Curve editor, Belinda Stening, spoke to two experts at Philips Healthcare – Sean Hughes, Chief Design Officer, and Eric Silfen MD, Chief Medical Officer – to find out how design and a people-centric approach is key to addressing some of the world’s health problems, now and into the future.

Healthcare systems around the world are struggling to cope with the demands of our ageing population.

In developed countries, unhealthy and sedentary lifestyles are increasing the occurrence of insidious illnesses like obesity, heart disease and diabetes, while healthcare systems in developing nations are failing to reach people living in poverty or even those affected by natural disasters.

With such an overwhelming demand for adequate healthcare, how can design play a more strategic role in ensuring we live healthier lives and receive the healthcare we need?

“The healthcare industry is in crisis and is facing paradigm change,” says Hughes, who is based in Andover, near Boston. “However, there are plenty of opportunities for innovation within this crisis.

“Over the last two decades, Philips Design has developed a people-focused innovation approach that has generated tangible proof-points of the Philips Healthcare differentiator of ‘People-focused, Healthcare simplified’ across the home and hospital healthcare domain,” he says.

Hughes explains that the role of the designer at Philips Healthcare is changing from creator to the role of facilitator. “Our designers are looking at experience design, mapping the experience of people in multi-dimensions.

"This requires a holistic design approach that’s research-based and involves multidisciplinary design teams, including designers, psychologists, researchers and cultural anthropologists to better understand both the functional and emotional needs of, in the case of healthcare, patients, families and clinical staff.

“Our unique approach is driven by qualitative research, applies design thinking to identify innovation opportunities, and leverages design skills to propose solutions with measurable end-user value. It has proven relevance in business processes, ranging from strategy to product development, and has successfully supported both short and longer-term innovation for us.”

From a company perspective, it’s not only Philips that benefits from its design expertise. “We also work with external healthcare organisations and companies.

"By engaging with them, using our design capabilities, we create a win-win situation for both Philips and the external party. They benefit from the knowledge we have built up from decades of designing, we benefit from the valuable insights we gain by working closely with the people in their healthcare environments,” says Hughes.

Dr Silfen has a background in both the medical field and technological research – a very valuable com-bination – and he is an exponent in bridging the application of technology and innovation with the medical world, in such a way that it is humane and meaningful, to help to establish a ‘medical consciousness’ for Philips.

Silfen says, “The landscape is changing in a multi-directional way. This is not just due to increasing numbers of elderly patients. I refer to it as the longer lifespan of people. It’s not just a question of taking care of people who are older. It’s about understanding what it means to take care of all people, starting at whatever age, as we live longer.”

Significant transformations are occurring in the healthcare system as a result, making it essential to find the resources to support new technical innovations that are improving the standard of personal health and well-being, as well as competencies of the healthcare workforce.

“Medical care should be delivered to people in the way they want it,” rather than in the way the medical industry thinks they should have it, explains Silfen – who has a very strong relationship with design at Philips.

“The way people want medical care depends upon their personal feelings and beliefs, and that can only be addressed if you have a strong design organisation working with you.

“Technology may be one thing,” he continues, “but knowing who the doctor is, how medical care is delivered and presented, all of that is about design. We can’t be effective as a company without this very strong bond between medical thinking, innovative advancement and design’s ability to make sure it is people focused. It’s about what people want, not what we tell them they need.”

When Philips designs, they look at – what they call – the entire cycle of care, or care cycle, which consists of five phases – prevention, screening, diagnosis, treatment and surveillance – and the people that are involved.

Hughes explains, “What we see happening in this cycle of care is that the impact of digitisation is growing. Patient records, payment systems, image data-bases – all this will continue to be integrated, move online and move with the patient.

"Clinicians will look for information to make a diagnosis and expect to have it at their fingertips via clinical decision support software tools, delivered on increasingly smart mobile platforms.

"In order for them to collect and interpret this information in an efficient and easy way, we – as designers – add value by creating intuitive user interfaces that help them to manage their workflow effectively and streamline complex data flows smoothly.”

Experience design in healthcare

Being in a hospital can be a particularly stressful and daunting experience for children and adults. Hughes explains how in 2004 a people-focused solution to a design challenge was the beginning of bigger projects in experience design for Philips Healthcare.

“As designers we believed that the experience for a patient in a medical imaging department in a hospital could be much better,” says Hughes.

“So in 2004, we proposed to the Advocate Lutheran General Children’s Hospital in Chicago that we could improve this through design and a creative approach.” They immersed themselves in this problem, mapping the experience of the delivery of Computed Tomography imaging (CT) in the radiology department.

“We wanted to make it less intimidating for patients to be scanned in a radiology ward,” continues Hughes. For this first installation they created a total experience for the patient by extending the product experience to a more soothing environmental experience.

“It made children feel at ease. Before the examination started a child could play with the Kitten Scanner in the hospital waiting room. The Kitten Scanner is a scaled version of the CT scan and includes a televi-sion screen and toys with an RFID tag.

"When a child places one of the toys in the scanner it activates an animation on the television screen that tells the story of that particular character and mimics the results of a scan.

"In the examination room the child can choose a mood theme or ambient environment by waving a radio frequency card over a cord that triggered special lighting and animated visuals onto walls and ceilings.

This was the first Ambient Experience, as Philips has since named it. From there they designed Ambient Experience environments for other imaging suites such as Magnetic Resonance Imaging (MRI) suites and catheterisation laboratories.

“In cath labs we didn’t just focus on the patient experience, but also on the staff experience. Clinical staff are always present in the lab because it concerns interventional procedures, therefore we wanted to make it easier for them to achieve their tasks,” he adds.

A similar, and more recent, installation to the Ambient Experience at the Florida Hospital for Children has broken new ground as it covers the whole of the hospital’s dedicated children’s emergency department, extending far beyond a single examination or procedure area.

“With the Florida Hospital for Children, the main challenge was to apply this experience in a space where there was no Philips imaging equipment involved,” says Hughes.

“So we designed the entire experience flow, and not just the environment within an examination room. We had to take many aspects into consideration, like the state of mind patients and their families are in when they enter the department, who they meet, where and for how long they have to wait and how to balance relaxation with positive distraction.

"So we had to put together a coherent set of solutions for each situation.”

Here, the Ambient Experience extends from the emergency department entrance to the waiting areas, the triage area, nurses’ station and the emergency treatment rooms. The focus of the experience is to create an overall sense of calm in the more public areas.

The corridor that leads to the emergency department features a ‘glow wall’ of frosted glass panels backed with LEDs that slowly change colour.

A wall outside the triage area is covered by a LED display with a translucent honeycomb structure in front of it. This produces abstract images in many colours and shapes, and has a calming effect like a flickering fire. The main waiting area features an interactive illuminated wall where children can ‘paint with light’ by touching it.

The child is admitted to an emergency room that is equipped with a proscribe tablet to allow the selection of an animated theme for projection onto a wall, and children can listen to audio provided or can plug in their own music.

Philips is now rolling out Ambient Experience programs in over 200 hospitals worldwide.

Home-based healthcare

The delivery of healthcare at home is helping to relieve pressure on hospital systems worldwide. For the elderly, in particular, home-based care systems promote independence and increased self-esteem.

Hughes says, “Delivering healthcare outside the clinical environment represents a big challenge. In mature healthcare markets, such as North America, healthcare systems can’t cope, and healthcare authorities have been looking for ways to efficiently treat more people. One way is to treat people outside of the hospital.”

Philips Lifeline with AutoAlert function is an enhanced medical alert device and service. Designed as a non-stigmatising, reliable solution for elderly people based at home, Philips says it offers foolproof fall detection, and offers home-based and elderly people a solution to maintaining independence.

Falls are a leading cause of injury in the elderly community and often admission to hospital is required. The Lifeline features a pendant-style help button that can automatically call for help if a fall is detected.

The pendant is designed to be low maintenance – water-tight and easy to clean. According to a Philips laboratory study of simulated falls, Lifeline with AutoAlert detected ninety-five per cent of falls, with a very low rate of false alarms.

Philips sees home-based care as the way of the future for everyone, regardless of age. “Healthcare delivery will continue to expand away from the clinical environment as individuals will be forced to take more responsibility for their own care,” says Hughes.

“In the future,” he continues, “I think we will make the move into the realm where healthcare is as much about prevention as it is about intervention, and providing people with the healthy choices in all aspects of their lives will become increasingly important.” Lifeline AutoAlert received an iF product design award for 2011.

Philips’ innovative Design Probes program is a dedicated ‘far-future’ research initiative to track trends and developments that may ultimately evolve into mainstream issues that have a significant impact on business.

Exploring the future, and how people will interact with each other and themselves, is integral to their aim of achieving people-focused design solutions. By imagining extreme versions of far-future scenarios, the Design Probes team attempts to understand more about the issues that affect people today and tomorrow.

A recent Probe project called Self Health is a concept that takes a provocative look at health issues and could have a profound effect on the way we understand and monitor our own health and make lifestyle choices twenty years from now.

Self Health investigates a shift in emphasis from curative to preventative medicine – the differences in cultural perception of health and the possibilities of self-diagnosis.

The Probe research uncovered how people may be suffering from ‘touch hunger’, resulting from our growing physical isolation from each other (in some cultures) and poor lifestyle choices. People need to take more responsibility and interest in their health and well-being to prevent illness.

This prompted further exploration into issues such as the rise in eating disorders, addiction to plastic surgery in some societies and the therapeutic effect of physical contact.

Philanthropy by design

The Philips Philanthropy by Design program provides meaningful and socially responsible solutions to problems faced by communities with limited healthcare resources.

“Our continuing challenge,” says Hughes, “is to ensure we fully understand people in the broadest healthcare context. You can imagine designing a solution for an intensive-care unit in a leading university hospital in the US has a completely different need than developing a solution appropriate for rural India.”

The World Health Organization estimates close to 1.6 million deaths a year occur from inhalation of toxic fumes from indoor cooking using biomass fuels, such as wood, dung and peat.

The Chulha smokeless stove designed for rural India by Philips is developed to solve this problem and save lives. It has won many design awards, including a recent INDEX award.

Over the course of a five-month period, a three-person design team from Philips Design in Pune in India turned the initial design idea into two field-tested prototypes.

This was a collaborative effort involving local NGOs, entrepreneurs and a few families in cooperation with the Appropriate Rural Technology Institute, an NGO that develops and promotes innovative technologies to improve the quality of life in rural India.

The Chulha project extends beyond the design of a healthier, safer and more efficient way of cooking. The philanthropic business model for the Chulha uses an unconventional model to give it widespread acceptance in rural communities.

Local NGOs are able to use the intellectual property and design and mould stoves for free. A complete support package has been created that includes not just the details of the stove’s physical design, but also marketing information for local entrepreneurs, communication materials for NGOs and installation instructions. A customised version of the Chulha has been introduced in Kenya.

A more recent philanthropic project, the Breath Counter, is a ‘breath timing’ device to assist care-givers in rural and remote areas to diagnose pneumonia in young children. The device is solar powered and can be used by anyone – regardless of literacy skills.

“We are driven by clinical excellence,” says Silfen. “We are people focused and based upon the needs of patients, care-givers, clinicians and others involved in the world of medical practice – everything we do is driven by a medical understanding. And only then do we bring forward our technology and innovation.”

People are the central focus of design for Philips. Whether a conservative and controlled clinical environment or a remote rural village – design needs to be totally informed with rigorous research – putting people first. This is a core value that we can all bring to design.  

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