Collaboration is Cure
My ‘backliner’ journey started with a simple design, a face shield frame. The initial prototype was given out to medical professionals and other frontliners with a simple request: that they provide us with a user feedback, so we could continuously improve the product to better suit their needs. In total, the team was able to make and distribute 1500 face shield frames to small hospitals and local government units around the Philippines.
Later, I was fortunate and blessed to be able to join the UP Manila’s Surgical Innovation and Biotechnology Laboratory (SIBOL) team of tech professionals. It is basically a think tank composed of big names in research brought together by Dr. Edward Wang. However, in the eyes of a young professional like me, it pretty much looked like an Avengers team (or Justice League if you are a DC fan). I can still vividly remember our first Zoom meeting. There, on my screen, were the leading researchers in various science and engineering fields in the country. I sat in my room facing my laptop in awe! (Sucks that I couldn’t meet them in person to fanboy but considering the circumstances, it’s definitely for the best).
Working and exchanging ideas with these multidisciplinary experts was really exhilarating. Personally, I believe the lack of face-to-face meetings is one of the main challenges of ideation in the pandemic setting. But how do we make online ideation intimate and personal? How do we transcend the virtual borders and create a useful designer-client connection?
Given the limitations of the type of communication, it is important to compromise a little bit on the designer-client idea exchange and focus on one-way idea transfer. What this means is full reliance on the experience and knowledge of the medical professionals regarding what they need and fully letting go of that tenacious engineering/design trait known as the “hero complex.”
Don’t be a hero
The hero syndrome is exactly how it goes for most engineering projects I know. But here’s the thing: a three-day immersion will never match the locals and residents’ years of experience. They face those challenges every day so they probably know the most fitting solution that can easily be adopted given their culture and condition.
The same applies when engineering or designing for healthcare. As a backliner, it would be detrimental to the communication and design process for us engineers to take the lead, even more so given the non-ideal online setup of the design sprint. Our limited knowledge and experience with medical processes and culture would have prevented us from making appropriate solutions. Listening to the doctors’ needs became key. Essentially, the entire design process is just a retelling of their story and a strengthening of their narrative.
Designing for care is designing for diversity
As some of the proposed projects started rolling out, I discovered that healthcare engineering means considering diversity and inclusion without exception. This wisdom came to me as our team designed and fabricated the “Sanipod: Self-contained Disinfecting Cubicle”. The Sanipod is basically a small enclosed area that will aid healthcare workers in doffing their protective coveralls safely after a hard day’s work saving lives. This innovation aims to prevent and control nosocomial infections, or in simple terms, hospital-acquired infections. As we fabricated the alpha prototype, we went through a few (a lot, really) of revisions, particularly on the height and width of the cubicle and the positioning of the spray nozzles. This is actually nothing new; after all, design is an iterative process. But as I became exceptionally frustrated re-drilling holes and re-positioning the piping system, I began to realize what we were missing. We were always thinking of the AVERAGE. We asked questions like “What is the average height of Filipino males and females? What is the average width of the potential users?” There is nothing wrong about this per se. If truth be told, all engineering and design classes will teach you to always consider the standard user when developing a product. However, medical products are on an entirely different level. It is not about accessibility for most, it is about accessibility for all. If we had designed the Sanipod based on the standard, those with proportions at the extremes would never be able to fit in there. The medical professionals I worked with, Dr. Cathy Co and Dr. Edward Wang, made me realize how limiting my design thinking was and showed me a whole new way of designing for diversity and inclusion.
Move slow and DO NOT break things
Being a product developer, it is important to move quickly as new products get created every day. I also teach my students that at the initial phase of the ideation process, quantity is more important than quality. This way, they will be able to easily identify the best among the rest, living by Facebook founder Mark Zuckerberg’s motto, “Move fast and break things.”
This design motto does not apply to the healthcare industry, however. In contrast, it does not allow you to take risks when inventing and innovating. Why? Because in the medical industry, it is always a matter of life and death. Everything, even the smallest details, must be carefully thought of, including how the product can be integrated to the hospital operations before letting the product out. Believe it or not, our alpha prototypes, particularly the Sanipod, were already functional and ready for deployment given the cautious scrutiny of the medical professionals we worked with. This way, I learned that there’s no such thing as ‘too much care’ in healthcare.
The Need for Speed
Healthcare providers need to be agile and quick when attending to a patient. During emergencies, their pace may lead life or death. This pace becomes the driving force for hospital equipment to be more mobile and portable. The same goes in designing medical devices.
When our team was working with Dr. Cathy Co on her idea of a laryngoscope disinfection device, we had a predicament as to how to integrate the various disinfection techniques into one holistic product. We were determined to include as many features in the device as possible, to make it more beneficial. Needless to say, the first design I submitted was as big as an industrial washing machine! Upon seeing the design draft, Dr. Co made recommendations focusing on making the equipment lighter and more mobile, as doctors might need to move it around the hospital as quickly as possible. Honestly, I never considered size and weight implications during the design stage. The more, the better, right? Obviously, I was wrong, again. With the right mindset, the team then designed a laryngoscope disinfection device the size of a toolbox.
Sometimes it is the little things
A designer always dreams big, especially those in the architecture and similar fields. But to quote Sir Arthur Conan Doyle, “It has long been an axiom of mine that the little things are the most important”.
This illuminating moment came to me after we got the request to design and make Inline Metered-Dose Inhaler (MDI) adapters. Relative to the other components, the MDI is unnoticeable being a humble connector/adapter. What makes it extremely important is that it allows medications to be administered to the patient while hooked to the ventilator machine.
We initially focused and put all our efforts on the overall shape and geometry – which we thought was extremely relevant for the air flow. After the first test, it turns out, that wasn’t the case! What was actually essential was a small component in the adapter we tend to call the “nozzle”. This small part controls the drug administration and at the same time prevents the backflow of potentially infected air. As might be expected, we had to redesign the whole thing but this time prioritizing the small nozzle first and adjusting the rest of the parts accordingly.
Up close and personal
When we were designing Dr. Mikki Miranda’s digital stethoscope, we had to meet her in person. She wanted to show us the difficulties in using a conventional stethoscope with full PPE on. My close friend Engr. Charleston Ambatali who worked on the circuitry and electricals of the device, organized a safe meeting setup for all of us. We were also taught how to use a stethoscope and were shown its basic parts.
Online meetings, presentations, and seminars on medical equipment can never compete with real-life interaction. Design is fundamentally about spending time with the real users. That is how we obtain immense amount of texture and richness about how the product and experience will take shape. So, I came up with this rule — to immerse, interact, and have fun doing so!
ENGR. Jason Pechardo | Published in Healthscape Special COVID-19 Issue No. 15
