EXCLUSIVE: Valuing user perspectives in medtech development
Dr Chris Warwick, Senior Consultant at Health Tech Enterprise, and Joop Tanis, Director of MedTech Consulting for Health Tech Enterprise, share why it is crucial to get user and clinical perspectives when designing medical technology solutions to ensure their success.
In order to develop usable, efficient medical technology to help lessen the ever-expanding pressures upon our health service, it is crucial that innovators utilise all opportunities available to include user perspectives within the design process.
Technological solutions designed with the end-user in mind are more effective at improving overall patient care. While not a silver bullet for the pressures facing the NHS, investigating and including the needs of clinicians and patients provides developers of new medtech and digital technology solutions with an advantage and increased insight into how best a device might be used to save time and improve the clinical outcome and overall patient experience.
Several perspectives should be considered when developing new technologies. As a first step, the main user should be identified and the question of whether this will be a clinician or a patient, or both, must be answered. Inventors and developers can then gain perspectives from all user groups and consider their needs before progressing with the design process.
For example, during the development of a digital health solution, innovators need to recognise that a clinician will want easy access to the data this solution collects, which is likely to be a different priority to what the patient will want to prioritise from their user experience. But both inputs are equally important to ensuring the technology gets used and delivers the impact, as intended. Device accessibility and ergonomics may need to be tailored to one user group, while the data and analytics recorded might to be presented in a way that is appropriate for another user group.
When developing new technologies for children and young adults, it is perhaps even more essential to take this into account and consider how the specific needs of these distinct user groups may differ. All too often, when designing for this target group, developers have relied on simply scaling down versions of the technology originally designed for adults. As many paediatricians will attest to, the issue with this approach is that children are not simply a scaled down version of adults, and that they are physiologically, emotionally, and socially so different to adults that not designing with them in mind will create an ineffective solution, or one that will not be used.
For example, a new technology that is focused on voice recognition for usability can be easily programmed for adults. But when considering a child patient, whose voice is likely to deepen, change, and break over time, additional layers of adaptability to the user, and perhaps by the patient, are required.
Medical technology solutions for children, particularly those designed for long-term usage, need to be adaptable to the patient as the user grows and changes. All this needs to be considered at the start of the device development process, because retrofitting this capability may not be feasible and is more challenging than accounting for it to begin with.
So, access to both of these user groups is fundamental if a new technology is to succeed and meet the standard required for adoption within our health service. Over the last two decades, we at Health Tech Enterprise, have nurtured and developed valuable relationships within the NHS, and our experience of working with one of the world’s leading health services and regulatory systems has enabled us to provide access to both of these areas, allowing developers to get the insight they need.
Often, a medtech developer will have a personal reason for designing a device, and its usage is intended to focus on a specific clinical area. We join the process by allowing a wider perspective to be considered and, together, facilitate a demand led approach for engaging the developer in new R&D projects that are both patient focussed and collaborative in nature.
One way that Cambridge Children’s Hospital is addressing this issue is through the Cambridge Children’s network, an initiative similar to GenerationR, which links healthcare services to a national network of Young People’s Advisory Group’s (YPAGs) based across the UK. GenerationR YPAGs are predominantly made up of 10 to 15 members aged between 8 and 19, and their views feed into the design and delivery of medtech for children and young people via the hospitals at which they might receive treatment. The input of these young people and the access to their perspective in the design process has shaped crucial changes to newly developed technologies within three user groups: users, buyers, and beneficiaries.
Gaining effective user input doesn’t come without its challenges. Many times, innovators understand the technology they are trying to develop and how it will solve a problem, but fail to dig deeper into understanding patients’ wider unmet needs – which is why user insight is so vital at the start of the design journey.
Integrating new technologies into patient groups can uncover unforeseen problems; for example, an elderly user group might struggle with new technology adoption, which can cause issues should the technology require self-monitoring or patient input. It’s also notable that some user groups may have preconceptions about certain technologies based on their past experiences, and, if such a user group is strongly motivated to give feedback, it may not represent all of the users, or indeed the development of this technology since their last experience. This challenge, although not completely absent, is perhaps less likely to be encountered within a younger demographic.
Those designing new technologies shouldn’t underestimate the value of routine. Technologies that disrupt daily routines, especially those that are self-regulated and for which the patient has responsibility, tend to fail unless they can be easily integrated within the day-to-day. It’s crucial for developers to remember that self-management can’t be imposed on a patient, so building a technology around a patient’s lifestyle helps to remove barriers to adoption. Good examples that consider integration with daily routines are the Dexcom and Freestyle Libre self-monitoring systems for Type 1 diabetes patients, which both use mobile applications.
To address some of these challenges, a collaborative design process can serve to unify clinicians, patients, engineers and manufacturers to develop and evaluate devices. This process can be summarised in three stages: firstly, outlining a concept to match users’ needs; secondly, developing the device, engaging with user groups throughout; and thirdly, the evaluation stage, in which actual users provide feedback to validate that the innovation meets the original users’ need. This collaborative way of working not only ensures the medical device is safe and accessible, but also effective and easy to use.
Great examples of getting this process right with younger user groups can be seen through Open Bionics, a UK-based company that uses an open-source approach to develop 3D printed bionic limbs for patients with below elbow limb differences. Following insight from NHS patients that, due to both the stigma and the cumbersome nature of adapting to a prosthetic, children were actually more likely to adapt to life without their limb than they were to adapt to a prosthetic.
The company worked with the NHS to improve the experience for patients, and to create a new bionic product that is inspirational for users. In 2015, the company even secured a licensing deal with Disney to create superhero-themed prosthetics, which further encouraged adoption by children.
There are ever-growing opportunities for digital solutions to streamline and improve the patient journey in areas such as asthma, diabetes, and mental health, provided the correct level of consulting with the main user base has occurred. If these solutions are to become integrated within a younger demographic, developers need to consider how to make actively managing their condition more engaging which presents an opportunity to explore gamification as a solution.
In 2021, the World Health Organization confirmed that the use of video games could prove useful in producing positive healthcare outcomes. There are opportunities for this to be utilised within areas, such as physiotherapy and rehabilitation, using VR simulators. Interestingly, this can also be used when training clinicians in specific techniques and device usage.
Gaming can act as a powerful motivator for younger patients, and, through gamifying exercises, the end-to-end user experience will be improved. However, it is notable that a game cannot simply be designed hastily with the hope of positive outcomes and, as such, will require extensive research and user insight before the development process begins.
So, the benefits of gathering insights from varying user groups, to obtain the necessary intelligence required to make a new innovation serve its purpose and be successful, are clear.
This is an area that the team at Health Tech Enterprise know well, delivering end-to-end support for hundreds of projects and products. With over 18 years of medical innovation experience, which has contributed to the acceleration of crucially needed innovations to improve patient care, reduce hospital wait times and save costs, they can help make your product development journey successful. To find out more, please visit: https://www.healthtechenterprise.co.uk