Letter to the Editor

Originally Published MDDI March 2003

NEWSTRENDS

Dear Editor:

I was reading the article entitled "Applying Universal Design to Medical Devices" by Stephen B. Wilcox in the January 2003 issue of MD&DI and wanted to ask a question about one paragraph. Dr. Wilcox states the following in the second paragraph:

"Patients and medical professionals could not be more different. Medical professionals are less likely than the general population to suffer from various disabilities, and are more likely to be above average in the capabilities required to operate medical devices. In contrast, users of home-healthcare devices may suffer from chronic diseases, or experience dexterity or mobility problems; visual, auditory, or other perceptual deficits; or even cognitive disabilities." 

My question is: What authoritative references can be provided to support this supposition? Are we to suppose that healthcare providers do not suffer from chronic disease; experience dexterity or mobility problems; or have visual, auditory, perceptual, or even cognitive disabilities? 
My experience of 25 years in healthcare and medical device evaluation indicates they most assuredly do. So, is the intent to say that design for home-care patient user versus healthcare professional user should differ because it is OK for the healthcare professional users to "screw up" because they can be expected to do so less often? 

How about: Potential device-design-precipitated user errors that can be foreseen as a result of these limitations should be designed out of all devices, regardless of the expected area of use or basic user type.

Gary Harding
Director, Technical Services
Greener Pastures LLC
Durango, CO

The author replies:

I was evidently not adequately clear in my article. I, by no means, meant to imply that medical device designers should not consider the limitations of medical professionals, and, in general, apply the concepts of universal design to in-hospital products. Of course, medical professionals can suffer from dexterity problems, poor vision, etc. My point, though, was that designing for patients brings such issues to the fore much more dramatically than designing for professionals. Yes, some surgeons may have imperfect vision, but that is a whole order of magnitude different from, say, diabetic patients, who often suffer from visual deficits because of their disease. Likewise, it is prudent for the device designer to assume that professional users will not always be "rocket scientists" (or brain surgeons), but that is different from a home-healthcare device aimed at the Alzheimer's patient.

So, I don't think that Mr. Harding and I really disagree. I completely agree with his statement that: Potential device-design-precipitated user errors that can be foreseen as a result of these limitations should be designed out of all devices, regardless of the expected area of use or basic user type.

Again, my point was just that the migration of devices from the hospital to the home puts additional pressure on device designers to follow Mr. Harding's advice. 

Stephen Wilcox
Design Science
Philadelphia, PA

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