1. 1. CONFIDENTIAL 10 ways innovation, design, demographics and global trends will impact the future of healthcare in 10 years
2. 2. CONFIDENTIAL bill evans president bridge design, inc Design Research & Strategy | User Experience | Industrial Design | Product Engineering
3. 3. CONFIDENTIAL 3 www.designinvitro.com
4. 4. CONFIDENTIAL 4 designer heal thyself taking participant observation to the max
5. 5. CONFIDENTIAL 5 the spirit of my observations: the critical and the kind
6. 6. CONFIDENTIAL ten years is a long short time
7. 7. CONFIDENTIAL 7 2005 2015 2025 ? ?
8. 8. CONFIDENTIAL 8 2005 2015 2025 ? ? CONVERGED
9. 9. CONFIDENTIAL 9 average medtech VC backed startup takes 8 -10 years to exit (and costs $60M-$100M to get there)
10. 10. CONFIDENTIAL 1 demographics
11. 11. CONFIDENTIAL 11 demographics global health/ wealth data source: gapminder.org
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13. 13. CONFIDENTIAL 2 globalization
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15. 15. CONFIDENTIAL 15 3rd world skipped wireline for cell why copy the western healthcare system? (or evenremotely be able to afford it)
16. 16. CONFIDENTIAL 16 urban infrastructure in china
17. 17. CONFIDENTIAL 17 rural infrastructure in china
18. 18. CONFIDENTIAL 18 growth of low-resource environment products designed and made in these environments aravind clinics and low cost IOLs GE and others investment in regional design centers different approach to business models behind products (pay- per-use, razor-razor blade, OPEN SOURCE generic platforms not proprietary) shameless use of consumer technology to drive costs down
19. 19. CONFIDENTIAL 3 cost pressures
20. 20. CONFIDENTIAL 20 Sources: World Bank, WHO, PwC analysis (projected from 2011 data)
21. 21. CONFIDENTIAL 21 elephant in the room per-capita cost is our industry taking this into account enough?
22. 22. CONFIDENTIAL 22 how do we deal with the fact that cost is affected by issues of efficiency across the continuum of care and most of us only have hold of a small part of it?
23. 23. CONFIDENTIAL 23 In 10 years: emphasis will shift from fee-for-service to managed care to better integrate care across the continuum reducing redundancy and improving outcomes
24. 24. CONFIDENTIAL 24 What will help in the next decade?
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26. 26. CONFIDENTIAL 26 compliance will be redefined
27. 27. CONFIDENTIAL 27 accepting the way people behave & pushing the boulder with them Image right from: Providence St. Joseph's Hospital
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29. 29. CONFIDENTIAL 29 EHRs (and all the other acronyms for HIMS): move past historic emphasis (dinosaur systems) to assisting action that improves outcomes a clinical emphasis interoperable (HIE) two-way smart products acting on Dx data combined with specific HER use technology for expert data analysis to assist people at POC across the continuum of care
30. 30. CONFIDENTIAL 4 Wireless & mHealth
31. 31. CONFIDENTIAL 31 Note: 1 Billion smart phones!
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33. 33. CONFIDENTIAL 33 while 2014 may have been a peak year for digital health at CES, the discussions that took place at the event this year seemed much more grounded MobiHealthNews January 2015
34. 34. CONFIDENTIAL 34 by 2020 160M Americans will be monitored & treated remotely for at least 1 chronic condition
35. 35. CONFIDENTIAL 35 wireless solutions enabling consumers to take charge of their health shift from cobbled together elements to seamless integration with no need for patient interaction getting up to the cloud anyhow shifting demographic means accelerating adoption
36. 36. CONFIDENTIAL 36 android inside. . . and the Internet of things
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38. 38. CONFIDENTIAL 38 all this data! what makes it actionable?
39. 39. CONFIDENTIAL 39 so much data will challenge who makes medical decisions And how medical decisions get defined by regulation
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42. 42. CONFIDENTIAL 5 augmented reality
43. 43. CONFIDENTIAL 43 superdimension virtual broncoscope guidance
44. 44. CONFIDENTIAL 44 virtual colonoscopy
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46. 46. CONFIDENTIAL 46 GP Exam room in a decade everything is connected and inputs directly tablets use AR to show and explain issues to patients maybe even using real time patient data/images otoscope, ophthalmoscope, etc. feeds directly speech of MD transcribed during session
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49. 49. CONFIDENTIAL 6 design trends
50. 50. CONFIDENTIAL 50 active + independent
51. 51. CONFIDENTIAL 51 patient centric
52. 52. CONFIDENTIAL 52 home care
53. 53. CONFIDENTIAL 53 is not
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57. 57. CONFIDENTIAL 57 technology tempered by human needs
58. 58. CONFIDENTIAL 7 culturing innovation
59. 59. CONFIDENTIAL design & design thinking = buzz-words what does this really mean for the future?
60. 60. CONFIDENTIAL our customers will demand it why cant the products I use in my job be as easy to use as my smart phone?
61. 61. CONFIDENTIAL the waking up of brand values and its impact at every touch point
62. 62. innovation will becomepartofa companysDNA this will bea challengewithour industryslengthyproduct developmenttimeandlife-cycles
63. 63. wealso needtranslators tocarryinnovative sparksto majestic fireplaces
64. 64. CONFIDENTIAL designand designthinking the next10 yearsfor devicecompanies: clinicalefficacywillruleevidence-basedmedicine usabilityandcustomerappealwillset companiesapart wherethere ischoiceor adoptiondifficulty
65. 65. CONFIDENTIAL user-centered design = competitive heat
66. 66. CONFIDENTIAL user-centered design Alair an interventional procedure hand controller
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68. 68. CONFIDENTIAL we observed procedures and identified pain points in the current process
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70. 70. CONFIDENTIAL 70 Current Equipment Moving to segment (5 treat zones) Sub Total 06:18 45% Advancing Cath to distal 5 sucessful Sub Total 01:18 9% Treat 21 times Sub Total 03:28 25% step through pulling basket proximal to move to new treatment zoneSub Total 02:40 19% Other pause Sub Total 00:23 3% Grand Total 14:07 Estimated time to do one treatment 0:50:00 May not be true for this particular MD but.. Optimized scenario with stepping through much faster Moving to segment (5 treat zones) Sub Total 06:18 56% Advancing Cath to distal 5 sucessful Sub Total 00:39 6% Treat 21 times Sub Total 03:28 31% step through pulling basket proximal to move to new treatment zoneSub Total 00:32 5% Other pause Sub Total 00:23 3% Grand Total 11:20 Reduction from existing 02:47 20% Estimated time to do one treatment 40 Goal is 20 minutes (reduced from current 50 minutes) Minimum if you just moved and treated (impossible of course) Moving to segment (5 treat zones) Sub Total 06:18 62% Treat 21 times Sub Total 03:28 34% Other pause Sub Total 00:23 4% Grand Total 10:09 Reduction from existing 03:58 28% Estimated time to do one treatment 36 Goal is 20 minutes (reduced from current 50 minutes) half from existing to make advancing faster (but very hard to do it faster as it requires skill) 16 times with each step reduced to just 2 seconds (requires "automation")
71. 71. CONFIDENTIAL 71 0:00:000:14:240:28:480:43:120:57:361:12:00 0 40 80 120 160 Number of activations Time(hour:min:sec) 0 25 50 75 100 125 150 175 200 225 250 # 1 # 1 Improved # 2 # 2 Improved # 3 # 3 Improved Time(sec) Activation Time Deployment Suction Communication Navigation Patient Management Adjacent Non Adjacent Other Issues
72. 72. CONFIDENTIAL we analyzed modes of use and translated them into ergonomic handle designs
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77. 77. CONFIDENTIAL 8 personalized medicine
78. 78. CONFIDENTIAL 78 predicting the inevitable has been around for 60 years
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81. 81. CONFIDENTIAL 81 The low cost genome will affect personal choices about behavior how care is delivered how insurers/payers react healthcares view of compliance
82. 82. CONFIDENTIAL 9 combo devices
83. 83. CONFIDENTIAL 83 exploring need for new routes and new features
84. 84. CONFIDENTIAL 84 all the ways in and increasingly complex locations the time domain removing patient from as many compliance responsibilities as possible cloud connectivity Dx to Rx closed loop pushing point of care to lowest cost and skill
85. 85. CONFIDENTIAL 10 sustainability
86. 86. CONFIDENTIAL 86 why even consider sustainability? patients reporting more concerns healthcare professionals frustrated at daily waste pressure for change building at major users alegent hospitals VP of sustainability kaisers green scorecard legislation
87. 87. CONFIDENTIAL 87 what sustainability is NOT about using corn plastic instead of other polymers making everything reusable putting it above safety, efficacy and cost making products cost more making products less usable warm and fuzzies it will make good business sense in the next decade
88. 88. CONFIDENTIAL 88 what well see: lessmaterial in disposables different break points on disposable/reusable portions less disposables a rethink of razor/razor blade models more use of pay as you use technology to maintain margins but lower cost at POC The Minnetronix Cognita System is a remote medical device monitoring and intelligence system that gathers data from device fleets and translates this information into actionable business intelligence &
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91. 91. CONFIDENTIAL Thank You bill@bridgedesign.com WHITE PAPER: 7 Pitfalls to Avoid in mHealth Web or App Design http://goo.gl/yLWhIJ Bill Evans, president at Bridge Design, Inc Industrial Design | User Interface | Design Research | Mechanical Engineering