often) elegant design of consumer products like MP3-palyers and the (often) clunky designs of most medical products? A few possibilities:
- Market Alignment – As Amy pointed out in her talk, many medical devices are paid for by insurance companies, not directly by consumers. Payers significantly shape the market, and they are less likely to be concerned with design than with durability, reliability and such. Perhaps they haven’t realized that poor design can actually lessen the extent to which consumers use and benefit from medical devices.
- Regulatory Requirements—Most medical devices go through an extensive FDA clearance process. Again, the emphasis is on whether a device is reliable, not whether it’s cool.
- Limited Market Size – This point may be relevant for devices associated with rare conditions, but it shouldn’t impact the design of devices for widespread ones like diabetes (with more than 20 million in the US alone).
- Image—Colin Evans of Dossia raised this point during informal hallway conversation at the Expo. Consumer brands spend millions shaping an image—one that typically glorifies youth and health. Like it or not, the Apple iV-drip wouldn’t add a lot to Apple’s brand. But does that really matter? We don’t literally need Apple (or any of the well-known consumer brands) to fix all the design problems of the world. Why can’t great design come from a company that’s already making medical devices, and not subject to such image constraints?
If we agree that healthcare in the US has been relatively provider and system-centric, the lack of emphasis on patient needs in device design makes sense. If we are shifting (in part with the help of PHRs and related applications) to a system in which the patient truly is “at the center” – all of this may begin to change. Or will it? What do you think? Why aren’t “health” and “design” more often closely linked?
A few other recent blog posts inspired by the Project HealthDesign’s Expo:
DiabetesMine -- Five things I Learned About HealthDesign
Ted Eytan’s blog -- It's not the record, it's what you do with it
e-Care Management blog -- From PHRs to PHRSs
I think the answer as to who controls the connection between health and design depends on who pays.
Given the current labyrinth of the US system, the buyer is so far removed through so many layers from the user that user requirements (things that would encourage patients to use or do in accordance with their physician's recommended regimen) have nothing at all to do with cash flow.
If you'll follow the money that is certainly one way to bypass the current system. For example, a program that offers patients a way to save on out of pocket costs for visits to their remote specialist. Since remote visits are rarely if ever covered by insurance, the out of pocket nature connects the buyer to the point of service and cuts out all of the disinterested middlemen. This has resulted in an entirely new suite of tools for families of kids with type 1 diabetes in Texas, for example, within a program called diabetes housecall (http://diabeteshousecall.com). The service and technology component has been developed by my company while the participating endocrinologists are a rare breed that are willing to seek out new models of real-life care.
Posted by: Kevin McMahon | September 21, 2008 at 10:03 PM