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Glucose Monitor First to Use E-Ink

Abbott Freestyle Optium Neo
The Abbott Freestyle Optium Neo is one of several diabetes care products from the company with a consumer-technology-inspired design. (Image Courtesy of Abbott)

Imagine trying to design a blood glucose monitor that has consumer-tech-inspired features such as a touchscreen user interface and high-contrast display--but also an extremely low price point, low enough that the monitor's cost is similar to a smartphone connector dock rather than an actual smartphone. And the monitor needed to intuitively convey to an array of users--people speaking various languages--how much insulin they should take.

That is exactly what Abbott's diabetes care business unit (Alameda, CA), collaborating with the design firm Bridge Design, was able to accomplish with its FreeStyle Optium Neo blood glucose and ketone monitoring system.

The device, which is currently available in Europe but not the United States, is noteworthy in that it is the first glucose meter with an e-ink display. E-ink, short for electrophoretic ink, has become a household term thanks to e-reader devices such as the Kindle and the Nook, which have displays mimicking the appearance of the printed page.

"We really wanted high contrast and legibility, and wanted to go with e-ink, which gives you a beautiful screen display," says Diana Greenberg, director of user experience design and design research at Bridge Design.

The designers were able to give the device touchscreen functionality by incorporating tactile switches directly underneath the flexible screen. "What's amazing is that the screen is half a millimeter thick and when you push it, you are flexing right through it. Even though it is a limited array, you don't perceive the user interface to be limited--you just perceive a touch screen UI," says Bill Evans, president of Bridge Design. "As far as we know, it's the first case where an e-ink display with buttons underneath has replaced a whole touch screen."

The winners of the Medical Design Excellence Awards will be announced in a ceremony held on June 11 in conjunction with MD&M East, June 9-12, 2014 in New York City.

The use of "subterranean" buttons underneath the e-ink screen provide tactile feedback when pressed, giving the users--who could possibly have compromised eyesight from diabetes--a confirmation that an on-screen selection has been made.

 "Abbott is committed to finding innovative ways to make glucose monitoring and insulin therapy easier for people living with diabetes," says Mark Jesser, senior director of innovation and commercialization, Abbott, Diabetes Care.  "Freestyle Optium Neo is one of several new products that Abbott has introduced in recent years that leverages designs and technologies from consumer electronics to make better medical devices."

The plastic e-ink display had the advantages of offering drop resistance as well as high contrast and readability, while also offering a better battery life than conventional LCDs. "The e-ink technology only consumes power when there is a state change--when the screen is refreshing; it uses no power when it is in a state," says Andy Santos-Johnson, user interface designer at Bridge Design.

Integrating buttons underneath the screen proved to be a considerable challenge when designing the icons that would be on its screen. Approximately half of the available segments were used up with the on-screen characters alone. "We spent months doing all kinds of clever rearranging to make the whole thing work," Greenberg says.

That rearranging proved to be complicated because of the functionality packed into the device and the need to make the device simple to use for both patients and clinicians. Freestyle Optium Neo, which is programmed by a clinician, is designed to help people with diabetes remember, calculate, and log insulin doses. The device alerts users when their blood glucose is trending too high or low. "The settings are complex," Greenberg observes. "There is the patient-use part, and there is the part that the clinician needs to set up." Although some of the simpler protocols such as fixed doses can be programmed on the device itself, more complex dosing instructions are programmed using a companion app on a PC.

To simplify the user's experience, the designers sought to keep the user interface "flat," making key functionality accessible without tunneling through multiple menus. The designers refined the design based on thorough in-field testing to confirm that a range of users--some with poor vision--could intuitively use the device.

The e-ink display with touch screen functionality, although challenging to create, proved to be ideal for the application.  

Bridge Design has been asking its clients to consider e-ink for about a decade because of its superior contrast and low energy. "This is the first product we've been involved in that has made it to market," says Bill Evans, president of Bridge Design.  "It can be challenging for large companies to adopt new technologies, requiring additional effort to test and incorporate these innovations into their global manufacturing processes. We feel very fortunate to have been able to assist Abbott's Innovation team on several projects over the years because this team continues to demonstrate a passion for meeting this challenge and bringing breakthrough products to market."

The e-ink touchscreen display could end up being used more extensively in the medical device space--especially for drug-delivery applications, Evans says. "Drug-delivery device makers are very interested in making their products help users adhere to medication routines. We've already begun to see connected inhalers and pill bottles. I can imagine future connected devices having these kind of e-ink screens," Evans notes. "With the ability to inexpensively display large high-contrast icons or messages and allow user simple interaction they are well poised for these kinds of needs."

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

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