There should be no confusion: good design pays dividends. Literally. Many highly successful medical products that substantively improve the delivery of healthcare also significantly increase market share and revenue. But just what is the elusive good design that delivers success on multiple levels?

What Is Good Design?
Good design fits like a glove. It feels right. Good designs perform the way users think, feel, and behave. Good designs are simple, unambiguous, and match physical and cognitive capabilities. They seamlessly extend the human mind and body.

Good designs also create emotional connections with users that build a bond with the brand. Over and above perfect, flawless performance, good designs invite users to engage. Good designs never intimidate the user into paralysis. They mitigate initial fears of change and encourage the experimentation that generates user adoption.

Good designs anchor in successful first impressions that make or break a “sale” in the user’s mind. How a product presents to the user and conveys value before the first use is the critical threshold for product success. And that moment is controlled by good design.

What You See Is Not Always What You Get
Looks can easily deceive in product design, especially medical products, due to their complexity and unique functional environments (e.g., surgical theaters, clinical labs, patient rooms, home health applications). In a typical medical device sales cycle, sellers and buyers sit in an office, meet between surgeries in a change room, or talk on the 9th hole of the golf course about the great new product. Clinicians may imagine using the products to envision possible results while sales reps extol the product features and benefits, point to detailed clinical studies that rarely get read, and try their level best to convey supreme confidence in the new design to engage clinician trust and trigger the buy. The less intuitive and less apparent the product design’s relationship to its use, the more the sales rep must rely on his or her ability to persuade the buyer.

Telling a Believable Story
Clinicians, understandably, find it difficult to provide objective evaluations of a product’s features, benefits, design detailing, and ergonomic considerations, as well as how these factors may impact performance, prior to actually using the device. Clinicians are not human factors engineers or design research experts trained to provide objective evaluations of product performance.

Telling the product story is the most effective way to sell it to a prospective user. New products with good designs solve current problems, so the story must begin with a clear and concise identification of the unmet and/or unarticulated user needs the product addresses. An effective product story is based on facts, not fiction. It is authentic, devoid of ginned up marketing claims of faux ergonomics and performance benefits that are unmeasurable. Overpromising on features and benefits then under-delivering during usage undercuts trust in the product, severely harms the brand and product portfolio, and can kill a business overnight. The start of an authentic story begins earlier by studying end users.

The DNA of Authenticity
Contextual inquiry, human factors engineering, and design thinking are the primary tools to study user needs and usability, and to identify innovation opportunities. These tools allow teams to determine specific ergonomic and product performance attributes that the successful design must incorporate. Good design research not only focuses the person/product interface; it must also consider the ecosystem in which the product is used. The use environment—the variety of adjacent devices and systems used in conjunction with the product, disposables, how usability is visualized (either directly or indirectly on a display)—through to other digital footprints for monitoring, recording, and post hoc analysis all significantly impact good design (Figure 1).

Human factors engineers and design research specialists watch and record precisely how people use a product and listen meticulously to how they say they use it. Observing and recording is essential because what people think they do and how they describe it are never the same as real behavior. Good design means going to the point of sweat to observe user behavior, taking note of all hacks, workarounds, and Post-It notes that compensate for unintuitive designs and unintelligible IFUs.

User needs research is the holy grail of good design. Lack of understanding about where or how a product is broken means all downstream design efforts are profoundly compromised.

Functional Aesthetics
Too often, designers focus on aesthetics at the cost of functionality. In consumer electronics and everyday products, the balance between aesthetics and functionality is markedly different from healthcare product design. The axiom “form follows function” provides the best driver for medical product designers because no amount of cool design styling will rescue a product that is unintuitive, hard to use, or demands excessive cognitive and/or physical resources. At the end of the day, if the product doesn’t work, it fails, no matter how beautiful it is.

Good design in medical products requires functional aesthetics where each and every detail, texture, color, surface treatment, and form factor tell a specific story to the user about the product (Figure 2). A convex surface with texture tells the user to place the fingertip here. A scalloped control surface on a handpiece collet communicates the direction of action needed to release the disposable tool tip.

Functional aesthetics remove all ambiguity through visual and tactile design cues that explicitly convey the most effective way to interact with the product.

Emotional Design
Good design must also consider the culture in which the product performs. Surgical techniques and hospital protocols are steeped in tradition and memorialized in hospital procedure manuals. New products challenge these conventions and create trepidation in clinicians regarding the learning curve, impact on performance, and the potential for use errors. Further, given the pressure to monetize surgeon time, a potential change that may lengthen a procedure or increase time fidgeting with a medical device may lead to organizational pressure on that clinician.

Designing a product is like solving a puzzle. With medical product design, it’s not uncommon to have more pieces to the puzzle (i.e., more needs) than initially expected or ultimately necessary. This abundance of needs introduces the significant challenge of prioritizing and balancing them with the cost of bringing a product to market at a price that can deliver profits.

Overcoming emotional barriers to adoption can only be accomplished by presenting a product design story that clearly and concisely articulates the problems and challenges of the current design and how the new design eliminates them and provides a higher level of fidelity between the user and the product.

Design Integrity
Good design is authentic, reliable, and provides a seamless extension of human capabilities. It enhances clinical performance and is better for patients and clinicians. Good design incorporates functional aesthetics that communicate all features and benefits embedded in the design in a way that is explicit and intuitive. Good design empowers, and as a result, is sought out by clinicians because it enhances their own personal performance. But before all these benefits can be realized by users, good design projects confidence, quality, simplicity, and ease-of-use, which builds an immeasurable bond between brand and buyer. Good design has integrity that, by its very nature, translates into value for the product, the brand, and the bottom line. 

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Dr. Bryce Rutter, founder and CEO of Metaphase Design Group Inc., is a leading expert in the research, ergonomics, and design of medical products, and a worldwide specialist in hand-intensive products and packaging. His work includes collaborations with numerous global prestigious brands and high-profile startups on products ranging from robotic surgical systems, powered and manual instrument design, and drug delivery systems to disposables, mobile and wearable devices, and personal care products to IFUs, as well as usability and contextual inquiry research programs. Metaphase delivers innovative designs that redefine industry standards, invigorate sleepy brands, and create new product categories. Under Dr. Rutter’s leadership, Metaphase has received more than 120 international design excellence awards and 117 patents. Dr. Rutter holds degrees in industrial design and a Ph.D. in kinesiology, specializing in hand function. Contact him at bryce@metaphase.com.