Reflections on our 'Future Health Services' Event

By: Alistair Ruff Date: 21/10/2016

The Service Design Fringe Festival London was a schedule of events that ran alongside the main London Design festival over 10 days, including excellent events covering the underlying need for service design and giving insights into the skills needed to conduct service design projects. We at PDR saw the opportunity to organise an event in our new London office that shared some of our experience and encouraged focussed discussion, going deeper into a specific subject area, with an aim of making it really valuable for attendees.
Medical and Healthcare is a field where PDR has a wide range of expertise, including the design of hospital consumables, complex interactive medical devices, consumer healthcare applications and surgical implants. Bringing a team that works across these areas meant we could go into detail, bringing out specific obstacles and ways of overcoming them, which we then used as reference points for other possible difficulties.

Personally I work on designing, prototyping and testing interactive products, applications and services and whilst working on projects at PDR we have as a team experienced the challenges that are faced when seeking to use technology to improve healthcare provision first hand.

For the event, each colleague from PDR shared their own experiences of how technology is impacting their work in healthcare at present and also posed a What if? Question to highlight a potential opportunity or challenge that had captured their interest. Watch the video in full to hear all the points discussed in detail but I’ve tried to cover in brief the points that stood out to me:

Future Services in a Technology Enabled Healthcare System from PDR on Vimeo.

Summary of presentations

Where are we at right now

Paul Thurston, PDR’s Head of Innovation kicked the afternoon off, introducing the situation as he sees it after having worked in service design in and around healthcare for over 10 years. Specifically Paul raised the need to move the discussion on Service Design on, suggesting that uptake has not kept pace with the promise of service design as it has grown in recognition over recent years.

“We are currently living with a Technology Disabled Health Care System”

Medical Device Design trends

Ben Nolan, Senior Design Consultant at PDR, shared the trends that he has seen over the recent years and particularly the ones that he is seeing impact upon his work in the design of physical medical devices.

●      Connected Devices for an aging population
○      Connected and wearable devices such as the Acticheck Assure can provide real value for an aging population, but for this to work we need to design for physical and cognitive inclusivity.
●       Increased Levels of data will drive future developments
○      These devices will be collecting data - designers need to be prepared to utilise this in their process to fuel innovations that meet real patient needs.
●      Tech Giants investing in healthcare

○      The blurred boundaries between consumer and medical devices which is providing a challenge for legislation and gives potential for new devices designed based on huge amounts of data and by design teams with huge resources.

“I’m excited about where the increased investment in healthcare from Tech Giants might take the industry”

Ben was particularly interested in the implications of current progress for medical device manufacturers, identifying how the new wave of devices and investment across the globe will inform future developments.

This informed his discussion question: What if... tech giants diverted their investments in autonomous vehicles to autonomous healthcare, what results would we see and how soon would we see them?

Trends in Interaction Design for Healthcare

I presented my own experience of working as Interaction Designer on a range of healthcare products and services, pulling out the three most prominent themes I have found.           

●      Higher Expectations
○      We are all using devices in our day to day lives that are desirable, accurate and powerful, raising our expectations. This means medical device companies can no longer focus on technology at the cost of a good experience for users.
●       Non-dedicated Hardware
○      As medical applications and software move onto consumer hardware, like our award winning Rene concept, designers and device manufacturers need to embrace that they no longer have full control over the whole product and design accordingly.
●      Beyond the Graphical User Interface
○      Wearable and connected devices are often foregoing touchscreen interfaces due to form factor, as the GUI is hidden the service provision is increasingly important.

“When we are designing for use across devices in any context, the user is reliant on a consistent and reliable service provision”

I was keen to communicate that the speed of development in consumer products hasn’t been matched by medical devices, especially in the realm of interactions. When reviewing current medical devices it is often shocking to think that they aim to keep us alive, but the overall experience of using them is significantly more frustrating than consumer devices.
Given the speed of development of consumer devices and open source programming, I wanted to discuss: What if... Technologically aware patients take matters into their own hands and begin developing their own products and services using off the shelf kit?

Medical Device Development Legislation

Claire Andrews, PDR’s User Centred Design Lead presented on how the regulations governing the development of medical devices are being challenged by current trends and how they are attempting to respond to them.

●      Lack of Generative
○      Many medical products are driven by marketing specifications rather than returning to generative research methods to identify true user needs. This leads to new functionality being bolt-ons and the assumption that existing products fulfil needs as best as they can already.
●      What is a Medical Device?
○      The new range of consumer devices and apps are being used to manage conditions and aid diagnosis, at present they are predominantly not covered by regulations - but are they actually having a positive impact?
●      Testing the Intangible
○      Service solutions that encourage lifestyle changes aiming at prevention rather than treatment are very difficult to ‘user-test’ in line with regulations, they are intangible, longitudinal and used in multiple contexts by different users.

“Many wellness apps are claiming to help monitor medical conditions but use absolutely no evidence based practice”

Claire picked up on themes from the previous talks, especially the blurring of the boundaries between consumer and medical devices - the response from legislators on this topic will likely have a big impact upon the development of products and whether the two groups develop in harmony and possibly merge, or become warring factions.

Claire presented the results of recent studies into wellness apps which prompted her to ask: What if... we begin to see examples where ‘wellness’ services put people at risk of harm?

3D printing for Patient Specific Healthcare

Gavin Thomas works to design and develop software that will bring the ability to design custom implants for surgical use into the hands of healthcare professionals. His talk covered difficulties he is seeing in attempting to introduce a specific piece of technology into a healthcare setting. He is part of the Surgical and Prosthetic Design team awarded with the prestigious Queen’s Award for Research in 2015.

●      Highly technical nature
○      Medical staff are not typically trained to design for 3D printing using complex CAD packages, this currently leads to need for lots of collaboration with design engineers, it raises the need for a user-centred approach to developing appropriate software.
●      High upfront cost
○      The deployment of this new technology is limited to cutting edge departments with the motivation and budget. The long-term savings will outweigh the upfront costs but this is hard to demonstrate.
●      Demanding targets
○      Current processes of collaboration using existing technology aren’t able to respond to the most urgent trauma cases within the required timelines.

“With theatre time costing upwards of £1000 an hour, we know that in the long term procedures that increase accuracy can save thousands, but evidencing this is difficult and necessary to encourage uptake”

Throughout, Gavin was very clear that he saw a great opportunity for service designers to improve the way the technology he was involved in designing was implemented. As well as this, I could see that these challenges were not limited to this specific project, with the need for technical skills, long-sighted budgeting and a never ending flood of deadlines impacting on the uptake of any kind of technology within healthcare.

To round off Gavin asked us: What if... inappropriate technologies and approaches are applied to people?


Upon finishing the four lightning talks we opened up the discussion to those in attendance, using some of the trends identified as a starting point of conversations.

Discussions around the use of artificial intelligence quickly came to the forefront, focussing on both point of diagnosis and as a preventative measure. Alongside this was the feeling that technological advances should not come at the cost of empathy at the point of care.

Another topic was the blurring of the lines between health and social care, with long term care increasingly being done in the community. The possibility for technology to positively impact in the growing area of remote care seems huge, potentially enabling the kind of personal and empathetic contact needed in care to be scaled up. Service design definitely has a part to play in exactly how this is implemented.

One surprise was around the freedom with which people talked about both health and social care being delivered in the community, often outside of government organisations. As a nation that takes great pride in a National Health Service, the expectation from many present that less and less would be done by the NHS was an interesting discussion - the discussions predominantly focussed on service offerings external to the existing health service as opposed to possible improvements from within. This may be tie up with Paul’s welcome in which he described what he saw currently as a technology disabled health care system.
Personally I thoroughly enjoyed the event, and whilst I think the PDR shared some detailed insights from our own work, the main success was the ability to have focussed discussion around how technology can enable healthcare in the near future. Attendees from Insurance providers, central government, pharmaceutical companies and a wide range of other industries took part and weren’t afraid to provide different perspectives from their industries.

Interested in attending future events?

At PDR we’re already looking forward to hosting another focussed event on the trends we’re seeing in another of our specialist areas, and igniting more discussion around the topic. With plans for another event before Christmas, maybe we’ll see you there and hopefully get you involved in the discussion.
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