A future for food||

A future for food; the need for innovation in agriculture

Currently agriculture is facing challenges from many directions. Modern hyper-intensive farming (demanding the highest crop yield from monocultured crops with less regard for long-term fertility or ecosystem metrics) is interrelated with the great environmental threats; destabilising climate change, biodiversity, oceanic dead zones and poor global soil health. In turn these issues are impacting agriculture.

Often it is trends in our society that influence business strategy and investment. CDP has an in-house team dedicated to tracking them and based on the mega-trends we see today, we think that agriculture is heading for a revolution.

CDP’s Year in Industry Students Charles Griffith and Isaac Blanc, give us a Gen Z view of the future.

The Big Picture

Agriculture has undergone three great revolutions. The first was ten thousand years ago, which saw humans first begin to cultivate seed crops and domesticate animals. The second was three centuries ago during the Industrial Revolution, which saw human and animal muscle power replaced by machinery. The third came about in the last half of the 20th century, which saw the start of modern intensive food production, and has supported an ongoing boom in the human population. This revolution was characterised by increased agrichemical use and highly specialised and lately GMO crops.

Perhaps today we are starting to see signs of a new agricultural revolution, with the emergence of a new technology called Controlled Environment Agriculture (CEA). As the name suggests, this involves producing crops for food or pharmaceutical products, using technology to control many or all growth parameters. Whilst typically referring to controlled indoor environments for plants, it also extends to animal agriculture. Here, factors like animal autonomy, reproduction and hormonal balance, as well as environmental conditions, may be controlled to maximise feed conversion ratios. Taking control of traditionally “natural” factors in this way is allowing CEA to offer significant gains in productivity, reliability and quality of produce. Currently, commercial CEA is chiefly producing leafy greens, while more complex crops like nuts, coffee or avocados are trickier and require the technology and market to mature further.

However, we can see four mega-trends that we think together will stimulate the innovation needed to create a fourth revolution in agriculture.

Health and Wellness

Consumers are increasingly becoming aware of how the food they eat can further their health and wellbeing. As an example, we’ve all heard that leafy greens are good for us (they are rich in many micronutrients) and so it’s resulted in an increased demand for them. However, leafy greens are highly perishable and, due to the logistical challenges in supplying these foods year-round with traditional farming methods, their prices are high for what is essentially just a leaf.

It makes sense that in its early days, most current commercial CEA crops are leafy produce as no pollination is required, the plants have a small form factor and offer fast ROI as their lifecycle is short. Consumers concerned with chemicals and pollutants in their food can seek solace in the bio-secure origins of controlled agriculture produce. Additionally, leafy greens from vertical farming or controlled greenhouse operations (like BrightFarms, which was born in New York) can boast higher mineral profiles compared to outdoor crops.

Premiumisation and Traceability

Mega-trends of ‘premiumisation’ and ‘traceability’ are also catered for by CEA. In terms of premiumisation, with affluent consumers becoming ever more interested in the quality and production of their food, some CEA warehouse operations market their produce as being more local, grown with minimal or no insecticides, herbicides or fungicides, and offering superior quality compared to outdoor plants, both in perceived freshness but also nutritionally.

In terms of traceability, there has been an increasing desire amongst consumers to buy locally, which has emerged from several factors including supporting the local economy, eating fresher food and reducing carbon emissions and pollution caused by transport. However, with an increasing proportion of the global population now living in urban areas the question is: how can you buy locally grown food when you live in a huge city?

CEA start-ups have a unique opportunity to capitalise on this dilemma, as the technology is ideal for urban agriculture. For instance, Gotham Greens, which run three high-tech greenhouses in NYC and one in Chicago, boast that their produce is “hyper-local” and even grow a type of rocket they call ‘Chicago Crisp’. Business seems strong for companies like this; BrightFarms have grown about 10x in crop capacity between 2015 and 2019.

Sustainability

Perhaps the trend with the widest impact is sustainability. The Earth has finite resources and it’s critical that we use these in a more efficient and circular manner. Taking water as an example, the global freshwater supply is under increasing strain and water prices are rising. Outdoor agriculture can consume an enormous amount of water whereas when using techniques like hydroponics, aeroponics, deep water culture or the nutrient film technique (NFT), CEA warehouse projects are able to make saving upwards of 90% when compared to similar crops grown outdoors.

There is also a huge strain on arable land. Industrial agriculture has led to degradation of much topsoil while deforestation and heavy tilling have rendered land unabsorbant and vulnerable to extreme weather (of course, more likely with progressing climate change). Heavy agrichemical use can decimate the soil microorganisms that play a crucial role in decomposing and upcycling nutrients (therefore more fertilisers are needed for the same growth, and the cycle continues). The reduction in agricultural capacity contrasts with the growing human population, not to mention the need to rewild and reforest in order to capture carbon and foster the recovery of our biodiversity.

Clearly, innovation is needed here and while single-story controlled agriculture can significantly boost productivity and reduce land use, there is another somewhat more hyped branch of CEA – ‘Vertical Farming’. This practice of producing food in vertically stacked layers increases the yield per square metre. However, the construction cost is high, and so is better suited to urban environments where the land use savings will counteract this. Artificial lighting, most often provided by LED lights, consumes power which may not come entirely from renewable energy sources. There is a great need for increased efficiency in vertical farming, in both building and running the systems.

Changing the demand side

Of course, while we all want to eat more greens, we can’t discuss food sustainability without mentioning the impact of animal agriculture. The most comprehensive study on agriculture to date, found meat and dairy provides 18% of global calories and 37% of protein, yet requires 83% of currently used farmland and produces 60% of agricultural greenhouse gas emissions, when all production factors are included. The UN has urged, for the sake of sustainable resource management, for humans to shift away from meat and dairy. The impact of animal agriculture is not bound to land either; for example, the fishing industry is responsible for a significant amount of plastic found in the ‘great pacific garbage patch’. Meanwhile, other studies have shown that such a shift would be better for public health too.

This has all led to our final mega-trend: the rise of flexi’s, veggies and vegans. Changing what we eat has the most potential of all to reduce the environmental impact of our food. Consumers would benefit from help to do so, one way to do this would be the introduction of environmental labelling on food. We have labelled household appliances in this way for years, and they have improved so much in response that we have had to create new energy efficiency categories. The top right image in this article’s illustration is an example of such a label, inspired by a proposal from Joseph Poore at the University of Oxford. Additionally, rapid advances in alternative meats mean this transition is looking increasingly attractive to those consumers who don’t want to change their diet.

Conclusion

Innovation in agriculture is not only being driven from evolving consumer preference, but also from the needs of our planet. We are living in an age of widespread intensive agriculture, for all its achievements, it has also brought about environmental challenges. Without wide reaching, transformational innovation to change our food system, there may not be enough capacity in the future to feed us all.

Fortunately, innovation is emerging, for example advances in CEA are facilitating new food systems that offer benefits on many fronts from increased freshness, locality and nutritional profiles to reduced environmental impact. However, many challenges remain to increase efficacy, reduce costs and upscale. Solving these will require inspirational engineering, new digital approaches, robotics, AI as well as biology and commercial innovation.

As young engineers at the start of our career, we are looking forward to addressing these challenges!

It’s all about the UX

It’s all about the UX

There is no doubt that User Experience (UX) is a hot topic throughout today’s design world. But how is the personal approach to product development affecting the field of healthcare? Lucy Sheldon, people-centered designer, and Andres Barrera, user experience designer, went along to the first ever User Centred Design (UXD) Healthcare conference to find out…

Lucy and Andres write: Here at Cambridge Design Partnership, one of our specialisms is designing healthcare devices, from asthma inhalers to blood sugar monitors, that are used by patients rather than health professionals. In such situations, the experience of the user/patient is key to the success of the product. Do they like using the design or will they give up on it?
Because of this, we were intrigued by a new conference devoted entirely to User Experience (UX) within the world of healthcare.  So we headed off to the User Centred Design (UXD) Healthcare conference in London this spring to find out more and report back:

Who was there?

Attendees ranged from new start-ups to digital health specialists employed by global pharmaceutical companies. This was a chance for us to check out what’s happening right across the board in healthcare UXD.

What was the focus?

Many of the presentations were about the ways in which digital technologies can deliver a cost-effective and successful preventative healthcare model. Loud and clear came the message: a people-centered healthcare approach requires great UX at its heart. Healthcare solutions that the patient uses in their own home have to be problem-free and a joy to use. Otherwise compliance becomes a real problem.

Which innovations stood out?

We liked the look of the myCOPD app, an app which offers patient education for people with Chronic Obstructive Pulmonary Disease. This app delivers advice from world experts and is, in effect, a complete online pulmonary rehabilitation class. Another interesting project is the Babylon Health start-up, which offers online GP consultations. This company is already working with the NHS, allowing patients the option of signing up with Babylon Health rather than a traditional GP surgery.

Why is UX so much at the forefront of healthcare these days?

The rising incidence of long-term health conditions such as diabetes, heart disease and asthma is driving investment with a shift in emphasis. Now the focus is on helping patients to cope with their chronic illness, in terms of both reducing symptoms and improving outcomes. There is also much more investment in preventing lifestyle-related illnesses occurring in the first place.

What is the aim of UX in healthcare today?

Several of the speakers referenced the term healthspan (quality of life), which is now considered alongside lifespan as a measure of healthcare success. The question is no longer just: how long will you live? What matters is now how long you will live in good health.

What else is new?

Presentations which outlined how augmented reality in digital tech could be used in healthcare. Gaming-based digital tech allows users to overcome phobias in virtual reality. One idea we heard being discussed was a digital game in which the user overcomes their fear of heights by travelling up escalators, going onto balconies, etc. This is proving genuinely effective in helping people overcome debilitating phobias.

Did AI feature?

Absolutely. We were struck by a presentation which outlined the ways in which Artificial Intelligence (AI) – or perhaps more specifically machine learning – frees up healthcare professionals to do their high-level work more effectively. Algorithms can analyse patient data such as heart-rate, flagging up noteworthy results and saving hours of human time poring over charts to spot anomalies.

The appetite for digital therapeutic treatments is certainly growing and, for conditions such as depression there are, we discovered, several therapies that the patient uses themselves that have already been clinically validated. This impressed us a lot.

Did you come back to Cambridge Design Partnership feeling inspired?

Definitely. Here at CDP we work on a wide range of healthcare projects that have UX at their heart and we know just how crucial it is. For example, we designed the First Response Monitor as a way of helping first responders such as paramedics triage patients. The monitor helps assess which patients need help soonest via nose clips which record oxygen levels and display results using AI on a smartphone dashboard. In such a high-pressure situation as. Say, a serious road accident, kit needs to be reliable and simple to use. Our UX design, both for the physical product (the nose clip) and the digital tech (the smartphone dashboard) was key to its success.

How can CDP offer the best UXD to its clients?

We offer global companies the opportunity to create healthcare products – be they digital or physical – that not only fulfil the brief but truly delight the user. Our Potential Realised product design process, which links research, design, technology, engineering and manufacturing into a single integrated process allows us to meet and exceed customer expectations for UX.

Finally, how is the future looking for UXD in healthcare?

There is an exponential growth of health-tech start-ups right now and design in healthcare is evolving towards a more holistic and democratic approach. Patients no longer simply expect a prescription or a pill to solve their problems. Instead, they are taking ownership of their treatment and their health, often using digital technology. Where this is supported by machine learning, we are convinced that UX has the potential significantly to enhance healthcare delivery.

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What’s next for Hemodialysis?

The 56th European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) conference takes place this year on June 13-16 in Budapest. With this in mind, Matt Brady, Partner & Head of Medical Therapy at Cambridge Design Partnership and Jess Carroll, Mechanical Engineer from Cambridge Design Partnership consider the future of renal disease patient care.

Home dialysis on the up?

There have been some business moves recently in the renal care sector that may well signal that home dialysis is set to become more common. In February this year, NxStage, one of the world’s leading manufacturers of home hemodialysis (HHD) machines, was bought by German renal care giant Fresenius Medical Care in a $2 billion deal.

Back in the 1970s, 40% of dialysis in the US took place in patient homes but this lost popularity in the 80s and 90s in favour of patients travelling to purpose-built medical centers. Disadvantages of home hemodialysis (HHD) included the fact that bulky devices and their associated consumables took up a lot of space in homes and patients struggled with device maintenance. However, recent developments have led to smaller machines with streamlined consumables, and which are easier to clean and disinfect.

Fresenius Medical Care is the world’s largest provider of dialysis products and services and, as such, is well placed to drive the market. Its takeover of NxStage is, we believe, a move which could spark an industry-wide migration to home dialysis.

The provision of home dialysis requires support staff to check up on patients regularly and to deliver both training and the co-ordinated delivery of consumables to the patient. However, this may not be such a barrier to change: existing dialysis centers could easily be outfitted to host training events and support staff normally employed to monitor patients in center could instead offer home visits. Dialysis centers are already well dispersed in communities and well placed to support home dialysis. They could also benefit commercially from an ability to grow their patient base without requiring more seats.

What benefit would this bring to patients?

Home dialysis has many advantages for patients compared to the more usual In-Center Hemodialysis (ICHD). Treatment out of the home is notoriously time-intensive – patients typically have three sessions per week, each lasting around four hours, plus there is the travel time to and from the dialysis center. Home dialysis, by contrast, has significant lifestyle benefits. It allows the patient to have a flexible treatment schedule with no need to travel, allowing them to stay in employment/education and generally have far less disruption in their daily lives.

Additionally, research indicates that shorter, more frequent dialysis may offer medical benefits, too. It reduces post-dialysis recovery time, improves overall sense of wellbeing, improves blood pressure and reduces the amount of medication the patient needs to take. Alternatively users may choose to maintain the 3x per week schedule but conduct overnight sessions, benefitting from a slower, gentler treatment as well as the obvious lifestyle benefits. In both cases users can avoid the dreaded “dialysis weekend” inherent in the schedules of most dialysis centers.

However, it’s not just patients that look set to drive the demand for home dialysis. Payers are also leaning towards it, due to its potential for cost reductions and cost incentives. As long ago as 2011, the USA Centers for Medicare and Medicaid Services (CMS) had already adopted a new payment system for their Medicare renal disease programme which favours home dialysis. This gave dialysis providers more financial incentive to offer home dialysis services and already seems to have had an effect in the US and may also have contributed to growth in home dialysis utilisation generally.

The statistics are certainly beginning to bear this out. In 2008, 93.5% of US dialysis patients received their treatment in centers but by 2016 that figure had dropped to 89%. It is also worth noting that the overall numbers of US patients receiving dialysis has risen from 108,945 in 2008 to 121,209 in 2016, which gives a sense of the rising demand for this treatment.

In the UK, the National Institute for Health and Care Excellence (NICE) already recommends that patients are given a choice over the setting and type of dialysis. In terms of cost, NxStage has reported to NICE that the average price per treatment for their System One home dialysis device is just 60% of the current NHS tariff price for home dialysis, a strong financial incentive to make the switch.

Back in 2009-2010, a study assessed that chronic kidney disease care per patient receiving dialysis can be crudely estimated at £27,000 per annum. In that same year, dialysis cost the NHS just over half a billion pounds a year (£504,680,228) with transport of the patient to and from dialysis centers costing just over £49.5 million.

As of Dec 2013, just over 27,000 UK patients were receiving dialysis, with 5% (1,113) being treated at home. The overall number of people on home hemodialysis has increased by 3% since then, with 1,256 patients receiving home treatment in 2016.

Although home dialysis is clearly an attractive alternative, there are many perceived barriers that may discourage patients from choosing it. Many cite fear of losing the in-center back-up from staff and a reluctance to self-cannulate (introduce a thin tube into their veins). Other factors include wanting to separate home life from medical life and not wishing to burden family/friends with having to assist with treatment.

However, it is likely that these barriers can be overcome with innovative new devices and systems, adequate education, including motivational training to empower the patient, as well as supportive medical staff. Another barrier which may be more difficult to overcome, though, is a lack of suitable accommodation for home dialysis, especially given today’s trend for smaller new homes and expensive house prices. One recent study of patients from a predialysis clinic in London found that only 29% of homes assessed were suitable for peritoneal dialysis and only one home was suitable for home hemodialysis.

As well as NxStage, there are several more manufacturers of home hemodialysis equipment well worth keeping an eye on. These include Quanta Dialysis Technologies (UK) which makes the table-top SC+; Outset Medical (USA) with its mobile Tablo machine and French company Physidia’s S3 monitor. Baxter, another large US manufacturer of traditional dialysis machines, again participated in Outset Medical’s $132 million investment round in August of last year, another sign that well-established players in renal care are feeling the pull of home dialysis.

Emerging competition from China?

Chinese companies Wego, Biolight and Bain Medical were in all attendance at last year’s ERA-EDTA international conference. So far, these companies have focused on the Asian dialysis market. Will their need for continued growth, alongside the much-discussed slowdown in the Chinese economy, drive a strategy of expansion into established markets?

Like Fresenius (and to a lesser extent B.Braun), Wego both produces dialysis machines and operates dialysis centers. Wego could use its experience and resources to open dialysis centers in Europe or the US in direct competition to Fresenius. Biolight produces traditional dialysis machines and related consumables. It is likely to be able to offer lower costs than European or American companies and may be attractive to payers.

Bain, by contrast, solely manufactures blood purification consumables but we noted that it displayed a functional pump at last year’s conference so is clearly growing its business. Bain already has well-established relationships with many renal care companies outside of China, and thus may be in a position to expand into machines, certainly in China first but given their impressive expansion to date we shouldn’t bet against more global ambitions in time.

So far, Wego and Biolight haven’t made any visible moves towards home dialysis so companies like Fresenius have the advantage in this field, at least for now. As home dialysis becomes more popular with patients, we predict that promoting home dialysis could be an effective commercial response by established Western and Japanese players to new competitors entering the renal care market.

It is very likely that the race to dominate the home dialysis market may drive innovation, reducing running costs and increasing patient benefits as well. All in all, this is an interesting time for the renal care industry and one which, we anticipate, will lead to better treatments for patients.


Matt Brady

Partner & Head of Medical Therapy
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Jess Carroll

Mechanical Engineering Consultant
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How is digital technology maturing in healthcare?

The recent Digital Health World Congress 2018, which was held in London at the end of November, covered aspects of medical and mobile technology. It certainly presented an interesting and diverse line-up of speakers and exhibitors.

A key learning we took from the event is that digital health (the intersection of digital technology and healthcare) is maturing. In recent years, digital health has experienced a strong ‘hype cycle’ but, as the event illustrated, we are beginning to see real-world roll outs that address true user needs and have measurable business success.

Keynote speaker, Adrian Byrne, CIO at University Hospital Southampton NHS Foundation Trust, presented a fascinating maturity model of patient information systems delivered by Healthcare Information and Management Systems Society (HIMSS). He explained that the adoption of electronic medical records is a key building block that serves as a foundation for new digital services and associated technical innovations that can improve healthcare. But the creation of systems for electronic medical records is only the start of the journey – to succeed it needs the willingness of end users to adopt it and continued championing to maintain momentum.

A key takeaway from the event was that where deployments have succeeded, they provide quantifiable gains for patients and other stakeholders. An example that Adrian described is a simple patient ID barcode solution, which enables the patient to be scanned prior to any medication being given to them. Already it has prevented over 300 patients from being given the wrong dose.

Another real-world example, which is being rolled out in Kent, is a simple App called WaitFree. It recommends which A&E facility the patient should attend in order to help minimise waiting time. Using the information of current waiting times at each A&E facility in conjunction with an estimation of the user’s travel time to each facility, it recommends which facility they should attend in order to be seen quickest – which may not necessarily be the closest one! This has a clear benefit for the patient but also benefits the healthcare system as load on the system is distributed more evenly, maximising utilisation of scarce resource.

A major theme from the event was leveraging smartphones to provide new diagnostics. For example, healthy.io is turning a smartphone into a regulatory-approved urinalysis device. Its first product, dip.io, uses the phone’s camera to assess various urine test results. This means that a subset of the 42 million tests conducted each year in hospital can now potentially be moved into the home, increasing convenience to the patient but also reducing costs on healthcare incurred through hospital visits.

An example of the convergence of medical and consumer diagnostics is Nimasensor, a connected gluten and peanut sensor device. Whilst gluten and peanut allergies are increasingly recognised and catered for, the creator identified the significant challenge to sufferers who would commonly be ill after meals out even if they had been careful to select food without allergens. The Nimasensor enables users to conduct an on-the-go analysis of foodstuff, thereby enabling restaurant visits with more confidence that illness or even fatal consequences will not occur.

All of this is reflective of a trend that is increasingly seeing consumers take ownership of their own wellbeing and healthcare. It’s moving away from the traditional model of sick care provided at a surgery or hospital. With this traditional model users have no real means of determining how sick they actually are before accessing services and creating an ever-increasing demand with health services stretched to the limit. However, companies like Doctorlink are trying to simplify user access by triaging and facilitating efficient access only when required. This enables practitioners and providers to be utilised more efficiently.

Whilst at the event there were many examples of services being built into Apps to help HCP’s during their day-to-day jobs.  There was also a healthy mix of companies embarking on a product and service deployment. For example, Qardio is providing a wide range of health wearables like blood pressure monitors, and Tytocare has developed a camera-based toolkit for home diagnosis that feeds data straight to the clinician.

Augmented Reality/Virtual Reality (AR/VR) was also demonstrated at the event. Proximie is conducting some very compelling remote surgery assistance where the experts no longer need to travel the globe to assist in theatre. Instead, they can be virtually ‘there’ via the latest webcams, and so enhancing the level of support they can provide to a wider audience.

Equally compelling was Oxford VR who demonstrated dramatic behavioral improvements with people fearful of heights. With the use of VR tools they are quickly able to quash people’s fears and within a few hours empower them to tackle heights, escalators etc.

Overall, at Digital Health World Congress 2018 we saw many passionate and insightful enterprises pitching into the healthcare market, sometimes with a boost of funding, and then growing organically to deliver increasing levels of benefit around a specific need. Whilst this is exciting there exists the inevitable potential for fragmented and competing services, which is already one of the biggest problems in healthcare.

Here, at CDP, we start by examining a new healthcare challenge from all angles. This enables us to focus innovation on a sound foundation rather than taking new technology and looking for a home for it. This involves researching and thinking around users and how their needs can be best addressed, as well as the business imperative to create a profit. So when we finally deploy technology it efficiently addresses both user and business needs, with the foundation for scale built in.

A practitioner’s view of ‘jobs to be done’ theory

Many people are now familiar with the ‘Jobs to be Done’ or JTBD theory of innovation and it is becoming a prominent model that is deployed in successful businesses, big and small, as they look to grow through innovation.

Stated simply, the JTBD theory is grounded on the understanding that people ‘hire’ products to enable them to get a job or jobs done. The jobs, or goals, can be functional, emotional, or social in nature. New innovation opportunities are based on discovering and addressing the jobs people are struggling to get done. The JTBD theory allows for an inherently solution-agnostic approach to insights capture for innovation through a job-based frame of the problem. Instead of focusing on existing products and services; instantly time-stamping and limiting insight, JTBD defines time-stable innovation measures of unmet need and unshackles creative teams from existing technologies and platforms when considering how to address that valuable, newly uncovered opportunity.

Simple enough in its conception, confusion with JTBD can arise with specifics of the language used in its practice and you could be excused for thinking that an explanation somebody has provided on how they will “do” JTBD for you does not match your own understanding of how it is applied.

The confusion arises because there are a number of different JTBD schools of thought. Whilst each of them is grounded on the same simple premise outlined above, we would argue that each teaches a practice that harbours particular strengths well-suited to addressing different business growth challenges – from the near-term new product development to the long-term strategic direction-setting and within the three-dimensional functional, emotional, social needs space occupied variously by healthcare, consumer and industrial markets.

Here we briefly introduce the three most prominent forms of JTBD practice as a means of demystifying the language and comparing their application strengths.

Jobs and forces (the Switch approach)

Established by Bob Moesta of The Rewired Group, the Switch approach to JTBD focuses on the reasons why people fire and hire products and services. It strives to understand the moment of ‘switching’ and the (im)balance of forces that ultimately compels someone to make a purchase. The switch happens when combined forces of the switch enablers – problems with the existing solution (the push) and the benefits of the new solution (the pull) – overcome the switch blockers – the worries about the new solution (anxiety) and existing habits and switching costs (inertia).

In practice, Switch is applied by dissecting the purchasing timeline from the moment of the very first thought of switching through passive looking (for a new solution), active looking, deciding on a solution, to buying; to uncover the pushes, the pulls, the anxieties and the habits. Very quickly, emotional jobs that augment the assumed functional job begin to materialise providing new insight into the real struggles that customers face.

Jobs, pains and gains

Developed by Alex Osterwalder at Strategyzer, the Value Proposition Canvas provides a framework that enables businesses to develop and implement value propositions by identifying the jobs that customers are trying to get done, the negative pains they experience when doing so and the positive gains that they desire from product and service solutions; providing a focused customer profile to design for.

Jobs and outcomes

Pioneered by Tony Ulwick at Strategyn, and productised by their Outcome-Driven Innovation method, jobs and outcomes approaches break a job down into the many metrics (outcomes) that customers use to define job success (how well they are able to get a job done).

By identifying which outcomes on a job are most important and least-well satisfied, companies are able to uncover detailed descriptors of innovation opportunity ripe for product or service development.

At a higher level, applying the same principles within a broad market space allows companies to uncover the most important and poorly satisfied jobs; helping to answer the more strategic question of ‘where to play’?

Then there is…

The CDP way

Well actually, at CDP we don’t have a way of “doing Jobs to be Done” we have many! We like to practice what we preach by first listening to our customers – our clients – at the earliest stage of engagement to discover their jobs to be done. We will then devise an insight for innovation enquiry that selects the most appropriate JTBD approach; even merging them where required, to develop a front-end innovation solution that best meets our client’s needs.

We find that using outcomes as the unit of research analysis provides the precision required to translate insight directly into requirement specifications. This approach is particularly powerful when dealing with highly functional jobs to be done; as often seen in healthcare and medical device development. It can define, with precision, what your next product should be. On the other hand, considering firing and hiring forces using the Switch method can wrap a layer of emotional insight around the functional and rational dimension; ripe for product and experience innovation in consumer-focused markets. Whilst defined jobs, pains and gains provide targeted creativity input to conceptualise new products and services with specific pain-relieving and gain-creating features.

There are also occasions when JTBD isn’t even the most appropriate theory or tool at all. Just as we wouldn’t use a sledgehammer to crack a nut, nor would we use one to tighten a screw and so we will draw upon other research tools as demanded by the goals and scope of the research enquiry. These include stakeholder co-creation, expert interviews, global trends mapping and client research synthesis.

In short, we believe that there is no one template or blue-print for front-end innovation success. Our insight for innovation team can pool decades of aggregated innovation experience applying JTBD theory in its many guises and other research tools, across multiple market sectors; to match front-end solutions to business challenges on a case-by-case basis.

As end-to-end innovation partners, we progress from insight to concept to product, applying our Potential Realised innovation process from opportunity definition to product realisation. We are as invested in ensuring that insight is appropriate to our clients’ needs and relevant to their market as they are.

So, you may know of innovation research as jobs, push, pull, anxiety, habits, pains, gains or outcomes… whatever your innovation language, rest assured that, at CDP, we have people who speak it!

How to speak your customers’ digital language

Digital is reinventing whole industries. In sector after sector we are seeing incumbent market leaders threatened, and sometimes displaced, by new entrants who can deploy digital technologies quickly and effectively – because they have the new skills and don’t have to protect their cash cows and legacy infrastructure.

Advertising is a good example – advertising in the digital domain is big business. Huge business in fact. Fewer of us are watching terrestrial TV and, even when we do, we tend to do so when it suits us – and hence watch the recorded programmes we want to watch, fast-forwarding through any adverts along the way. So much of the advertising revenue is switching to other media – those pop-up banners that appear whenever we view any digital content on our phone or PC. Cookies are tracking us wherever we are on the web, with everyone watching everyone else to see who clicks on what. Our online persona and browsing history is a remarkable portal into our own personal world and, as such, has very real value to a lot of companies.

However, less is sometimes more. P&G was recently in the news for reducing its digital marketing spend in the second quarter of this year by more than $100 million. What happened? Nothing. No visible impact on any of its product lines. Those products that were growing continued to do just that. Why? One theory is that a great deal of its previous spend actually went on advertising P&G brands on websites that were more likely to be viewed by bots, not by you and me.

How is this so? Are bots about to take over? Not quite but they are here to stay – they’re already driving most of our internet search traffic, trawling the web on our behalf so that search engines can provide the fastest and most accurate page feedback. The problems start with their misuse (they can generate huge amounts of ‘false’ web traffic) coupled with companies who evaluate their own digital marketing success simply by analysing the number of clicks/page views.

As P&G has now realised, context is king. Simply analysing web activity isn’t enough to plan and predict the success of marketing campaigns. Companies need to better understand the context around any given click. They need to recognise and eliminate automated behaviours, and better respond and adapt to those increasingly rare occasions when it’s actually you and I doing the viewing and clicking. Bots may well ultimately become our trusted digital assistants, as they mature into our preferred go-to interface to the digital world. But, for now, they are largely uncontrolled and can confound our metrics and key performance indicators.

As digital marketing channels continue to morph and develop at an ever-increasing rate, it will be the companies that truly understand the intricacies of this future world – and can build the new tools and systems to navigate through it – that will thrive and dominate.

If you’d like help with figuring out how to succeed in your own digital world, please get in touch with us via hello@cambridge-design.co.uk.

The future of digital healthcare

The digital future world is one where we genuinely feel in control and central to our own healthcare. Where we’re engaged and those that interact with us are trusted to provide timely, appropriate and effective support.

I recently attended an event at the House of Lords, led by Kai Gait, senior global digital director for GSK. Among the many in attendance was Professor Brian D Smith, advisor and author on the evolution of medical technologies in the digital age.

A key discussion point was the lessons that can be learned from other markets, primarily from the consumer products world. This was refreshing as we’ve seen for a number of years consumers quickly adopting digital services to transform traditional product experiences into service led, differentiated propositions. Think SONOS/Spotify wireless music-streaming in your house, Uber or AirBnB. Wherever clear benefits are to be had for the consumer, they vote with their feet. They adopt and quickly. But the value is no longer in the standalone product, it’s in the ecosystem that it connects to.

Healthcare is more complex than most consumer markets and doesn’t traditionally embrace fast change, with good reason. The sector is dealing with people’s health so in this environment the optimised consumer strategy of rapid Beta test and quick roll out of a minimum viable product, followed by rapid enhancements that allow users to benefit from the latest incremental service enhancements is not possible within the conventional industry framework. But this sort of tactic is somehow needed for a step change to more patient focused solutions.

Consider the starting point, a patient who doesn’t want to be ill but they are faced with a conventional ‘one size fits all’ healthcare solution, which they must fit into their daily ritual. Add to that the typical trappings of a conventional digital solutions, downloading apps, creating user accounts and passwords, forms to fill in, standardised e-mails, functionality that is not quite what you want. This is a hard-enough sell with a captive audience of enthused techy followers looking for the latest trend to share with their friends on social media. Any patient will tell you they don’t have time to do any of this. However, let me share another insight, 1 billion. That is the number of hours people spend on YouTube per day. So actually we do have time. It’s just that we’re currently spending it doing things we find more interesting, more ‘us’.

To add to the challenge, patients are already faced with a myriad of technology offerings from wellness apps through to virtual Doctors on Amazon Echo, that all offer well-intentioned advice and yet the vast majority are not approved or regulated. What do we trust? They are like any other consumer proposition; they offer convenience and expect the user to accept some minor errors along the way. Acceptable for takeaway pizza, less so for a heart-attack assessment.

So how can digital healthcare break through? Engage with the patient.

Here at Cambridge Design Partnership we have a team who specialise in devising new products and services that are ‘ahead to the curve’ for brands around the world. Our approach always focuses on the user and first gains a deep insight into their needs and emotions, before we look at technology opportunities and regulatory, quality and wider business issues.

We can foresee a legitimate roadmap of regular interactions with patients, in a way that they value. These would support and reward good behaviours and coach them positively, helping to explain the impact of their choices and actions. They would get to know them and build relationships through quick feedback, customisation and personalisation, making services more and more relevant to their needs.

We think the pharma industry could play a major role in this transformation because of the knowledge and expertise it has. But to achieve this may need a new approach, perhaps new commercial structures, partnerships and brands to encourage patients to embrace this future.

If we look at other markets, we see the same issues; for example in banking and insurance. They’ve invested heavily in newer, friendlier brands and start-ups that take a more holistic view of the customer’s needs and find new ways to offer more value. Maybe healthcare can do the same.

If you’d like to discuss how we can help address these challenges, do please get in touch at hello@cambridge-design.co.uk.

New connected wearable device helps medics save lives in disasters and on the battlefield

Innovative technology and design consultancy Cambridge Design Partnership today announces that it has developed the world’s first wearable device designed to measure and monitor the vital signs of multiple trauma patients for emergency response in disasters and battlefield situations.

The First Response Monitor is designed to help medics monitor both heart rate and respiratory rate. Respiratory rate is often neglected by automated monitoring systems and has been described as the ‘forgotten bio-sign’, as many existing wearable monitors focus on heart rate alone and those that do measure respiratory rate have low accuracy or are difficult to use in an emergency situation. However, the benefits of accurately monitoring respiratory rate are clear, and when combined with other parameters – such as heart rate and body temperature – can indicate life-threatening conditions such as sepsis.

When designing the new compact device, Cambridge Design Partnership interviewed a range of army medics about their needs and challenges in multiple casualty emergency situations. An unmet need was identified for a low-cost device to bridge the gap between manual methods of vital signs measurement – which can be laborious and challenging amidst the noise and stress of a disaster or on the front line – and more expensive patient monitoring systems.

The lightweight, robust and low-cost wearable biometric device not only monitors patients but collects and transmits data in real-time, enabling the medic to care for a greater number of casualties, providing more effective casualty triage to deliver improved patient outcomes.

The small device clips onto a patient’s nose and monitors breathing rate and heart rate, giving ‘at a glance’ indication of both parameters, and this data is added to a trends graph showing how these measurements have changed over time. This enables the medic to focus their efforts on providing care rather than taking measurements but also enables the care giver to understand how the patient’s condition has changed over time. The data can then transmitted using Bluetooth low energy to a smartphone app or tablet, enabling other data analyses such as multiple patient triage or situational awareness across the group.

Although the device has been primarily designed with first response medics in mass casualty incidents in mind, it has applications in many other fields – such as civilian medicine where additional monitoring of conditions has demonstrable benefit in patient outcomes, wellness monitoring and within sports for training and performance monitoring. The technology can also be developed to provide a low-cost solution for low resource healthcare settings.

Speaking about the new development James Baker, Partner, Cambridge Design Partnership said: “At Cambridge Design Partnership we’re always looking for ways to find a solution to a clear, unmet need. With the First Response Monitor we’ve combined our expertise in wearable connected devices with our extensive medical experience to develop a technology for effectively measuring breathing and heart rate. The monitor can help save lives in a variety of environments and we’re really keen to speak to partners about developing the potential applications further.