Touching Diabetics' Lives through Consumer-Inspired Technology

The FreeStyle InsuLinx Blood Glucose Monitoring System from Abbott Diabetes Care (Alameda, CA) is a touchscreen device that helps determine optimal insulin doses. Chosen as a finalist for this year's Medical Design Excellence Awards (MDEA), the system is the only touchscreen meter that tracks insulin doses and glucose readings together. Users receive customized suggestions on their meter about how much insulin to take each day. This makes choosing the right dose easier, and supports tighter glycemic control--a critical health goal for people living with diabetes.

"What quickly emerged from our early [development efforts] was the idea that the product should look like a piece of consumer electronics rather than a medical device," says Bill Evans, president at Bridge Design (San Francisco, CA). 

Creating a device that was consumer-like had two key advantages: it helps optimize usability of the product, and it limits the potential embarrassment people with diabetes might feel when using the device in public.

Invention within Constraints

Achieving this consumer-inspired design goal, however, was a major challenge. The blood-glucose monitor market is based on the razor/razorblade business model: the devices are given away for free, and the manufacturer makes money by selling test strips. "Early on in the project, we thought the very low cost-of-goods target would mandate a device similar to other meters on the market," says Diana Greenberg, director of user experience at Bridge Design.

"But in early user testing, we included a touchscreen among our concept models and it consistently outshone the other designs for usability and patient preference." Greenberg adds. Abbott reviewed the results and agreed with Bridge: a touchscreen was the key to making the device feel more like a consumer product and different from other meters. It would push the boundaries of the cost target for the product, but was worth the effort to pursue.

"Bridge Design did a great job helping Abbott explore a range of options and uncover the touchscreen as a key feature," says Mark Jesser, senior director of innovation and commercialization at Abbott Diabetes Care. "Their understanding of diabetes and the medical device space is incredibly deep. Understanding how patients and healthcare professionals use medical devices is at the core of their value proposition. They really delivered for us on the InsuLinx project."

With a low-cost touchscreen as the driving design element, the team spent many months finding a way to make it work. "The system we worked out was a black-and-white touchscreen with a minimal number of touch zones, at a limit set by the engineers to stay within budget. The touch zones were in fixed positions, so it took a lot of interaction design to figure out where those zones should be and how the screen navigation would work."

Wrangling Complexity

The idea behind FreeStyle InsuLinx was to offer the functionality of an insulin pump to a broader patient population. Bridge and Abbott collaborated to ensure the interface would be simple enough for a wide variety of patients. "Insulin pumps have great insulin tracking and calculation features," Jesser says, "But they cost thousands of dollars and include hours of one-on-one training with diabetes educators. InsuLinx needed to cost a fraction of that amount and we couldn't remove too much functionality, or it wouldn't be helpful to patients. It needed to be easy enough that patients could take it out of the box and start using it."

"What made it super challenging to develop is that many people who could benefit from using InsuLinx aren't [necessarily] excited about having to learn how to use a device that is different from a basic glucose meter," Greenberg says. "Often, people are overwhelmed by having to manage so many things about their disease, and a new device feels like one more thing they need to learn. The real challenge is to make it something they are going to welcome as something that will make their life easier. And it needs to be something that their clinicians will recognize too, because they have a lot to do with who ends up using which device. If you have a nurse who doesn't think this is something that will really help you, she is not going to want to set it up for you."

Bridge Design sought to design the device to meet the needs of clinicians as well as patients. User testing revealed that a number of clinicians expressed reservations about a device with a smartphone-inspired user interface. "When we were doing our interviews, clinicians would often say: 'I don't know if my patients can handle this. Then we tested a prototype on patients and they understood how to use it right away," Evans says. "We also had patients who would say 'I am not very technical'; then they'd try out the device and just ace it."

Regardless of the reservations of some clinicians, users firmly gravitated towards the consumer-inspired design. "We had a broad age range of people expecting touchscreens," Greenberg says. "With diligent, user-vetted editing to avoid complex screens and unnecessary options, we created an interface that was easy to understand. The touchscreen made it even easier to use."

Benefits Meant to Last

Another challenge for developers of medical devices is to make the design durable. "The consumer lifecycle is a year for some products," Evans observes. "This product might have a design life of many more years. What this means for designers is that we have to really drill down and get to the essence of what makes something usable and focus on that, rather than on using the fastest processor or today's trendy look. You try to get to what really makes it simpler to use. We have to deal with a consumer whose expectations of usability are built up by the world around them, not just by medical devices" Evans says.

"InsuLinx has helped Abbott Diabetes Care provide a new level of support to the millions of people that use our glucose monitoring devices around the world," says Jesser. "We understand our devices help with only one part of the day-to-day challenges people living with diabetes face, but anything that makes that experience easier and supports longer, healthier lives is the core mission for our innovation work."

Brian Buntz is the editor-in-chief of MPMN. Follow him on Twitter at @brian_buntz.