Presentation at the American Telemedicine Association (ATA) Conference, by Mark Benson on May 1st, 2012. ABSTRACT: Slow regulatory cycles combined with the reality of fast-moving technology curves can cause new homecare telemedicine products to feel old to users that have the latest consumer technology in their pocket. This presentation explores problems and potential solutions to combating this effect. Problems include (A) fast-moving consumer technology keeps setting the bar for user interaction and design standards, (B) keeping current with latest technology often requires the creation of non-standard proprietary solutions, and (C) the desire to exert control over the safety and efficacy of a medical product causes medical device companies to naturally trend towards vertical integration, and trend away from horizontal market relevance. This presentation presents possible solutions to each of these problems, but above all, argues that a careful and smart approach to interaction design is the key to wide-spread adoption and success.

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Preparing for future health technology trends
by analyzing current consumer demand
Mark Benson
Director of Software Strategy

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About Logic PD
History
• 1960’s Founded as Polivka Logan
• 1980’s Added Mechanical Eng
• 1990’s Added Software, Electrical Eng
• 2000’s Added Products, Manufacturing
Products and Services
• Product Design
• Product Engineering
• Embedded Products
• Manufacturing
Industries
• Industrial, Medical, Aerospace, Military
Employees
• 130 design consultants
• 300 operations staff
Geographies
• Minneapolis, Boston, San Diego

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1. Mobile is proliferating on all fronts
2. User experience expectations are rising
3. Wet blankets (mortality rates, HRQoL, regulatory/economic lag)
4. Rising to the challenge with a nimble, modular, user-driven approach
Key takeaways
1. Pursue understandable, usable, and joyful user experiences
2. Innovate and streamline product development processes
3. Create modular product designs to adapt to future tech trends
Agenda

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0
50
100
150
200
250
300
350
1985 1998 2011
US Population US Wireless Subscriptions
MOBILE PROLIFERATION*
* Source: CTIA; US Census Bureau
Millions

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Industrial products

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Military radios

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Portable medical devices

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User experience expectations are rising
• Many older people have a smartphone (especially those in higher income brackets)
• In the next 10-30 years, this will inevitably increase
77%
80%
75%
60%
48%
38%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
Ages 18-24 Ages 25-34 Ages 35-44 Ages 45-54 Ages 55-64 Ages 65+
Smartphone Adoption by Age and Income*
<$15k $15k-$35k $35k-$50k $50k-$75k $75k-$100k $100k+
* Source: Nielsen, January 2012; Pew Research Center, May 2011
35% of Americans
own a smartphone

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Smartphone users have good mHealth intentions
• Average smartphone users check their phone 50-150 times per day
• Smartphones are a promising tool for potentially inspiring personal health responsibility
22%
22%
24%
44%
44%
47%
16%
16%
17%
0% 10% 20% 30% 40% 50%
I expect to use more
health/wellness mobile apps in the
future
I would be more likely to adhere to
a treatment program if I had a
mobile app to keep me on track
I would be more likely to use
online sources to manage my
health if they were available in
mobile app formats
Basic mobile users Smartphone users Total users
* Source: The Promise of Mobile Health – Bigger than DTC? Euro RSCG, November 2010
** PTSD Coach, 2012 ATA annual president’s award recipient for innovation
PTSD Coach **

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The wet blanket of mortality
72
77.9
10
20
30
40
50
60
70
80
90
100
1
10
100
1000
10000
100000
1000000
10000000
1970 1975 1980 1985 1990 1995 2000 2005 2010
Intel® Transistor Density (000) US Life Expectancy at Birth
* http://www.gotw.ca/publications/concurrency-ddj.htm
** http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5936a9.htm
4 decades of electronics industry growth = 6 more expected years of life

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Is our quality of life getting better?
Life expectancy may be going up, but some aspects of HRQoL are going down

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Is our quality of life getting better?
13.40%
13.90%
14.40%
14.90%
15.40%
15.90%
16.40% Percentage with fair or poor
self-rated health: overall
(all states, all demographics) *
* CDC HRQoL database (http://apps.nccd.cdc.gov/HRQOL/)
• It’s possible we are just becoming more aware of our personal health over time
• 3% = 8M+ people (youth: mainly emotional troubles, adults: mainly physical troubles)

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Techno-regulatory reality
1
10
100
1000
10000
100000
1000000
10000000
1970 1975 1980 1985 1990 1995 2000 2005 2010
Intel® Transistor Density (000) *
* http://www.gotw.ca/publications/concurrency-ddj.htm
Consumer technology moves quickly:
• TTM: 9-18 months
5 generations
of iPhone
= New medical device product launch
Medical technology moves slowly:
• Class I 510(k) TTM: 1-3 years
• Class II 510(k) TTM: 2-5 years
• Class III PMA TTM: 3-10 years
• 100k+ medical devices vs. 1B+ consumer devices
• IDC predicts 50B+ connected devices by 2020 (7.5 years from today)

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Techno-economic currents within the long tail
Volume
Products
High-Volume
Consumer
Long-Tail Niche Markets
(e.g. Medical Devices)
Experimental
Prototypes
Can we reverse this techno-economic flow?? R&D
Commoditization Effect

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It is not enough that we build products that function, that are understandable
and usable, we also need to build products that bring joy and excitement,
pleasure and fun, and, yes, beauty to people’s lives. – Don Norman

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Delighting the user: important dimensions
Pursue joyful user experiences
Users expect an experience that is not only
understandable and usable, but also joyful
Innovate development processes
Using Lean or Agile methods combined with
removing defects early, can help reduce TTM
Create modular and adaptable products
By separating safety-critical functions from the UI,
technology lag can be minimized and partially mitigated
1
2 3
Interoperability
Delight

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> Promote joyful living despite chronic illness
> Promote better personal responsibility for health
> Decrease learning time (barrier of use)
> Reduce human errors (increase safety, efficacy)
> Streamline development processes to reduce TTM
> Spend more time on human factors design, requirements
engineering, and validation testing
> Change the culture of medical device design
Pursue joyful user experiences
Innovate product development processes

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> Focus on industry standards for interoperability
> Layers:
Create modular and adaptable products
IT (communications standards, data formats)
Product (RF coexistence, protocols, interoperability)
System (architecture subdivision, decomposition)
Board (SPI, I2C, memory busses, modular displays)
Chip (accelerometers, gyros, FPGAs, radios)
Sub-chip (multicore SoCs, power management, DVFS)

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1. Mobile is proliferating on all fronts
2. User experience expectations are rising
3. Wet blankets (mortality rates, HRQoL, regulatory/economic lag)
4. Rising to the challenge with a nimble, modular, user-driven approach
Key takeaways
1. Pursue understandable, usable, and joyful user experiences
2. Innovate and streamline product development processes
3. Create modular product designs to adapt to future tech trends
Summary

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Delight the user

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Thank you