In the afterglow of three separate gold-winning MDEA honors, Tom Merle, chief development officer and general manager of Continuum Advanced Systems, the medical and technology innovation arm of design consultancy Continuum (West Newton, MA), spoke with MPMN about the company's involvement in the design of the V-Series patient-monitoring system, Compass interchangeable modular system, and Vedera KXS vision-correction device. Find out more about these devices and all of this year's MDEA-winning products.
 

MPMN: In what areas does Continuum specialize?

Merle: The Continuum Advanced Systems business focuses on the development of solutions that are at the intersection of technology and human-centered design. We specialize in opportunities where there's a significant new technology or technological advancement, but the fundamentals of why we do it or what informs us is all about the people--whether they are patients, caregivers, family members, or hospital administration staff. We broadly define human-centered design as all aspects of the human interaction or the human experience.

MPMN: Continuum is a supplier to three of this year's gold-winning MDEA products--an impressive feat. What's the secret to your success?

Merle: I think the secret is that these three products really benefited from the fundamental commitment of the manufacturers saying: 'What's going to differentiate our product in the market?' What allowed us to succeed in three very different applications was that, at the root of it, we were trying to look hard at the environment of use and how hospital administrators, care givers, and patients are trying to manage healthcare today. The common element among the three products was that there was a real need in the healthcare system that started and ended with the people, and we helped these three companies figure out technology solutions for these people that really did differentiate the products in the market.

MPMN: What did Continuum bring to the table in the design of the V-Series patient-monitoring system?

Merle: We partnered with the Mindray team, which manufactured the device, and worked on the critical interaction element of the device. This was basically a grounds-up redesign of the presentation of key pieces of information and the most prominent pieces of information that nurses and caregivers need. We really looked at how this device is actually used: What are the situations in which it's transported? How do we enable the flexibility that's required in the hospital room?

First and foremost, it was critically important that the nurses have the accessibility and clarity of thought to be able to quickly retrieve the information they need. We worked closely with the Mindray development team and delivered the first patient monitor ever to have a vertical aspect ratio, for example. That approach allowed for much more information to be on the screen and saved valuable space in the room because it didn't have quite as long of a landscape aspect ratio. It also provided an increased level of visibility from across the room and simplification of the key pieces of information that a nurse needs. It gave us a great platform on which to build a family of products that had the same language as well.

MPMN: What role did Continuum play in the development of the Compass modular system?

Merle: The Compass is an amazing flexible system that allows the patients' experience to be much more tailored to their needs. It truly takes into consideration important things for long-term stays such as storage, access to beverages and liquids, and call buttons. It also allows hospitals to have a reconfigurable room to be set up; in today's economy, you don't want to have a captive room devoted to only birthing or recovery, for example. These modular pieces are basically hung on a rail system, and you can remove them, replace them, move a sink to one side, move storage, reconfigure for one patient or two, etc. This modular, flexible system represents a breakthrough for hospitals, and the benefits really do cascade right back to the patients. It really did open up a completely new way of thinking about the patient dynamic and also within the administration in the hospital. For the patient, there was particular attention paid to some of the modular capabilities that some of these pieces have. The headboard, for example, was redesigned so that it was simpler for the nurse but not so overwhelming for a patient that was in proximity. The sink was at a height accessible for someone who may have just had surgery. There's an area for a computer connection. A lot of the recovery aspect of the patient is also part of the mental status, so to be in this room that was very bright, modern looking, and functional allowed them to do things they just can't do today.

MPMN: What did Continuum contribute to the Vedera KXS vision-correction device?

Merle: This is a very new-to-the-world technology that represents an alternative to Lasik surgery. This was truly a new science that was trying to find its way into an ophthalmology environment and do that in a way where both the surgeons and technicians were comfortable and there were some real benefits. There was a significant technical aspect to this product, which delivers microwave energy to the eye in order to reshape the cornea without doing laser surgery. There was a lot of consideration for the design of this product because ophthalmology offices are not very big. How do we package this in a way that is reliable and spatially accommodating so ophthalmologists can integrate it into their current office space? This particular program probably got the attention of the MDEA judges because this is a truly breakthrough, revolutionary technology delivered as an alternative to a very prominent procedure. Frankly, many people are scared of cutting a slit in their eye and having Lasik done. This system presents a very viable alternative, and is reversible and tunable as well.

MPMN: Of these three products, which presented the most significant design challenge?

Merle: They all represent very different design challenges. Compass represents both business and system challenges because it's not only affecting patients and nurses, but hospital administrators that have to be an advocate for its success. The Vedera, on the other hand, is probably the most technically driven product of the three. Science needed to be delivered to our client and we did that. The V-series monitor is probably the most prolific of the products and will have the most placements; patient monitors are everywhere and Mindray is receiving a tremendous response to the user experience with that product. I think all of the products had an emphasis that was significantly different, but I think the common thread that allowed us to bridge all of these applications was that there were some aspects of technology in all of them and some aspects of the user experience that needed to be delivered, and it only really worked if the people side of it was successful.

MPMN: As an active company in this sector, what are some of the most prevalent trends you're seeing in medical device design?

Merle: In general, the patient or user of these systems is becoming much less tolerant of bad experiences and much less accepting of beds that don't work, monitors they can't see, plugs they can't reach, and interfaces or screens that are hard to read. Because of some of the advancements in consumer electronics, people are thinking that everything should be designed to that level. The out-of-box experience should be simple. The setup should be simple. The device should be intuitive. I think, in a good way, that it's forcing the medical device industry to think long and hard about what it's like to be a patient and what it's like to be a doctor. They have to consider how to make a very robust, very simple experience for people.

MPMN: What new challenges have such trends presented to the medical device industry?

Merle: I think that some companies have rested on the idea that if they have the best technology, they will win.  They're finding out now that's not enough. It's great to have a superior technology, but if it's not delivered well to a patient or doctor, it's truly not going to win in the long term. There will be a fast follower or alternative technology that people will prefer.

MPMN: What's the next frontier for medical device design?

Merle: The time in the hospital is decreasing with each procedure and with each advancement in how things can be managed within a hospital. The whole model of people getting well at home will continue, and that will put a particular burden on medical device manufacturers to understand that process and to understand the communication that may be necessary from the home. We have termed this trend "the hospital of one." What happens when the patient goes home? Who is the person that will be administering care? And for those involved in procedures, it all comes back to the fact that time is money. The less training required for a device, the better, as is the flexibility of skills required for a clinician to perform procedures. If a nurse can do it instead of a doctor, the whole cost of execution will be less.