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Have You Considered the Potential of Deep Design?

Careful observation of clinical processes could reveal some design opportunities.

Kathleen Harder, PhD, Director of the Center for Design in Health at the University of Minnesota

How much time do medical product designers spend on understanding clinical processes?

Perhaps not enough.

Product designers “often don’t see their devices as part of a system,” says Kathleen Harder, PhD, director of the Center for Design in Health at the University of Minnesota. But there can be adverse ripple effects with devices, she warns.

Harder also serves as director of graduate studies in the Human Factors Program at University of Minnesota. For more than 15 years, she has worked with clinicians to test ideas that guide users toward desired behaviors in healthcare delivery. With a background as an experimental psychologist, she has studied ways to shape human behavior in order to achieve the desired outcome. At the upcoming MD&M Minneapolis conference on November 9, Harder will share those insights with medical product designers and engineers in “Deep Design: Using Technology to Improve Clinical Work Processes.”

To help product engineers understand what’s needed for “deep design,” (i.e., human-centered design at a very granular level), Harder encourages medical device companies “to send their engineers out into the field before they start developing a product so they can see what is needed. They can then get the lay of the land and the complete context” of how their products will be used. “Nothing happens in a vacuum,” she adds.

“A device needs to enhance, not hinder a system,” continues Harder.  “Even though we can’t control all the variables in the real world, we can design to address these variables.”

Once in the hospital or other clinical environment, engineers should “immerse themselves in the healthcare process and observe,” advises Harder. “Don’t go in with preconceived notions of a need or a form—otherwise there’s the danger that you’ll focus on that one thing, which could cause you to miss other pieces that would take you in a more productive direction. Be extremely alert, and soak up details like a sponge.

“You cannot do this from a desk or looking at documentation,” she adds.

Harder says that it is important “to see the ways people succumb to pitfalls because of poorly designed processes—or a lack of process.” Being immersed in healthcare environments allows one to see behavior patterns as well as talk with frontline workers. “They may not know how to solve problems, but they have the best insights about their work,” she says.

Engineers should also “gather information from all roles and talk to everyone involved, even the cleaning staff turning over an operating room,” she says.

Harder says that while she herself is immersed, she “tests ideas and solutions strategically, to foster their buy-in. And then I go away and put my creative hat on.”

Harder asks a number of tough questions: “How can we design to improve human performance? How can we design to shape behavior to achieve the outcomes we want? How can we design to capture and sustain attention at critical points in the clinical process? How can we design so that seamless, effective checks are in place?”

As designers focus on the details of the process through “deep design” or design at the granular or micro level, they also need to keep an eye on the “macro level” and remain mindful of the overall goal, she adds.

For more insights and some anecdotes on deep design, be sure to attend Harder’s presentation on November 9. Click here to register.


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This is true, and people have been saying it throughout my 50 years in medical device engineering. Apparently we are slow learners. How can you effectively design a device for which you have little to no knowledge of how it is actually to be used, and the environment of that use. Design validation is supposed to address this (did you meet the user’s needs) but it obviously too often does not. The ongoing issue of the un-usability of Electron Medical Records is another example.