This is a presentation given by Bridge Design President, Bill Evans, at 2015 MD&M East Conference. 10 Ways Innovation, Design, Demographics and Global Trends Will Impact the Future of Healthcare – over the next 10 Years.

1. CONFIDENTIAL
10 ways innovation, design, demographics and global trends
will impact the future of healthcare – in 10 years

2. CONFIDENTIAL
bill evans
president
bridge design, inc
Design Research & Strategy | User Experience | Industrial Design | Product Engineering

3. CONFIDENTIAL 3
www.designinvitro.com

4. CONFIDENTIAL 4
designer “heal thyself”
taking participant observation to the max

5. CONFIDENTIAL 5
the spirit of my observations:
the critical and the kind

6. CONFIDENTIAL
ten years is a long short time

7. CONFIDENTIAL 7
2005 2015 2025
?
?

8. CONFIDENTIAL 8
2005 2015 2025
?
?
CONVERGED

9. CONFIDENTIAL 9
average medtech
VC backed startup takes 8 -10 years to exit
(and costs $60M-$100M to get there)

10. CONFIDENTIAL
1
demographics

11. CONFIDENTIAL 11
demographics
global health/
wealth data
source:
gapminder.org

12. CONFIDENTIAL 12

13. CONFIDENTIAL
2
globalization

14. CONFIDENTIAL 14

15. CONFIDENTIAL 15
3rd world skipped wireline for cell
why copy the western healthcare system?
(or evenremotely be able to afford it)

16. CONFIDENTIAL 16
urban infrastructure in china

17. CONFIDENTIAL 17
rural infrastructure in china

18. CONFIDENTIAL 18
growth of ‘low-resource environment’ products
designed and made in these environments
 aravind clinics and low cost IOLs
 GE and others investment in regional design centers
 different approach to business models behind products (pay-
per-use, razor-razor blade, OPEN SOURCE generic platforms
not proprietary)
 shameless use of consumer technology to drive costs down

19. CONFIDENTIAL
3
cost pressures

20. CONFIDENTIAL 20
Sources: World Bank, WHO, PwC analysis (projected from 2011 data)

21. CONFIDENTIAL 21
elephant in the room
per-capita cost
is our industry taking this into account enough?

22. CONFIDENTIAL 22
how do we deal with the fact that cost is affected by
issues of efficiency across the continuum of care
and
most of us only have hold of a small part of it?

23. CONFIDENTIAL 23
In 10 years:
emphasis will shift from fee-for-service to
managed care
to better integrate care across the continuum
reducing redundancy and improving outcomes

24. CONFIDENTIAL 24
What will help in the next decade?

25. CONFIDENTIAL 25

26. CONFIDENTIAL 26
‘compliance’ will be redefined

27. CONFIDENTIAL 27
accepting the way people behave & ‘pushing the boulder’ with them
Image right from: Providence St. Joseph's Hospital

28. CONFIDENTIAL 28

29. CONFIDENTIAL 29
EHRs (and all the other acronyms for HIMS):
move past historic emphasis (dinosaur systems) to assisting action that
improves outcomes a clinical emphasis
interoperable (HIE)
two-way smart products acting on Dx data combined with specific
HER use technology for expert data analysis to assist people at POC
across the continuum of care

30. CONFIDENTIAL
4
Wireless
& mHealth

31. CONFIDENTIAL 31
Note: 1 Billion smart phones!

32. CONFIDENTIAL 32

33. CONFIDENTIAL 33
“while 2014 may have been a peak year for digital health at CES, the discussions that
took place at the event this year seemed much more grounded”
MobiHealthNews January 2015

34. CONFIDENTIAL 34
by 2020
160M Americans will be monitored & treated remotely for at least 1 chronic condition

35. CONFIDENTIAL 35
wireless solutions enabling consumers to take
charge of their health
 shift from cobbled together elements to seamless integration
with no need for patient interaction
 getting up to the cloud – anyhow
 shifting demographic means accelerating adoption

36. CONFIDENTIAL 36
android inside. . .
… and the Internet of things …

37. CONFIDENTIAL 37

38. CONFIDENTIAL 38
all this data!
what makes it actionable?

39. CONFIDENTIAL 39
so much data will challenge who makes ‘medical’ decisions
And how medical decisions get defined by regulation

40. CONFIDENTIAL 40

41. CONFIDENTIAL 41

42. CONFIDENTIAL
5
augmented
reality

43. CONFIDENTIAL 43
superdimension virtual broncoscope guidance

44. CONFIDENTIAL 44
virtual colonoscopy

45. CONFIDENTIAL 45

46. CONFIDENTIAL 46
GP Exam room in a decade
 everything is connected and inputs directly
 tablets use AR to show and explain issues to patients – maybe even
using real time patient data/images
 otoscope, ophthalmoscope, etc. feeds directly
 speech of MD transcribed during session

47. CONFIDENTIAL 47

48. CONFIDENTIAL 48

49. CONFIDENTIAL
6
design trends

50. CONFIDENTIAL 50
active + independent

51. CONFIDENTIAL 51
patient centric

52. CONFIDENTIAL 52
home care

53. CONFIDENTIAL 53
is not

54. CONFIDENTIAL 54

55. CONFIDENTIAL 55

56. CONFIDENTIAL 56

57. CONFIDENTIAL 57
technology tempered by human needs

58. CONFIDENTIAL
7
culturing
innovation

59. CONFIDENTIAL
design & design thinking
=
buzz-words
what does this really mean for the future?

60. CONFIDENTIAL
our customers will demand it
why can’t the products I use in
my job be as easy to use as my
smart phone?

61. CONFIDENTIAL
the waking up of brand values
and its impact at every touch point

62. innovation will becomepartofa company’sDNA
this will bea challengewithour industry’slengthyproduct
developmenttimeandlife-cycles

63. wealso need‘translators’ tocarryinnovative sparksto
majestic fireplaces…

64. CONFIDENTIAL
designand designthinking
the next10 yearsfor devicecompanies:
clinicalefficacywillruleevidence-basedmedicine
usabilityandcustomerappealwillset companiesapart
wherethere ischoiceor adoptiondifficulty

65. CONFIDENTIAL
user-centered design
=
competitive heat

66. CONFIDENTIAL
user-centered design
Alair
an interventional
procedure hand controller

67. CONFIDENTIAL

68. CONFIDENTIAL
we observed procedures and identified
pain points in the current process

69. CONFIDENTIAL 69

70. CONFIDENTIAL 70
Current Equipment
Moving to segment (5 treat zones) Sub Total 06:18 45%
Advancing Cath to distal 5 sucessful Sub Total 01:18 9%
Treat 21 times Sub Total 03:28 25%
step through pulling basket proximal to move to new treatment zoneSub Total 02:40 19%
Other pause Sub Total 00:23 3%
Grand Total 14:07
Estimated time to do one treatment 0:50:00 May not be true for this particular MD but…..
Optimized scenario with stepping through much faster
Moving to segment (5 treat zones) Sub Total 06:18 56%
Advancing Cath to distal 5 sucessful Sub Total 00:39 6%
Treat 21 times Sub Total 03:28 31%
step through pulling basket proximal to move to new treatment zoneSub Total 00:32 5%
Other pause Sub Total 00:23 3%
Grand Total 11:20
Reduction from existing 02:47 20%
Estimated time to do one treatment 40
Goal is 20 minutes (reduced from current 50 minutes)
Minimum if you just moved and treated (impossible of course)
Moving to segment (5 treat zones) Sub Total 06:18 62%
Treat 21 times Sub Total 03:28 34%
Other pause Sub Total 00:23 4%
Grand Total 10:09
Reduction from existing 03:58 28%
Estimated time to do one treatment 36
Goal is 20 minutes (reduced from current 50 minutes)
half from existing to make
advancing faster (but very hard
to do it faster as it requires
skill)
16 times with each step
reduced to just 2 seconds
(requires "automation")

71. CONFIDENTIAL 71
0:00:000:14:240:28:480:43:120:57:361:12:00
0 40 80 120 160
Number of activations
Time(hour:min:sec)
0
25
50
75
100
125
150
175
200
225
250
# 1 # 1
Improved
# 2 # 2
Improved
# 3 # 3
Improved
Time(sec)
Activation Time
Deployment
Suction
Communication
Navigation
Patient Management
Adjacent
Non Adjacent
Other Issues

72. CONFIDENTIAL
we analyzed modes of use and translated
them into ergonomic handle designs

73. CONFIDENTIAL 73

74. CONFIDENTIAL 74

75. CONFIDENTIAL 75

76. CONFIDENTIAL 76

77. CONFIDENTIAL
8
personalized
medicine

78. CONFIDENTIAL 78
predicting the inevitable has
been around for 60 years

79. CONFIDENTIAL 79

80. CONFIDENTIAL 80

81. CONFIDENTIAL 81
The low cost genome will affect
 personal choices about behavior
 how care is delivered
 how insurers/payers react
 healthcare’s view of ‘compliance’

82. CONFIDENTIAL
9
combo
devices

83. CONFIDENTIAL 83
exploring need for new routes and new features

84. CONFIDENTIAL 84
all the ways in and …
 increasingly complex locations
 the time domain
 removing patient from as many “compliance
responsibilities” as possible
 cloud connectivity
 Dx to Rx closed loop
 pushing point of care to lowest cost and skill

85. CONFIDENTIAL
10
sustainability

86. CONFIDENTIAL 86
why even consider sustainability?
 patients reporting more concerns
 healthcare professionals frustrated at daily waste
 pressure for change building at major users
 alegent hospital’s VP of sustainability
 kaiser’s green scorecard
 legislation

87. CONFIDENTIAL 87
what sustainability is NOT about
 using corn plastic instead of other polymers
 making everything reusable
 putting it above safety, efficacy and cost
 making products cost more
 making products less usable
 warm and fuzzies – it will make good business sense in the next
decade

88. CONFIDENTIAL 88
what we’ll see:
 lessmaterial in disposables
 different break points on
disposable/reusable portions
 less disposables – a rethink of razor/razor
blade models
 more use of ‘pay as you use’
technology to maintain margins but
lower cost at POC
The Minnetronix Cognita System
is a remote medical device monitoring and intelligence
system that gathers data from device fleets and
translates this information into actionable business
intelligence
&

89. CONFIDENTIAL 89

90. CONFIDENTIAL

91. CONFIDENTIAL
Thank You
bill@bridgedesign.com
WHITE PAPER: 7 Pitfalls to Avoid in mHealth Web or App Design
http://goo.gl/yLWhIJ
Bill Evans, president at Bridge Design, Inc
Industrial Design | User Interface | Design Research | Mechanical Engineering