Going deep into anaesthesiology.
With MSD Merck Sharp & Dohme
To rethink a medical monitoring device to monitor neuromuscular blockade, for and with anaesthesiologists.
A validated prototype of the ideal device, with recommendations on the type of material, characteristics, and connectivity.
Neuromuscular blocking agents are usually administered during anaesthesia to facilitate endotracheal intubation, optimise surgical conditions, and assist with mechanical ventilation. Very few anaesthesiologists make use of the devices that allow them to monitor neuromuscular blockade. We dived deep into the world of anaesthesiology to understand why. Were there enough devices available? Why were the available ones not being used? How could we design a device that did meet the needs of anaesthesiologists?
Portuguese anaesthesiologists were trying to change the future of this medical branch, and while there were many ideas, there weren’t many certainties. It all changed when designers and anaesthesiologists came together.
Understand the problems behind the original device.
Redesign the medical device and validate it among anaesthesiologists.
From field observations to interviews with anaesthesiologists, we were lucky enough to go behind the scenes to find out a bit more about this speciality’s crucial role in an operating room.
After putting on some scrubs, we walked along operating room halls and observed surgeries. It helped to understand how important it is for the anaesthesiologist to be in control, and how that had to be taken into account in the solution we were going to design.
We interviewed different stakeholders, but we mainly talked with anaesthesiologists. They were the end-users of the device we were designing after all. Their input was crucial in creating just the right prototype.
spent in operating rooms
to simulate ‘going under’
Doctor doctor, give me the (bad) news.
After talking to a large number of anaesthesiologists, we were left with a number of findings. We discovered that these devices:
We also found that the original device required anaesthesiologists to have a higher mental and physical role than necessary during surgeries which, in turn, led many to perceive it as an unnecessary extra step.
Incorrect readings + difficulty when placing its electrodes + habit of relying on clinical evaluations = Unreliable device
Doctor doctor, give me the (good) news.
We did, however, also find that this device allows anaesthesiologists to:
In order for this device to become more relevant, we knew its characteristics must approach those of the mandatory monitoring — from the ECG to the pulse oximeter — which doesn’t require as much of a physical and mental role from anaesthesiologists. Above all, we knew it couldn’t be seen as just one more device.
We couldn’t help but wonder: could improving the usability of this medical device revolutionise the operating room?
Above all, we confirmed the need to develop a solution that didn’t disrupt the environment it would exist in but that, instead, seamlessly blended itself in it. We knew what we were aiming for:
For anaesthesiologists, the solution had to promote autonomy, allow anticipation, facilitate interpretation, increase access to knowledge, and guarantee control. To become indispensable, the solution had to be reliable, affordable, easy to use, robust, and contextual.
Research results aren’t usually presented to the people we interview. However, since we wanted to come up with a solution that was truly useful for anaesthesiologists, we needed to have their contribution. At the end of our co-creation session, different groups of anaesthesiologists whom we had previously talked to prototyped new solutions from the research findings we presented.
We had a fresh new prototype that we tested at the end of each round of interviews; it not only gave us continuous feedback, it also engaged the people we talked to, and it showed them how a concept could be translated into something real.
We took the ideas and prototypes from the co-creation session and merged them into one single solution. We validated it with the people who mattered the most, and then went back to the field to test our prototype in different hospitals. After 33 tests, we only needed a few adjustments.
Our final ‘prescription’ was made up of three components.
After another round of interviews with anaesthesiologists, we reached a consensus as to what would be the ideal solution:
How much a third of anaesthesiologists would pay to buy this device themselves.
After validating the prototype, we defined the material, characteristics, and connectivity specifications of the three components:
Adjustable, washable, airtight, shockproof, and bluetooth enabled.
Butterfly-shaped and disposable to ensure hygiene.
General and advanced viewing modes, visual & audible alerts, data export.
We also developed an implementation roadmap, broken up into two phases. The first phase included developing the tablet version of the app to allow an easier adaptation to other devices at a later stage. It would also be an opportunity to develop new features and complementary apps.
Stimulator and monitor release
Webserver, smartphone and smartwatch app launch
We didn't stop there, however, and suggested three different business models to start developing this solution: Bait & Hook, Freemium, and a Leasing model.
The Leasing and Bait & Hook models would be the most profitable in the short and medium-term, and could bring a faster return on investment. However, since the focus of this product is the democratisation of neuromuscular blockade monitoring, the Freemium model would allow for easier market entry.