Design 1st and Macadamian partner on early IoT project
Providing healthcare for growing, aging and often remote populations has challenged providers for many years. While Internet-based innovations designed to improve efficiency and cut costs appear all the time, it was not that long ago that remote medicine was an unexplored frontier where pioneering firms were still working out the basics.
In 2002, March Networks was one of those firms. They wanted to bring their expertise in video and broadband to the challenge of remote vital sign monitoring, helping to reduce remote healthcare costs through innovative healthcare IT products. The problem at hand was that expensive, highly skilled healthcare workers spent hours every day driving between housebound patients in both urban and rural communities. Their vision was to make easy self-administration of basic tests such as blood pressure, oxygen saturation, blood sugar and weight simple enough that patients could do them under the video conference supervision of a professional. Timon LeDain, currently Director, Internet of Things (IoT) at Macadamian, knew that a system like this would have to meet some tough usability and design challenges to be successful. “Interfaces for remote healthcare devices at the time looked a lot like the PCs of the day, and were inter-connected via awkward dial-up modem technologies, both of which were far too complicated and limiting for a largely elderly patient population.”
LeDain teamed up with Kevin Bailey of Design 1st, a consultancy with expertise in industrial design and hardware product engineering. With only twelve weeks from product conception to having a prototype ready for an industry trade show, making the right design decisions fast was critical. They chose to deploy set-top boxes to allow video conferencing and data upload over emerging broadband networks. “After all,” recalls Bailey, “TVs and the cable network already reached virtually every home in the developed world, and the user interface was as simple as the common TV remote, whereas the Internet was still unfamiliar territory for most people.”
They also chose the still-new Bluetooth interface for communication between the monitoring units that took patient readings and the set-top boxes, making the Health Monitoring Kit (HMK), as it became known, one of the first medical devices to ship as a Bluetooth certified product. LeDain relates that “choosing a consumer focused plug-and-play technology such as Bluetooth meant that users did not have to fiddle with complex and proprietary wireless technologies, which was a big factor in the success of the product.”
SUCCESS BY DESIGN
But other, more subtle design choices were also important. For example, the unit’s User Interface (UI) used simple iconography rather than complex terminology to prompt users to take actions. This was both less threatening and also language-independent. They even gave a lot of thought to the size and physical appearance of the units. Bailey explains that medical equipment in the home is socially challenging as it advertises the illness to guests and family members, so they designed the HMK units to be portable, blend in and stow away out of sight when not in use.“Competing products looked like hospital equipment in the living room,” he recalls. “We wanted to put patients at ease by introducing the medical equipment into their homes in a way that would be familiar and comforting.”
Other early design decisions that were critical to success involved the far end of the connection. Healthcare workers interacted with patients and their data via common web browsers. Not only was this a ubiquitous, standards-based approach to offering a thin client solution, it also meant that no patient data persisted on the host PC in the hospital, clinic or doctor’s office, so that if one was stolen or accessed without authorization, there would be no exposure of sensitive patient data. According to LeDain, “this was a very deliberate choice we made in anticipation of patient privacy rules, and it put us ahead of the curve on regulations such as the 2003 HIPAA patient privacy mandates.”
LeDain, Bailey and their teams succeeded in having a prototype ready in 12 weeks, and went on to a successful 50 patient field trial in less than a year. The product was fully commercialized by 2006, with a medical records back-end added over time as the healthcare IT landscape matured, making it a true IoT solution long before the term IoT was coined. Along the way, Macadamian’s LeDain and Design 1st’s Bailey became early experts in the complex world of healthcare regulations and how they apply to new technology offerings. They developed expertise not just in HIPAA, but also FDA and Health Canada certification requirements, ISO 9001 and the healthcare specific ISO 13485 quality management systems that helps them deliver successful client projects to this day. In fact, their knowledge of the healthcare regulatory space has made security, privacy, and traceability requirements factors they consider for all of the projects that they undertake.
Bailey relates that this and subsequent projects have succeeded because they craft experienced teams that encompass a “big picture” system architecture vision rather than a limited device-specific design point-of-view. He also notes the critical importance of integrating design and business teams from the outset, ensuring that design decisions are informed by business intelligence and market insight.
From this early partnership evolved an enduring relationship between Macadamian and Design 1st, allowing them to offer end-to-end software and hardware design services for IoT and other projects. In fact, virtually every IoT project Macadamian undertakes involves the integrated participation of Design 1st – a real testament to the strength of the relationship. Together, they bring user and system perspectives to projects, ensuring that business needs come first, and the same forward-looking approach that led them to choose a cloud-centric architecture and the still-new Bluetooth technology at the time continues to inform how they evaluate innovations that can help client projects succeed over the long term.