Health & Wellness insight

1. Digital transformationThank you. in the Health and Wellness domain October 2012 Slide 1 © Fjord 2012 | Confidential
2. Contents 1 Briefly about Fjord 2 Health and wellness challenges 3 Large digital trends 4 New digital dynamics in health & wellness 5 Inspiration and insights 6 Early ideas Slide 2 © Fjord 2012 | Confidential
3. 1 Slide 3 © Fjord 2012 | Confidential Slide 3 © Fjord 2010 | Confidential
4. At Fjord we do service design We create useful, effective, a nd desirable services that people love. Slide 4 © Fjord 2012 | Confidential
5. We connect people and technology Human needs, actions, and behaviour Devices, networks, software, s ensors and data Slide 5 © Fjord 2012 | Confidential
6. Some of our clients Slide 6 © Fjord 2012 | Confidential
7. Examples of our work in the domain E-Tech Awards Winner 2012 We‟re working with Adidas on two sensor-based wearable fitness solutions in their MiCoach range We‟re collaborating with Harvard Medical School to re- imagine the universal Pediatric Growth Chart We‟re working with this start-up to bring their high- performance athlete service to the masses Slide 7 © Fjord 2012 | Confidential
9. An aging population Today, people aged 65 years or over in the EU 18% By 2060 the share will be 30% Workforce decreases, leading to less income for society, while the healthcare costs increase Slide 9 © Fjord 2012 | Confidential
10. Bad lifestyles & chronic disease 1 300 50% Billion Million increase of the world‟s population of these 1 billion people in diabetes in the UK in is overweight are the last 5 years clinically obese Slide 10 © Fjord 2012 | Confidential
11. Age impacts what we care about 25 50 75 Look better Live healthier Prevent disease Treat disease Slide 11 © Fjord 2012 | Confidential
12. Some needs are universal “In the 19th century health was transformed by clean and clear water. In the 21st century health will be transformed by clean, clear knowledge.” Sir Muir Gray Slide 12 © Fjord 2012 | Confidential
13. A shared driver for people & society from to reactive proactive health management health management Slide 13 © Fjord 2012 | Confidential
15. Digital transformation waves Desktop web 1990‟s 2000‟s 2010‟s Slide 15 © Fjord 2012 | Confidential
16. Digital transformation waves Desktop web Mobility 1990‟s 2000‟s 2010‟s Slide 16 © Fjord 2012 | Confidential
17. Digital transformation waves Desktop web Mobility Living services 1990‟s 2000‟s 2010‟s Slide 17 © Fjord 2012 | Confidential
18. Digital transformation waves Complexity Desktop web Mobility Living services 1990‟s 2000‟s 2010‟s Slide 18 © Fjord 2012 | Confidential
19. The living services wave New devices and connected sensors enable the capturing of massive amounts of highly fluid data. • Living entities – living and evolving entities. We need to design for fluidity and change. • Built for and around people – built around people and their lives, adapting to context and needs. • Natural interfaces – go beyond click & touch, to voice, gestures, info from body sensors, etc. Slide 19 © Fjord 2012 | Confidential
20. The biggest enabler is sensors “People ask me what Web 3.0 is all about. It‟s about the web of sensors” Tim O‟Reilly Slide 20 © Fjord 2012 | Confidential
21. Digital is transforming the world “Re-imagination of nearly everything powered by New Devices + Connectivity + UI + Beauty” Mary Meeker of KPCB Image: http://gigaom2.files.wordpress.com/2012/05/eq7g4601.jpg Slide 21 © Fjord 2012 | Confidential
22. Digital and mobile disruption Finance Education Telecom Retail Traditional industry verticals The medical sector is a prime are often inward-looking. example of this. The disruption starts from a Medical Mary Meeker estimates the broader consumer-led „re-invention‟ market domain. impacted to have a turnover of over $35tn. Image: http://www.flickr.com/photos/eatingoutloud/3451406160/sizes/z/in/photostream/ Slide 22 © Fjord 2012 | Confidential
24. Quantification for everyone The world of logging apps and sensor-enabled devices is looking to the mainstream, and the pursuit of well-being for everyone. Slide 24 © Fjord 2012 | Confidential
25. Specialist equipment consumerised Slide 25 © Fjord 2012 | Confidential
26. The chart fatigue challenge For people who start monitoring themselves, initially it‟s interesting to see the raw data. But the novelty wears off. When you need to move from achieving a goal to maintaining a level, chart fatigue easily kicks in. Slide 26 © Fjord 2012 | Confidential
27. Who will own and access our data? • Will your hospital or doctor own your medical data? • Will the cloud masters own your data? • Should it belong to all of us? Slide 27 © Fjord 2012 | Confidential
28. A communication gap between healthcare pros and patients “The patient is the most underused resource in medicine” e-Patient David deBronkart Tim O‟Reilly Slide 28 © Fjord 2012 | Confidential
29. The risk of a doctor–patient gap DOCTOR PATIENT Most healthcare professionals have not adopted new digital tools at work. At the same time people‟s expectations are changing. Slide 29 © Fjord 2012 | Confidential
30. We evolve – From Homo Sapiens… Slide 30 © Fjord 2012 | Confidential
31. …to Homo Cumulus Slide 31 © Fjord 2012 | Confidential
33. Raw data is not sufficient CONTEXT WISDOM KNOWLEDGE understanding principles INFORMATION understanding patterns DATA understanding relations UNDERSTANDING Slide 33 © Fjord 2012 | Confidential
34. Adding meaning BEFORE AFTER Wired magazine redesigned the blood test results sheet to make it more meaningful. Slide 34 © Fjord 2012 | Confidential
35. Adding meaning Test Name In Range Out of Range Reference Range Lab CHOLESTEROL 211 125-209 mg/dL 63 BEFORE AFTER Slide 35 © Fjord 2012 | Confidential
36. Good data visualisation is critical The age of Big Data is upon us. This is certainly the case in health and wellness. But a challenge that needs to overcome is to not only present data, but also make it meaningful and actionable. Slide 36 © Fjord 2012 | Confidential
37. In wearables, style & fashion matter Slide 37 © Fjord 2012 | Confidential
38. The wrist is the next frontier The surge in smart watches successfully funded is increasing. There is however still a quest for the killer app. MetaWatch and TouchWatch are funded, but nowhere at the level of Pebble‟s $10M Kickstarter record. The Fuelband is seen on the wrist of many – people like it, but everyone complains about inaccuracy. Slide 38 © Fjord 2012 | Confidential
39. Sensors get lost and washed One clear drawback of the wearable sensors that are clipped onto our cloths, is that we tend to forget them, lose them, or destroy them in the laundry machine. Sensors that are worn on your skin or are embedded in the smartphone are less likely to be lost or forgotten. Slide 39 © Fjord 2012 | Confidential
40. Open wellness platforms emerging Data siloes is a real problem for users and healthcare professionals alike. Open activity collection platforms are seeing the daylight. Fluxtream and Health Graph are very interesting as they allow both read and write. Withings has launched a new wellness coach allowing you aggregate a range of services and sensors from Zeo to Bodymedia. Macaw from USPM is also moving towards aggregation. Slide 40 © Fjord 2012 | Confidential
41. Creating rituals and habits is hard 1. ENGAGEMENT 2. ENFORCEMENT 3. EDUCATION Slide 41 © Fjord 2012 | Confidential
42. A potent service design combo Aggregated meta data Wearable sensing Minimal presented in motivational Wearable sensing personal input form Wellness transformation Slide 42 © Fjord 2012 | Confidential
44. • DIGITAL PHARMA• Slide 44 © Fjord 2012 | Confidential
45. • CUSTOM DESIGNED DRUGS • Slide 45 © Fjord 2012 | Confidential
46. • HOME PRINTED DRUGS • Slide 46 © Fjord 2012 | Confidential
47. • THE SOULMATE• Slide 47 © Fjord 2012 | Confidential
48. • THE DEVICE • Slide 48 © Fjord 2012 | Confidential
49. • POCKET X-RAY • Slide 49 © Fjord 2012 | Confidential
50. • DIAGNOSE OTHERS • Slide 50 © Fjord 2012 | Confidential
51. • DIGITAL JEWELLERY • Slide 51 © Fjord 2012 | Confidential
52. • GLANCEABLE • • AND AMBIENT • Slide 52 © Fjord 2012 | Confidential
53. • COMMUNICATION • Slide 53 © Fjord 2012 | Confidential
54. • DIGITAL REAL-WORLD GAMING • Slide 54 © Fjord 2012 | Confidential
55. Games are becoming „real‟ again KINECT GEOCACHING ZOMBIES RUN Exercise: Low Exercise: Modest Exercise: High PHYSICAL ACTIVITY Promotions, like the Fjord-designed app for Batman „The Dark Knight Rises‟ can also challenge the users to physical activity – for example movements in their city to attack or defend it. Slide 55 © Fjord 2012 | Confidential
56. • REAL DIGITAL SOCCER • Slide 56 © Fjord 2012 | Confidential
57. • DIGITAL RITUALS • EXAMPLE EXISTING RITUALS TO BUILD ON • Getting up • Weighing oneself • Brushing teeth • Looking in the mirror • Taking a shower • Having a cup of tea or coffee • Running / biking • Sunday breakfast • Setting alarm when going to bed • Getting into the car or on board the bus/train/tram • Going to bed Slide 57 © Fjord 2012 | Confidential
58. TONGUE PICTURE AND SKIN MOLE CHECK Slide 58 © Fjord 2012 | Confidential
59. TOOTHBRUSH FOOD AND NUTRITION FEEDBACK Slide 59 © Fjord 2012 | Confidential
60. ECG AND BLOOD PICTURE Slide 60 © Fjord 2012 | Confidential
61. Thank you. Thank you www.fjordnet.com | @fjord Slide 61 © Fjord 2012 | Confidential

Notes de l'éditeur

This deck is the second iteration of an overall Fjord H&W Point of View. The material covers lots of ground, and can be used in a flexible manner.The notes give plenty of guidance and info for each of the slides.The other document that’s very useful for insights, and for more background to this presentation, is the whitepaper ‘Fjord_H&W_Insights2012_edited_v1.1.pdf’, also available in the H&W knowledge platform.
Depending on the audience, the presentation can be customized to remove some of the sections. There’s so much ground covered in the deck that for a 60 minute meeting / presentation, it’s probably best to narrow it down a bit.
This section aims to give the audience an overview of what Fjord does and with who, and to establish us as credible players in H&W through our project/client work.
The award-winning Macaw service is a long-term engagement between Health specialists USPM (U.S. Preventative Medicine), Qualcomm, and Fjord. More about the case study below, but please note that we have both ‘standard’ and ‘hero’ versions of this case study, if you need it. For Adidas we’re doing some very innovative work on two fronts, both in the area of ‘miCoach’, their brand for personal tech-enhanced coaching (their equivalent to Nike+). One engagement is about a basketball training coach service, enabled with sensors worn on the body. The second engagement is about a smart watch, also with sensors embedded. Both projects are very confidential, and we should not speak about them publicly.With Harvard Medical School and the SMART platform, we’re re-inventing the universal pediatric growth chart in the US. This is a tool that’s used with every single child across the US, to monitor their progress. More about our work here: http://www.smartplatforms.org/2012/07/new-smart-partner-fjord/Omegawave is offering very innovative technology for top athletes. The core technology was invented by a Soviet scientist who worked on how to optimise the performance of cosmonauts in the Soviet Union. The technology measures brain waves, and also heart rates with full ECG. The service is used by teams like Manchester United, Barcelona FC, etc. Fjord is collaborating with Omegawave to bring the advanced service to the masses, lowering the level needed (fitness & knowledge) for getting involved, why retraining strong differentiation. More about Omegawave here: http://omegawave.com/USPM and Qualcomm(Macaw)New ways to quantify health, and even ‘game-ify’ the subject, for consumersOpportunityFjord collaborated very successfully with USPM, a dynamic preventative medicine company. Their business consists of promoting healthy lifestyles within companies, by creating personalised plans that employees can follow to improve nutrition and exercise. Ideally, this lowers insurance costs for the company and the employee, and everyone wins.The client wanted an app to make the personalised plans easier to engage with. Fjord also devised a way of making these activities and tasks more fun to use by making them more playful.ApproachFjord’s team created a new suite of activities that dovetailed with the service and its existing reward scheme. For example, users can also track manually weight and steps taken per day. These can for the basis of interactive graphs and tools over time, all accessible within the app.We built a mobile app for Android and iPhone that stretched user engagement further and build the prevention plan into a more everyday use. Users can use the app to see how they are doing each week compared to others in the system, in terms of activities completed and cards complete. There is also an inbuilt GPS tracker that maps your running, walking and cycling.Experience“The new revolutionary Macaw app is an important tool that is designed to be the ultimate mobile health hub, enabling users to improve their individual health outcomes while potentially lowering healthcare costs.”Qualcomm are clearly innovators in the area of ‘quantified self’ or personal informatics. Developing these kinds of personalised services that are ideally accessed through consumer mobile devices is a key challenge for service design companies like Fjord.Fjord was pleased to be helping the client maximise the value of their existing products and services, and supplying insight into usability and user experience throughout the consumer interaction cycle.
This section highlight some of the biggest needs and challenges in the H&W domain. (The focus is the West, not emerging markets.)
An aging population is putting a massive strain on Western societies. It’s a huge structural issue. A huge group of pensioners with long-term illnesses is a growing problem.In future elderly people will account for an increasing share of the population People aged 65 years or over will account for almost 30.0 % of the EU’s population by 2060 (in 2010 17,4 %)Long term health conditions (LCTs) such as diabetes, heart disease and COPD (chronic obstructive pulmonary disease) will rise in Europe from currently 53 billion to 64 billion in 2025. The workforce declines, while the healthcare system – and the costs – is growing
Poor lifestyle choices that lead to various chronic problems and diseases is also a huge structural problem for society.More than 1 billion people in the world are overweight, and at least 300 million of those are clinically obeseMore than 8 % of the U.S. population have diabetes(estimated 79 million U.S. adults have pre-diabetes)In 2010 almost 2 million new cases of diabetes were diagnosed in people aged 20 years or older (In UK has been a 50 % increase in diabetes in the past 5 years, costing the National Health Service almost a tenth of its total budget in treatment)Medical expenses for a person with diagnosed diabetes are more than twice as much as the expenses of a person without diabetesPeople try to take a better care of themselves but still the obesity keeps rising in numbers (Knowledge makes us think, but not act)
As you grow up / grow old, you add new health- and wellness-related priorities. Naturally this graph is not universally applicable – for example there are many kids with serious illnesses – but it’s important for us as designers to recognise the fact that the primary drivers change and evolve over time. Young people don’t typically worry about the future so much, and about potential future illnesses. Many of them don’t really care about healthy living either. Their focus is on looking good and getting laid. But over time, as people go through different life stages, they start to pay attention to new dimensions, and start to spend time and effort in addressing them.
Everyone can benefit from better knowledge and more information about themselves, their bodies, and their minds. Not everyone chooses to ACT on the information, but having access to it can be transformative.Increasingly, as we’ll see later on in the presentation, technology is making information and knowledge available.
Both individuals and Governments have lots of reasons, and the need, to move from a reactive model to a proactive one.Chronic disease accounts for roughly 75% of health care costs each year in the USDiabetes is the leading cause of kidney failure and of new blindness in adults (in the US). More than 60% of leg and foot amputations unrelated to injury are among people with diabetes.Each year in US, over $33 billion in medical costs and $9 billion in lost productivity due to heart disease, cancer, stroke, and diabetes are attributed to poor nutrition.The main challenges with shifting the model are (a) people’s habits sincechanginghabits is challenging, and (b) the industry itself is rooted in a reactive mode.Source: http://www.uspreventivemedicine.com/Prevention-Movement/National-Situation.aspx
In this section we’re introducing the main digital trends that are impacting society, and also the H&W domain.
In digital services, we can see a few waves of transformation. The first one was about the desktop web. It was the first digital service wave that really disrupted and challenged traditional businesses. The wave started growing in the early 90s, and hit the commercial mainstream in the second half of the decade. Internet services – which were conceived in this wave – are still powering the digital economy.
The last decade was all about the rise of mobility. Again, there was a ton of activity and development in the first half of the decade, and then in the second half – especially with the launch of the iPhone – disruption and transformation really took off on a huge scale. This mobility wave is what we’re riding today, and it’s possibly even more transformational than the desktop web wave.
The third wave is growing right now, and like the previous two waves, it will be very powerful. People have different names for it.We call it Living Services, because in essence we believe that the major transformation is about real-time data and service adaptability, for the individual. It will allow us to design experiences that are truly alive, and which are shaped uniquely around each user.
There’s a challenge: complexity – that notorious digital bug.Each of the waves are additive. They add to and build on the previous waves. With all the good and exciting things that each wave brings also comes a real challenge: complexity.Complexity for end users, as more and more of their lives is mediated by digital services and devices.Complexity for companies, as they try to navigate a digital domain that’s increasing exponentially in complexity.Fjord’s focus on elegant simplicity is increasing in strategic importance. It’s important for end users – to bring them delightful service experiences that are easy to engage with and easy to integrate into their lives.It’s important for clients – to help them prioritise and make strategic decisions, and to help them develop winning service solutions.
The next big wave – living services – is enabled by an ever-growing range of digital devices that are connected to each other and/or the Internet. These devices also have various sensors, and this will allow the capturing and analysis of huge amounts of data – often in real time.This digital platform allows us to imagine and design services that are living.The services themselves can be constantly alive, flexing, adopting, and changing. So we will not design dead artifacts – we will design highly fluid entities.The services can be created around individuals to a greater degree than ever before. They can be uniquely tailor made for each person, and can change based on time of day, place, user needs, etc. The services can start to make use of more natural interfaces. Instead of being limited to a mouse or a finger tap, the services can work with voice, with gestures in thin air, and can react and change based on wearable body sensors or other inputs. This is a great design challenge – to shape the next language for the digital world.We’re already doing some significant work in this third wave.
Tim, who coined and popularisedWeb 2.0, is of the opinion that the next frontier of the web is the web of sensors. It’s about distributed sensors, and clever algorithms in the sky. This is further validation of the importance of the ‘Living Services’ wave.
Mary Meeker is one of the most well-known opinion formers in digital. She’s an analyst and a venture capitalist, and has been dubbed “The Queen of the Web”.In her latest overview of the state of the Internet, she summarises everything with this header:“Re-imagination of nearly everything powered by New Devices + Connectivity + UI + Beauty”She’s explaining how all aspects of society, and all types of companies, are being reinvented thanks to New Devices, Connectivity, UI and Beauty.This is what we at Fjord do. We create services that are experienced on new connected devices. We shape best of class UIs, and we deliver beauty.At Fjord, we’re at the very center of the re-imagination of everything.
There are several industry verticals that are affected by digital.At the center of the domain is the self-defined industry core. It’s usually inward-looking, and it has often erected high barriers of entry for other players.But digital and mobile in particular are challenging the old industry vertical order.Around the industry core is usually another wider domain, which is defined by consumers, people.The disruptive new service work often happens in this adjacent area first, and then it moves to the industry core.At Fjord, we’re actively looking for domains that fit this pattern of digital disruption.Finance & Money, Education & Learning, Telecom & Being in Touch, and Retail & Shopping are 4 examples of ‘disruption doughnuts’.The medical vertical is a massive doughnut too.
This section is highlighting the more important impacts of digital in the field of H&W.
It’s increasingly easy and affordable for individuals to detect and get info about various different aspects of themselves. This ‘quantified self’ trend is gathering momentum, and it’s evident across various consumer categories. For example:Sports: Nike+ in shes, in the FuelBand, with Adidas MiCoach, with Endomondo, SportsTracker, RunKeeper, Suunto, Polar, FitBit, etc.Well-being: Withings scales, Jawbone UP (monitors sleep patterns too), etc.In people’s smartphones there are also a lot of sensors, and there are numerous apps that can give you stats based on the movement of your smartphone and you.The mass-market habit of quantifying oneself is starting to build in the West.
Increasingly, consumer devices and services are also starting to play a role within the more specialist core of H&W.Powerful, reliable new sensor technologies are increasingly available to consumers and are being adopted through devices like smart phones or wearables. One example is the ECG (electro cardio gram) technology. Now one can buy an iPhone ‘sleeve’ with heart rate sensors.When the price of specialist technology like ECG goes down, and as the ECG availability moves from the hospital to everyone, it has the potential to change a lot.Using one of these ECG iPhone readers, the Doctor and mHealth guru Eric Topol saved a person’s life on board a passenger plane when he used one of these devices to correctly diagnose a massive heart attack. The patient still lives.
Fjord has identified a shortcoming with the current services: one that we call ‘Chart Fatigue’. While some of the current products are effectively motivating users to be more active and help them achieving a goal, the excitement and interest generated by self-measurement quickly wears off.This is a design challenge. These services need to move from a focus on helping to achieve to a focus on helping to maintain.
There is a growing trend – after lots of lobbying – for companies to give end users access to their own data. Google and Facebook have both given way to this demand.Wellness data could become a public resource – a collective pool of health information that belongs to us all rather than the proprietor of a wellness service.As a contributor I anonymously share my data on sleep / blood / nutrition etc which is pooled into the web of wellness. Services are then developed that help people understand their own condition in the context of everyone else.
As ePatient David deBronkart puts it, “the patient is the most underused resource in medicine today.” The healthcare industry treats symptoms, and is highly specialised, which leads to information not flowing well between the industry silos. The dialogue with the patient is often fragmented or no-existent. It’s a massive lost opportunity.
While self quantification and digital information are very positive development for users, Fjord’s research indicates that this is today still largely ignored or even discouraged by the professional medical space. Doctors need to embrace this development. There is a major opportunity for services that can bridge the gap between the professionals and the people; between doctor and patient. This should lead to services that fulfil the requirements and current shortcomings seen by the professional space, while still offering the advantages of social networking and knowledge exchange.
As digital is meeting H&W, as a species, we’re evolving. From the humans we know today…
…to Homo Cumulus, a technically enhanced physical and mental ecosystem.Our bodies and our gadgets (some of which are worn) will contain more and more sensors, and we can capture every aspect of our body and mind with ever more accuracy.This data is connected to the cloud (Cumulus) where it is analysed, compared, and utilised in clever ways. Smart algorithms will make predicitions, risk analysis, suggest optimisation, etc. The data collected will also be shared in appropriate ways with other services and environments that are related to the body ecosystem: our car, our home, our fridge, the world…
This section outlines a range of insights and inspirations for the domain.
Turning raw data into something meaningful is one of the primary challenges. Most of the current wearable wristband devices and other tracking products and services are little more than aids for data collection and visualisation. As the information hierarchy suggests, from data comes information, leading to knowledge and then finally wisdom. At the moment, it is down to the user to take even that first step.
Fjord believes this shortcoming can be overcome with service design. A perfect example of an improvement is the way Wired magazine redesigned the blood test results sheet. By visually putting the results in context of health averages, something the doctor would normally do in a verbal consultation, the user is able to gain a better understanding from the raw data.
When the context is visualised, the data becomes so much more meaningful for ordinary people.The new picture below is showing your data in relation to clear averages. Essentially, this visualisation is closer to a game’s leader board than to dry medical data. It’s both more understandable, and more engaging.
Data visualisation will be key to make data understandable, and also glanceable. The visualisation should not be merely pretty, but also understandable and actionable. As data and info constantly increases but our bandwidth remains the same, better ways to quickly glance and understand dynamics, patterns, and information, will be key.The visual on the left is a dynamic visualisation of the various purported health benefits of the health supplements on offer, their popularity and their effectiveness at actually helping. See it here: http://www.informationisbeautiful.net/play/snake-oil-supplements/The data visualisation in the middle is from Withings, and it uses simple visuals to help better communicate some simple statistics.The visuals on the right are from Nike’s Fuel-band service. Nike has worked hard on data visualisation – both on the hardware itself with LED text & numbers, and with coloured light strips, and in the digital user interfaces, like on the iPhone screen shown here, which shows the ‘fuel’ burned compared to the daily target of the user.
Wearables are moving to the mainstream, as noted by prominent Forrester analyst Sarah Rotman Epps in this article. One key aspect when it comes to wearables, is that when you start to wear technology, it’s about style, appearance, desirability, fashion. While you CARRY gadgets, you WEAR fashion. This is a design challenge.
The iPhone and other smartphones have shrunk and moved the computer to the pocket.The next frontier in miniaturization will be to move the computer to the wrist.Just like the smartphone used to have a strong umbilical cord that connected it to the old digital hub – the laptop – it will be important for smart watches to connect well with the new digital hub – the smartphone. The smartphone will have better text input, more screen space, better data connectivity, etc. The smartphone and the wrist-worn devices will be in symbiosis, at least in the beginning of this revolution.
We seems to wash and loose a lot of sensors in the early days of quantified self, this is a common problem with theFitBit.Sensors that are embedded in clothing are still lab stuff, or alternatively used in high performance sports only.
Currently people-related data is typically captured and kept in silos of individual services or the siloes of the healthcare system.One of the biggest data needs in H&W is to enable the data captured to be cross-pollinated and used in many places. Open platforms will become key, and the trend is moving in that direction.There are numerous regulatory and privacy matters to overcome, but until H&W data can be set free, its effects on society will remain limited.
To make improvements in H&W, people need to break bad habits, and need to start new better habits. Behavioural change sounds easy, but is one of the hardest things to accomplish. Just ask anyone who has ever made a New Year’s resolution :-)An important aspect of prevention through behavioural change is establishing rituals or habits. The medical domain enjoying most success in this are is probably dentistry. Kids are taught from an early age about the importance of regular brushing, and the combination of this activity with getting up and going to bed routines has ingrained it into our daily lives.Rituals come in different flavours. While there are daily rituals like tooth brushing, there are less frequent health related rituals like having your blood picture done once a year. The lower the frequency, the harder it is to remember and keep doing it. Again, dentistry is a good example since in many cases patients are actively reminded of such less frequent check-ups through postcards or reminder emails.Introducing new rituals is very complex, however. In the case of tooth brushing, it involves components like understanding of consequences (for example in the form of pictures and stories about what might happen to one’s teeth, or fear of going to the dentist and therefore doing anything to prevent that) and enforcement (like parents making their children brush their teeth)
As service designers, we will be exploring how we can create successful services in this general domain. One potent and interesting starting point is this, where we have 3 design drivers for 3 key aspects of the overall experience.There will naturally be other powerful dynamics and aspects to integrate too. One might be the social aspect of the service. Another might be target setting and gaming dynamics.
This section introduces a range of digital H&W ideas generated at Fjord.
Of particular relevance to digital transformation is the Pharmaceuticals industry. As digital service designers, Fjord believes that amore radical operating model forpharma is needed. We’re not alone in this belief. A recent article by McKinsey & Co. suggests that the Big Pharma companies need to think about a bolder and more radical operating model.
Part of it could be the digital transformation bringing Pharma companies much closer to the actual patients and consumers, as well as a shift from the current centralised mass-production model to a distributed, on-demand, customisation model. Genome sequencing and new drug production technologies currently being researched like 3D printing are potential enablers of such a new model.
The opportunities:Simplifying treatment regimens by combining multiple medications into single pills.Custom designed dosages that allow for regimens centred around individual habits and lifestyles.No more pill boxes and generic leaflets, but customised information leaflets for the particular user.Dynamic systems that allows for adjustments of dosage and mixture with each pill – this enables a continuous improvement and tweaking through the doctor.No more medicine cabinets filled with half-empty packages, only the pills actually needed are produced.User empowerment to include personal preference into medication design. Parents could chose the preferred taste based on what their child will be happier to take.
THE SOULMATE IS A SMARTPHONE THAT KNOWS MORE ABOUT YOU THAN YOU KNOW YOURSELFThe mobile phone has evolved to become an essential object of mobility. It is gradually replacing our wallet and our keys: now we wouldn’t dream of leaving our homes without it.But the smart phone is set to go through more transformations.
The first one is the smartphone evolution to a Liferecorder, a device that understands the context of the user and her environment. This transformation starts with constantsensory awareness. Today each sensor is turned on and off as needed, as there is simply not enough battery power to keep sensors on.But with the Liferecorder, a core bundle of sensors are constantly on – sensors that record our lives autonomously, including GPS, light sensors, motion sensors and the camera. By intelligently combining sensor input, the device can create meaningful awareness and thus a base for smarter decision making.Eventually the SoulMate will become a fusion of the Liferecorder and the Tricorder, a vision for a diagnosticinstrument used in the Star Trek movies.The SoulMate is the first fusion where biology andelectronics merge, an interface into the self. It knows and understandsyour genome. It knows your habits, your cravings and it can keep an autonomous dialogue with the coaches, experts and expert systems that you have empowered to help you live healthier and perform better.The SoulMate is like a smart mirror or lens into your life, it tracks changes in your skin, it could track patterns on your tongue, it could analyse your breath for anomalies. As such it has some abilities to see the future, as it can based on computing lots of past data predict how you will react.For example if you select fish for starter, then maybe meat and broccoli is the best complement. If you display a certain symptoms it can make a prediction when you will be well again.
This example shows a user that’s had a bike accident, and is using his SoulMate to analyze the damage, and send the details to a healthcare professional who can advice on what action to take.
The Soulmate can also be used as a scanner of life, quickly and easilybeing used on others. It becomes an indispensable tool for diagnosis when you travel. It enables you to scan your children and connect you with the right information.It will help you decide if you should involve a doctor, it could also start numerous parallel medical analysis. The SoulMate will through its sensors generate medically robust data that can be packaged into the right physician-friendly format.Because the SoulMate provides a parallel lens to multiple experts in parallel, it will help the physician and other life coaches to see a longitudinal view, rather than forming diagnosis from a snapshot in time. As it provides a holistic picture and it keeps a dialogue with ones GP it can help its user with proactive life management. When travelling in a foreign country itcan also translate and help make sense of the conversation with the medical professional.The SoulMate can see deeper than the skin: it is the X-Ray machine of the 21st century.There are many significant challenges with designing the SoulMate, one being to invent a robust and user-friendly interface to self. Currently medical data is expressed in Latin and chemistry, but increasingly it is being expressed into curves. It will be crucial to invent experience that make the rich data accessible, actionable but not dumb.In most cases life goes on and the SoulMate sits in the background without making a fuss. If it constantly nags, users will probably turn it off: so designing the right level of ambience is crucial.The SoulMate will not be an overnight transformation. It will be a gradual evolution of the Smartphone. At some point in the future, the Liferecorder will merge into the SoulMate. And on the way to it, we have becomeaddicted to some of wellness factors the Liferecorder records.
TOWARDS INTIMATE ELECTRONICS AND SERVICESHumans have decorated themselves with jewellery and worn ornaments on the wrist for millennia. More recently, we came to incorporate timepieces as objects of desire, and as watch movements shrunk, we were able to incorporate these into our jewellery.At Fjord, we think the wristwatch and also the armband are now evolving into smart objects.It’s part of a process in which electronic devices become more intimate, as they start to record our personal data. This kind of intimate data recording is set to take place on wrist wearables as they become the next major frontier in device and service design. Intimate and biological data recording is best done on the wrist.These devices will start to uncover your life patterns, using information that previously we would only share with loved ones and professionals in confidence.Activity and movement will become a central component of proactive wellness.
WRIST WEARABLES OFFER FOUR UNIQUE HUMAN FACTORS THAT SMARTPHONES FAIL TO MATCH:1. Worn 24/72. Provide skin contact3. “Glanceable” 4. Always onLike the smartphone, wrist wearables aretouch-friendly. From a business point of view, they offer additional value – they are fashion objects and have the ability to scale in value, far beyond the utilitarian value typically provided by gadgets. This opens up a very large and wide industry ranging from medical to social functions.Fjord believes that these objects, despite having a strong Health and Wellness implication, should be packaged into consumer goods. Turning wearablesinto communication tools is a great opportunity because at present there are no great ambient communication solutions for the deep relationships in life.As functionality grows, so do requirements for user interface. At some point the object morphs from a piece of jewellery and becomes a wristwatch. We think there will be a market for both smart connected jewellery and for smart connected watches.Fjord expects to see rapid innovation in gestural input along with the emergence of a general interaction framework across all wrist wearables, comparable to that which has emerged in the smartphone market.These are likely to include tap, doubletap, and rotating gestures, some onto the device, some in the air. Such gestures provide the active inputs. We expect touch to be integrated; early signs of this exist for example in the Mutewatch. The biological inputs are entered automatically. Initially these are based on a 3D accelerometer with sophisticated physio- algorithms.The output part of the interactions will rely on vibrations as well as on visual cues. The most interesting will be designing the ambient signals where either attention is required; motivation increased or maintain feedback is provided. Due to the limited real estate, a new form of language will emerge based on patterns, visual and light intervals and multi-modal combination of light and vibrations.
Enabling users to communicate with their performance and physical accomplishments, the intimate armband will motivate users through social motivation from friends and specific advice from a coach or guru.Think of it like this: Your loved ones are able to hug, kiss and stroke you remotely, and you will be able to use your wearable to love back. This ambient communication is built on the World Health Organisation’s classification of Wellness: Physical wellbeing, Mental Wellbeing and Social Wellbeing. Similarly, if the user is walking up stairs she can touch the green area and make a negative swipe indicating an element of fatigue. The mix between input and communication should be natural and smooth.It is important that it is low effort intensity, and can be done while doing other tasks, like walking up stairs. It can also act as a reminder for something that is love related. The device can flash in a particular manner to remind you of things. No textual notifications areneeded. If it is a reminder from or about ones loved.The armband is then visible via an app on your smartphone. This app provides richer controls and settings. The smartphone app is what keeps the armband focused, energy efficient, but without it wouldnot work. Settings complexity is moved to the app, where one has a richer user experience. Digital wearables are in symbiosis with the smartphone, but provide unique value.
Games are becoming ‘real’ again. Not only are console games like Nintendo Wii or XBOX Kinect involving full body activity in the gameplay, there are new technology-enabled niche games like Geocaching and Pervasive Gaming experiences like the ones designed by Hide and Seek that typically take place outdoors and involve a considerable amount of physical activity.Some of the examples mentioned in this presentation are already utilising game mechanics to help users achieve goals, including points systems and leader boards.But these mechanics can take different forms and don’t obviously have to feel ‘game-like’ to the user. A very effective way of creating behaviour change is a feedback loop. The idea is to put raw data in context, show consequences and offer actionable options to change the fact.11 Although not necessarily designed exactly in that way, many games create addiction through creating such a loop. The combination of your points score, the possible hi-score in the level or other people’s scores, and the ‘play again’ button is such a loop.
One example is the iPhone running game 'Zombies, Run!’ The game uses the data collected by the iPhone to combine the activity of outdoor running with an immersive audio game scenario delivered through radio messages and voice recordings. The player has to run away from zombies, defend buildings and collect virtual items like medicine.In ‘The Dark Knight Rises’ app the users set city challenges in their cities, and their physical activity and movements determine the outcome of the game in the app. Foursquare is used for determining and verifying location of the gamers.
Augmented reality glasses in combination with high-resolution depth cameras, once both reliable and effective, could increase the level of engagement.The opportunities:Outdoor games involving physical activity with the levels of engagement and immersion known from console and computer games.Internet-enabled multiplayer gaming in the real world.Training and practicing modes for single players.Goals and achievements set by or shared with the doctor-coach.Play anywhere – a patch of grass can turn into a busy football pitch with goals, lines and audience.
Fjord believes that rather than establishing new rituals, new services might be more successful when using existing rituals as their medium. Users of the Withings body scale have little problem stepping on it on a regular basis, because the new technology enabled service has replaced a ritual they had already adopted. For Withings, this is a base to grow from. If the service grows into taking additional measurements, an easy way of getting the users in a routine of frequent data sampling would be to include such sensing technology in the body scale, rather than introducing a dedicated product.We already have numerous existing rituals in life. Piggy-backing on these might be more effective than creating new ones.
Building services around interaction with the mirror. People are in front of the mirror several times a day. Can that ritual be turned into a simple diagnostics experience?
Integrating services into activities like tooth brushing. If the toothbrush could sense and analyse the type of food on the teeth, it could provide valuable nutritional advice.
Building services around smart scales is a natural evolution, and Withings are having some success with that already. Blood picture, pulse, body fat ratio, etc. – in addition to the basic weight information.

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