The next billion screenings: Bringing specialist care closer to patients
Redesigning medical devices to increase access to care
Designing for healthcare means understanding incentive structures across payers, providers, and patients. As medical device companies develop their next generation products, there’s a growing market for these devices as screenings and diagnostics tied to quality metrics move out of specialist environments. Healthcare quality programs such as HEDIS and Medicare Star Ratings use quality metrics to reward providers and health plans for improving preventive care and population health outcomes. As covered in our recent panel on early detection, this transition is meaningful to entities across the health system: providers can give better care, payers can advance preventative health goals, and patients no longer have to manage appointments with multiple providers.
For medical device manufacturers, this is a major opportunity to expand their market outside of specialist care. Acting on this opportunity is not as simple as placing existing devices into Primary Care Provider (PCP) offices and pharmacies. Doing so leads to low adoption and the eventual abandonment of deployments and pilots. Current devices are purpose built for a specialists’ practice, where they live in a dedicated room, are used by trained technicians, and are part of workflows very different from a primary care setting. Put simply, they are not designed for the usability challenges and site operations needed to address this new market.
A great example of this challenge are fundus cameras (devices that photograph the back of a patient’s eye) and diabetic retinopathy screenings. These cameras are well established in ophthalmological care, but adoption into PCP settings has been slow. While diabetic patients receive routine care from their PCP, they often fail to schedule follow up screenings with an ophthalmologist. If PCPs installed fundus cameras alongside a tele-retinal or algorithm based grading service, they could prevent blindness and close HEDIS/Star care gaps. However, existing fundus cameras don’t fit neatly into PCP offices. They’re finicky to use, don’t integrate easily with electronic health records (EHRs), and sites experience high staff turnover, which all prevents meaningful adoption.
From specialist tools to everyday care
Retinal imagery is just one example of where this shift is happening. From mammography to phlebotomy, many other procedures run into these same challenges when moved into more general environments. Each is an opportunity to redesign health technology for a new, larger market, especially as algorithms make it possible to screen or diagnose at the point of capture.
Solving these challenges takes more than deploying a larger sales team. It requires identifying customer and patient pain points, then using technology and design to solve them. At Smart Design, we have a long history pioneering human-centered design, with deep expertise covering hardware, software, design, and product.
In our work with Hyperfine, we transformed the traditional MRI, shifting it from a fixed, room-bound system to a portable, point-of-care device. This allows for the device to be sold and used in new clinical settings. Developing usable operator touch points for these new environments was critical to understand in the design process, and has led to a successful launch of the first generation device on market.
In practice, we’ve seen a few common challenges as organizations innovate on existing screening and diagnostic devices
Combining acquired companies and products into a meaningful offering
Combining EHR integration, patient scheduling, the device screening, on-device image processing, and return of results into a single offering is a compelling vision. However, acquiring separate companies and merging their products often falls short. This approach can lead to overly complex workflows where clinicians have to access several systems to complete a screening, introducing too much friction for a product to be realistically adopted.
To identify opportunities for next-generation investments, take a portfolio-level view of your products and map them against the real-world steps of your customer’s workflow. These steps will spotlight the key improvements that need to be made. With those areas identified, you can meaningfully redesign your product, focused on changes the market needs.
Alongside workflow mapping, we can work through the technical, product, and design challenges to make this vision a reality.
Preventing usability issues for patients and device operators
Many quality metrics depend on patients returning for the same screening every year. If a procedure is difficult, intimidating, expensive, or painful, patients may opt out of next year’s visit. If a device is hard to use with patients, appointment times will drag, causing sites to stop using the device over time.
Whether it’s designing ergonomic affordances that fit across a range of bodies, or developing an algorithm that lets a technician know when a patient isn’t positioned correctly, there’s a lot of room to cut both patient anxiety and appointment length. Designers are uniquely skilled at finding these opportunities and proposing solutions that keep a product aligned to overall business objectives.
Reducing time to result with algorithms
The vision for AI diagnostics is simple: take a reading, run an algorithm, deliver an immediate result. The path to a product is not. Just deciding where the algorithm runs (on device or on the cloud) holds a range of product implications across hardware and software. Finding the right answer relies on understanding your target customers.
There’s a growing number of algorithm providers for any given screening or diagnostic, and choosing one is a major investment. Not only is there the need to validate performance on your specific device, but you’ll need to confirm its output is actionable and understandable. Not all algorithms return results in the same way. Often, an algorithm-based result is presented in a way that doesn’t map neatly to clinical guidelines, and you’ll need to rely on operator training to interpret results.
Choosing whether or not to surface that result on device is another critical decision. While compelling from a UX perspective, presenting PHI or diagnosis directly on a medical device’s interface carries risk and regulatory implications. Getting this right has less to do with algorithm performance, and more to do with understanding the product’s intended use and users. We can help think through specific customer needs, and design workflows that safely and effectively return immediate results.
How we can help your organization
Advancing healthcare and patient outcomes is something we’re deeply passionate about. If your team is working through one of these problems, we’d welcome the conversation.