Autoinjector technologies have come a long way over the years, and recent advancements are paving the way for an exciting new generation of devices that can be used for a variety of different therapies. Epinephrine autoinjectors are one of the most common iterations of the technology, but lately, device makers have been expanding the realm of possibility for autoinjector technologies, specifically through new devices that can communicate with patients and incorporate user feedback.
Of course with new technologies, comes new challenges. Device developers still struggle with ensuring dose accuracy, minimizing discomfort, and overcoming the fears and stigmas associated with autoinjector technologies. Dennis Boyle, a founding member of the award-winning design firm and innovation company IDEO, has been trying to take on many of these challenges while working with clients to develop the latest in medical and consumer healthcare products and technologies.
Boyle has worked as a design engineer, project leader, and business relationship leader for the company, and has contributed to more than 50 patents along the way. He has spent decades developing innovative products that are designed for sustainability and creativity, and just recently partnered with Eli Lilly to develop a new autoinjector that can actually take into account the specific needs and wants of individual patients.
Boyle spoke at the MD&M East conference in New York on June 13, during the session “Designing a More User-Friendly Autoinjector.” We picked Boyle's brain about the industry, and about his company’s latest autoinjector design and the impact it could have on patients.
MD+DI: For starters, can you talk a little about autoinjector technologies, and how they’re having an impact on drug delivery and patients who self administer medication?
Boyle: Autoinjector technologies are enabling patients, and in particular first-time patients, to inject themselves with medications with lower error rates and less anxiety. These devices minimize or eliminate interactions with needles, removing a significant barrier to adherence for many patients. Needles are safely retracted or otherwise protected after a single use, eliminating the dangers of accidental needle sticks or potential reusing needles. These prefilled devices, when used correctly, guarantee correct dosage of medication.
The simple, ready-to-use aspect of an autoinjector replaces the hassle and possible social stigma of dealing with needles and the vials of medications, including safe storage and disposal, as well as the required careful dose measurement. Autoinjectors aim to impact adherence by eliminating needle handling, ensuring dose accuracy, improving safety, and generally simplifying the injection process.
MD+DI: What are some of the biggest challenges you’ve faced when it comes to educating patients on using autoinjector technologies? Are there any legitimate concerns when it comes to ensuring dose accuracy, discomfort, or other complications?
Boyle: Autoinjectors are designed to simplify the process of injecting medications, and to minimize opportunities for error. It is important, before home use, to have a training session with patients using a demo device or actual device to ensure that the placement, stability, and holding of the autoinjector is in place for an adequate amount of time, and all are done as per instruction.
MD+DI: When it came time for your company to begin addressing some of these challenges, how important was it for you to take into account the needs and desires expressed by patients who use these devices, and how did you go about addressing that kind of feedback?
Boyle: Representing the needs and voice of patients was a critical and essential part of the design process for this autoinjector, and it is the bedrock foundation of the human-centered design process that we practice at IDEO. The design team gained empathy over the first few months of the process by visiting and observing numerous patients in all stages and throughout the journey of injection therapies, from beginning users to experienced users. The design team then synthesized the findings of this design research along with a series of observations to create design principles that would guide the ideation and conceptualization stage. These design principles included:
- Meeting people where they are (design for flexible uses and provide agnostic support).
- Deliver a comprehensive solution (providing the elements that work together to create a consistent experience, nothing more).
- Minimize barriers (invite people into a simple and unhindered experience).
- Put people in control (give control where appropriate, and choice and support where desired).
- Practice good bedside manners (enable a personal, optimistic, and calm experience).
- Safeguard the valuables (provide protection where it counts).
A series of user interaction test prototypes were created over a six-month period using the output of this ideation phase. These non-medication-bearing prototypes were then taken back into the field and shown to and carefully tested with patients. Over a one-year period, this process was repeated to allow a detailed final design concept that we settled upon.
MD+DI: How challenging was it for you to develop this autoinjector technology that can address patient pain points without necessarily compromising on efficiency and quality of care?
Boyle: The autoinjector platform that we helped Eli Lilly develop was a considerable investment. Lilly had the vision and fortitude to allow IDEO and its other partners to stay the course over several years of careful conceptual and production design.
MD+DI: Do you think there might be ways to continue to improve on the design as you incorporate user feedback and work to enhance the underlying technology so that future iterations of autoinjector devices can become even more successful?
Boyle: There are undoubtedly ways to make the autoinjection system that we have developed for Eli Lilly simpler and at a lower cost. There is also a big frontier ahead of the industry in the realm of digital transformation. Through digitally connecting the injectors to various products and platforms available to the patient and the patient’s care team, to give an example, we might be able to help improve adherence and combine single therapy information with other therapies and patient lifestyle information to improve care and health outcomes overall.
MD+DI: In a similar vein, as autoinjector technologies continue to improve, what kind of an impact do you think they could have on healthcare, and do you think the technology will become more ubiquitous as a reliable vehicle for drug delivery?
Boyle: Given reductions in cost and digital connectivity, autoinjectors might well make inroads into areas that are currently owned by classes of pre-filled injection systems based on daily or weekly injections. In time, properly designed autoinjectors might even find a use in patient-managed variable dosage systems like insulin pens.
MD+DI: Finally, in a broad sense, what do you think is the most important aspect when it comes to developing autoinjector technologies that can be more user-friendly? In other words, what do you think is the key to making these devices more successful so that they can begin to improve patient care by making drug delivery easier on patients?
Boyle: Careful patient research is essential for running successful autoinjector design programs. This research establishes a preliminary understanding of the needs of a wide variety of patients from young to old, skilled to unskilled, those paying attention to those that are distracted, those that are calm to those that are anxious, etc. in order to address the needs of as broad a patient base as possible.
Then, using the design thinking cycle, the design team goes back to this wide base of patient users and tests a variety of concepts to create a complete conceptual design. Finally, through taking this conceptual design into the field and thoroughly testing it with users, our team can ascertain that its design intent has been fulfilled and that its operation is reliable and safe under all anticipated conditions.