Where’s the value in surgical robotics?

March 25th 2020

The first robot-assisted surgical procedure was performed in 1985. In the 35 years since, the field of surgical robotics has exploded, with both surgeons and patients demanding access to the technology. This boom has brought with it plenty of vocal advocates, and just as many critics, debating the risks and rewards of robotic technology over traditional open and laparoscopic techniques.

The main criticism of robot-assisted surgery comes down to the fact that, despite the lofty initial and recurring costs associated with robotic equipment, patient outcomes of robotic-assisted procedures seem to be no better than conventional laparoscopic procedures. Some may see this as evidence that investing in surgical robotics is nonsensical, but it is worth considering the future potential of the technologies. For while the tools and techniques used in conventional laparoscopy may see slow incremental improvements over coming decades, each new generation of surgical robots will likely continue to bring radical step-change improvements in procedural precision, patient safety and surgeon control and comfort.

Current benefits of robot-assisted surgery

The current generation of surgical robots offer a few significant advantages over traditional laparoscopy.

Ergonomics & surgeon comfort: the ergonomics of laparoscopy are not ideal and can take a toll on a surgeon’s body. During robot-assisted procedures, the surgeon sits at a workstation and controls his surgical tools using ergonomic master controllers. If the surgeon needs to take a break at any point in time, they can let go of the controllers, and the robotic instruments will maintain their current positions.
Precision: a robotic system translates the inputs from the surgeon’s controllers to output motion of the surgical instruments. This allows for motion scaling (for example, 3mm of movement by the surgeon results in only 1mm of movement of the surgical tool), providing unprecedented surgical precision.
Stability: while providing some haptic feedback to the surgeon is desirable, a robotic system can handle all the stresses and loads associated with a procedure without translating them all back to the surgeon’s hands. Along with surgeon comfort, this allows for improved stability.
Better visibility: the steerable robotic endoscopes provide a high-definition 3D visibility of the surgical site, allowing the surgeon to better see what they are doing, compared to 2D endoscopes used in laparoscopy.

More hands: while we humans are tragically limited to typically having only two hands, robots are not subject to such limitations. The da Vinci Xi, for example, has four robotic arms. The surgeon toggles back and forth between controlling different combinations of these arms using foot petals.
Fast learning curve: learning how to safely and effectively perform robot-assisted procedures tends to be faster than training to perform laparoscopic procedures.

Current limitations of robot-assisted surgery

Advocates of surgical robotic technologies tend to focus on the various benefits without mentioning some noteworthy risks and challenges:

Setup time: nurses and surgical assistants often complain about the long time it takes to prepare a robotic system for a procedure, including wipe-downs, draping and loading of surgical tools.
Lack of haptic feedback: current robotic systems provide very limited feedback of applied forces to the surgeon. Instead the surgeon is required to use the visual feedback from the 3D endoscope to judge what amount of force he is applying to patient tissue. Some studies suggest that surgeons apply significantly higher forces and stresses to tissue using robotic systems than using laparoscopic tools, potentially resulting in more damage to the tissue.
High cost: a daVinci Xi system costs about $2M USD. Each da Vinci surgery may cost $3,000 USD more to the patient / insurance company than a traditional laparoscopic operation.

The future

Many of the criticisms above are valid and must be taken seriously. Effectiveness and safety of robotic technologies must continue to be proven, and limitations should be assessed and accounted for. However, these should be seen as criticisms of current robotic systems on the market today, not as criticisms of robotic surgery in general. If anything, these criticisms hint at where surgical robotics is headed next. While Intuitive Surgical continue to innovate, the field of players is also getting wider, with companies like Johnson & Johnson, Medtronic and Stryker investing billions into research and development. Future generations of robotic systems will bring a range of short-term and long-term improvements and will redefine what is possible in surgery.

Increased haptic feedback is expected to be a key feature in some future systems. This will allow the surgeon to truly feel the motions and gestures they are executing with the robotic instruments.

The cost of robotic systems and tools is expected to decrease as the volume of robotic systems and tools sold continues to grow and with increased competition, as new companies bring their robotic systems to market in the coming years.

There may be potential benefits in surgeons being able to carry out procedures remotely. Already today, the surgeon workstation does not necessarily have to be in the same room as the patient. Taking this to the next level, future systems may allow an expert cardiovascular surgeon to perform specialist surgeries all around the world from the comfort of his own office.

The Big Question

All of these features still depend on a human being (the surgeon) having control of every movement of the robot. The big question is: at what point will we be comfortable giving up some of this control to a robot? Crossing this line will increase the productivity of the scarcest of resources, highly trained surgeons, and start to significantly improve the cost-benefit equation for these systems.

Leveraging image recognition and artificial intelligence, it is fathomable that, in the quite near future, we could have a robotic system capable of making decisions and performing certain tasks independently. Especially with repetitive tasks like suturing, a robot could be trained to become increasingly efficient and effective.

However, as we’ve seen with self-driving cars, we humans have very little tolerance for injury and death caused by robotic systems. Despite worryingly high death tolls caused by inebriated and distracted drivers, it is not enough for new technology to reduce injury and death. Even a single death caused by a self-driving car convinces some that the technology is not ready. This may be the same psychological and regulatory hurdle that surgical robotics must overcome to realise its potential.

Connect with CDP

For more on how to accelerate innovation in surgical robotics, from device design to clinical value, contact Cambridge Design Partnership.

GET IN TOUCH

Optimising material in design innovation

January 16th 2020

Mark Buckingham

The interplay between choice of materials and product design provides unique opportunities for innovation. The criteria for selecting materials for an application are constantly evolving. A holistic approach where materials, process and form are all part of the design provides the best route to maximise potential.

A key question repeatedly encountered in product design is ‘what materials will work in this application?’ A good starting point is to consider the purpose. How is function created by the interplay between the shape and composition of the product? Is it important what it looks like? Should it let the light in or keep it out? What about electrical properties? Does it need to insulate to protect the user from mains voltage inside, or conduct electricity to prevent build-up of charge? Should it be very strong, or break in a controlled way in extreme conditions to fail safely? If it gets very hot or wet, do we expect it to continue to function in the same way, or should it undergo a recognisable change to indicate that it is no longer safe to use?

First Impressions

In many markets, first impressions of a new product design are very important and different materials can convey distinct messages. Does it feel cold or warm, grippy or slippery, rigid or flexible? Does the surface texture give an impression of a quality product that will last? Should it be a particular colour to stand out or blend in?

Is It Safe?

We want our products to be safe, but choice of appropriate materials will depend on the application. Medical devices and products used by children or in contact with food need to be tested to the appropriate standards to check that no harmful ingredients might leach out during use. But inside a nuclear power station, the ability to continue to operate unaffected by radiation will be crucial.

Will It Last?

For many materials, properties will change with time, and this may affect the period of usability of a product. Predicting lifetime will depend on the temperature range over which articles are used. Accelerated ageing at a range of elevated temperatures can be carried out to model the expected life of products at room temperature. If use at low temperatures is envisaged, it is also important to check that materials which are flexible at room temperature do not become brittle when very cold.

For repeated or extended use, materials need to be chosen which retain their properties over time. Ease and comfort of handling may be very important, for example fit and grip, or the ability to stay clean and free of microbes. Items subject to repeated deformation may tend to change shape. For high voltage applications, the ability to retain safe insulating properties is important.

What About Costs?

We often focus on the opportunity for cost reduction by material substitution, but in many applications the cost of the materials is only a small fraction of the end price of a product. There may also be some scope to include small amounts of expensive materials in the formulation to provide additional functions. For example, ‘smart’ materials may be included to modify optical, magnetic, thermal or electrical properties.

Material substitution can often reduce overall costs by providing a route to reduction in process time or temperature. Choosing a more expensive material that can be handled in a simpler type of fabrication process is another option. Manufacturing methods are continually evolving; hence the choice of process needs to be regularly reviewed. When rapid delivery of prototypes is crucial, additive manufacturing may offer a route to fulfil this need. However, when moving to a different process for larger volume production, it is important to verify that the material will perform in the same way.

One Material or Many?

In the area of composite materials, thermoset systems have proved difficult to recycle, but the recent increased use of high temperature engineering thermoplastics in composites provides more possibilities.

Many material problems can be solved by understanding the interface between different items e.g. how implants interact with the human skeleton in the long term or careful process control of co-moulded plastic and rubber parts to ensure good adhesion between them. Often the simplest solution is to store newly manufactured parts under controlled conditions for a set time before exposing them to customer use.

Planning for the Future

The availability, price and customer acceptability of many materials continues to change, and consumers and manufacturers are increasingly looking to choose more sustainable alternatives. Be this through materials that facilitate recycling or repair, use of sustainable raw materials such as a move from oil based to plant based raw materials, or through a reduction in the energy embodied in the material manufacture, processing and recycling at the end of life.

New information about the safety of existing materials may also emerge. For example animal fur and asbestos insulation are no longer available and plastics are now often called resins. Which materials will become unpopular or unavailable next?

How Does Material Choice Integrate into the Overall Design?

The CDP team has very broad knowledge in a variety of areas of consumer, industrial and medical applications from materials for printed electronics through adhesives and hydrogels to pesticides for rodent control. We have not just a materials expertise but an expert interface with engineering and manufacturing disciplines to offer a range of product design solutions.

We have specialist experience in materials for energy generation and storage, from batteries to supercapacitors and fuel cells, enabling us to identify opportunities to generate intellectual property in both materials and applications.

In particular, the CDP skillset includes a detailed understanding of materials in healthcare applications. This is of particular importance for drug delivery devices, where this capability provides a vital insight into the possible chemical interactions between a medical device and the drug being delivered. Manufacturing processes such as sterilisation methods, coupled with formulation characteristics including viscosity, surface tension or particle size will all have an impact on the selection of materials.

In a Nutshell

When we consider materials, product form and manufacturing process separately, we can go a long way towards achieving a good design. But it is only when we look at the choice of appropriate materials as part of the overall design and manufacturing process that we can achieve so much more.

We use so many different products in our everyday lives and they all need to be made from the most appropriate materials so that they will continue to perform well for many years.

CDP opens new building at their Cambridge HQ

December 12th 2019

Cambridge Design Partnership recycles ten old shipping containers to create a new upcycled office building.

As you’d expect from a business specialising in innovation, when it came to extending their company HQ at rapid pace, they came up with a rather clever plan.

CDP have just opened a remarkable new building at their Cambridge HQ, created from ten shipping containers and a tensile fabric atrium. The innovative design provides a new canteen and refreshment area, as well as six meeting rooms and six video conference booths.

“The challenge was how to create a temporary building that would provide the spaces the business needed. Our current offices are built around a large courtyard car park, so we thought that it would provide an ideal location for a new structure,” says Mike Cane partner at CDP.

“We wanted a new working space that would be both inspirational and have a life after we finished with it. Basing the design on recycled shipping containers provided fast construction and several options for reuse”.

In the past six years, CDP has expanded from a team of 30 to 150 engineers, scientists and designers. Even with the establishment of a second engineering facility in Raleigh, North Carolina, CDP’s forward planning anticipated the need for more space at their Cambridge office.

“We had already added a new building to our site in 2014, but our continued growth meant we were becoming short of space again,” explains Mike. “Planning limitations meant we could not add a third building here, so in the medium term a move to a new larger site was inevitable. But we needed to bridge the gap. So as designers ourselves, we were inspired by other shipping container buildings we saw and decided to design our own interpretation. 20ft containers lend themselves to small, self-contained meeting and video conference booths, and their structural integrity means they need minimal foundations, so the building can be easily removed and the original car park reinstated for the next tenants. Tensile fabric roofs are translucent and make great, light and airy spaces for informal meetings and eating lunch.”

CDP was founded 20 years ago and now works globally on a wide range of technology and product design projects, focusing on the Healthcare and Consumer sectors. The company is employee-owned and won the Employer of the Year award in the 2019 Cambridge News Business Excellence Awards. CDP also recently attained a prestigious Red Dot award, deeming it to be the third best design studio in the whole of Europe and the Americas.

The shipping containers came over to the UK from China with cargo in them and have been re-purposed by Ipswich based company Adaptainer, with insulated linings, windows, electricity and IT infrastructure. The structural fabric atrium was supplied by Streetspace, with the high tech fabric manufactured in New Zealand.

“The building was constructed in just 3 months and is designed to last 3 years on our site. It’s bolted steel construction allows it to be dismantled, loaded onto trucks and moved to a new site, providing it with a second life.” says Mike. “But for now this building has helped us to stay in Toft longer, and allows us to continue to offer great service to our clients in a pleasant, relaxed atmosphere for our team.”

CDP engineer creates a remarkable musical instrument

October 24th 2019

Jonathan Morris

Jonathan Morris, Mechanical engineer, explains how he came to design and build a most unusual musical instrument at CDP

Q. CDP doesn’t usually make musical instruments, does it?
Jonathan: No! This is definitely one of our more unexpected projects here at Cambridge Design Partnership. But when composer Robert Laidlow approached us with a project celebrating computing and Artificial Intelligence, it was clear that engineering and design could help him create an entirely new musical instrument.

Q. Sounds intriguing, tell us more…
Jonathan: We have built ‘The Lovelace Engine’, a mechanical musical instrument inspired by the work of Ada Lovelace, who studied the earliest computers back in the 1830s and 40s. Lovelace was a pioneering computer scientist, and one of the first to realise the potential of computing to perform ever more complex tasks.

Q. The machine looks stunning – how does it work?
Jonathan: Essentially it is a mechanical engine that can make a variety of percussion rhythms, controlled by a single shaft turned by a crank handle. It was constructed here at CDP using our rapid prototyping capabilities, with many parts being 3D printed.

Q. What sort of music will be played on The Lovelace Engine?
Jonathan: It’s a major new work and part of a concert that is a tribute to Ada Lovelace at the Barbican in London this autumn, led by Professor Emily Howard, director of PRiSM at the Royal Northern College of Music. The engine will be played during an exciting new piece commissioned for the performance called Alter. The music will performed by musicians from the Britten Sinfonia with text written entirely by Artificial Intelligence.

Q. So is this instrument a replica of the first computers that Lovelace worked on?
Jonathan: It’s very much inspired by them and draws inspiration from the mechanical technology available to Lovelace in the 1800s – there’s no electricity or circuit boards involved. But this is a musical instrument, not a computer, so it is a tribute to Lovelace rather than a copy of the computers she worked with.

Q. Was it difficult to make?
Jonathan: It has been a unique challenge as we wanted the engine to be configurable, as Lovelace envisaged, so that it can change rhythm mid-performance. It’s been really interesting as a mechanical engineer to work on such an artistic, creative project.

Q. Not your everyday work at CDP then?
Jonathan: I’m in my first graduate job here at CDP and the variety of what we get up to here is fantastic. I am mostly working on medical devices and consumer products as well as designing experiments and test rigs. No two days are the same but, yes, a musical instrument is probably a one-off for us right now! I can’t wait to see it being played on stage.

The Lovelace Engine will be played at the Barbican on November 2 as part of “Ada Lovelace: Imagining the Analytical Engine”.

For more details, visit the site

CDP ranked in the top three international design firms

October 22nd 2019

Cambridge Design Partnership is recognised as one of the top three agencies in Europe and the Americas for design innovation, according to the Red Dot awards programme.

Red Dot has become established internationally as one of the most sought-after seals of quality for good design. They organise annual competitions looking to applaud the best in product design, globally.

This year Cambridge Design Partnership (CDP) came third in the ranking for design firms that continuously and progressively, produce cutting edge and forward-thinking product concepts.

“We are absolutely delighted with the news,” says Mike Cane, founding partner of CDP. “To have this sort of accolade on a global stage is really gratifying. It’s a testament to the hard work and creativity of our whole team.”

In presenting the award, Ken Koo, President of the Red Dot Award in Asia congratulated CDP and stated that the ranking recognised CDP’s continued investment in design and was a “vigorous reflection of real and sustainable design innovation capability”.

CDP was founded 23 years ago and has grown rapidly offering customer focussed technology and design innovation. Capabilities start with front end research, strategy and design, and include mechanical, electronics and software engineering as well as manufacturing and quality management. They work for market leading companies in healthcare, consumer technology and energy in Europe and US.

CDP innovations which have won coveted Red Dot Awards in recent years include the First Response Monitor, a wearable connected device which measures and broadcasts patients’ vital signs for instant analysis by medics in emergencies. Another is Klarus, a drug delivery system aimed at patients with conditions such as rheumatoid arthritis, which necessitates regular self-injection with medication.

Learn more about Red Dot Design Ranking

Can sleep tech become ubiquitous?

October 15th 2019

A good night’s sleep is increasingly considered to be just as important for our health and well-being as eating healthy food and exercising regularly. Unfortunately, today’s 24/7 high-stimulus, digital world is renowned for disrupting our natural sleep patterns. The average 21st century human is now sleeping significantly less than in the past. In 2017, McKinsey reported that more than one in three Americans does not get enough sleep – roughly the same number who are obese.

What is more, our sleep quality – as well as quantity – has decreased as well.

This emerging need has created an ecosystem of manufacturers, retailers and health service providers as well as pharmaceutical companies that has formed around sleep health. The McKinsey study reported the US sleep-health industry is currently worth between $30 billion to $40 billion and has historically grown by more than 8 percent per year, with few signs of slowing down.

In addition to the traditional categories of clinics, pharmaceuticals and bedroom furniture and bedding, a new wave of sleep gadgets has emerged. Crowd funding sites are full of novel sleep devices from masks to robots. Many are connected, continuing the trend of measuring and connecting our lives. Some even aim to stimulate the brain to create therapeutic effects.

Certainly sleep is becoming better understood, but scientific knowledge is still at a relatively early stage and this equates to a general lack of understanding through the population, government and mainstream industry.

“It’s an exciting time for the emerging sleep-ware industry”, says Clare Beddoes of Cambridge Design Partnership: “Here at CDP, we believe that sleep-tech is an exciting area that is evolving rapidly, following closely on the heels of the developments in the fitness and wellness sphere, which has seen an explosion of innovation in recent years”.

“We’re already working with companies assisting them in defining opportunities to innovate and we expect many interesting and successful advances in the area of sleep technology in the near future.”

With this in mind, here are five basic questions we think you need to ask if you are planning to bring a new sleep-tech product to market. If you have the answers to these then, with any luck, you won’t be losing sleep over your product development!

1. Can you show that your customers actually need your proposed product?

It’s great to have an idea for a product that you think might be the answer to an insomniac’s prayers. But are you sure it’s what the market really wants, needs and will pay for? Our approach is to start with the user and to identify the unmet needs where solutions will be really valued. This makes sure you’re heading in the right direction before you spend a lot of time and money pursuing a new idea.

2. What is the existing competitive landscape for similar products?

We’re fascinated by the plethora of sleep devices on the market and although it is increasingly crowded, we believe that the market is in an early phase and there are most definitely spaces for products that address the needs of broad market groups. So take the time to find out what the competition is and where the spaces are for innovation for the majority of mainstream consumers.

3. Where do market unmet needs align with technical solutions that can improve sleep?

The aim must be to create the must-have sleep-tech product. Just recently, here at CDP we worked on a technology to monitor REM sleep. We discovered that not only did users want to know how much REM sleep they had every night, they wanted to know whether it was enough and, then, crucially, they wanted to know what to do if it wasn’t. Successful products need to close this loop and not leave customers stranded.

4. What is the best revenue model for your concept?

This is crucial in the digital world. Will your product work if sold for a one-off payment or would it be a better proposition as the start of a relationship with your customer? Will customers pay for every night they sleep better, or will they not notice the difference? In the AI enabled world consumers are beginning to expect customised solutions, continuous updates and evidence- based feedback.

5. Who are the most impactful sleep professionals for you to work with?

To develop and launch your product successfully, you’re going to need clinical and scientific back-up. So, do you need to work with doctors, psychologists, clinical researchers or YouTube sleep experts? Should you be turning to the peer consumer community, personal trainers or artificial intelligence? It’s all about finding the best development support route and final endorsement.

That way, your innovation journey will stand the best chance of seeing those sweet dreams of success become a reality.

Why are music festivals leading the sustainability agenda?

September 24th 2019

Matt Morris

In 2019 the music festival industry experienced a sea change in their attitude to single-use plastic, with many large live events making the decision to ban it altogether. As the festival season draws to a close, CDP’s Matt Morris, mechanical engineer, sustainability expert and live music fan, looks at what product designers can learn from festival greening in 2019.

Matt says: The big change in the world of festivals this year was the move away from single-use plastics, all part of a general shift towards sustainability and better environmental practices at live music events.

In February 2019 the UK’s biggest festival, Glastonbury, announced it was banning single-use plastic bottles – saving the production of a million plastic bottles. Then many others followed, pledging to stop single use plastics by 2021.

Here at Cambridge Design Partnership, our aim is always to design out unnecessary waste so our clients are as sustainable as possible. So having attended several festivals myself this summer, and having seen the changes taking place first-hand, I am struck by what we can learn from these temporary communities as they strive to go plastic-free.

Join us to address some of the greatest environmental challenges of our era

We’re currently recruiting for a Sustainable Design Consultant, Life Cycle Assessment Engineer and a Head of Sustainability.

View vacancies

Starting with a closed system

Cutting out single-use plastic and greening your market is easier in a small enclosed community where the same organisation controls both the input of products and output of waste. This is, of course, the case at a music festival, where the sale, distribution and disposal of plastic is all within the remit of the same festival organisers.

It is far more straightforward, for example, for Emily Eavis to announce that Glastonbury is banning plastic bottles given that all the drink sales points and backstage hospitality facilities are licensed by Glastonbury Festival itself. The festival also organises the collection and recycling of waste after use, which means they are heavily invested in getting the recycling and disposal right.

However, in the wider world, communities and nations are faced with a far more challenging and fragmented proposition. Traditionally supply chains are one way, from manufacturers to consumers, and are motivated by maximising sales and minimising costs. Consumers are not encouraged by manufacturers to see any value in packaging, they often believe it is somehow free so don’t value the materials and energy encapsulated within it. In addition, waste systems are there to collect and dispose of packaging in isolation of its use and production. This means there is little incentive to coordinate the cycle of production, use and recycling. Although some forward thinking communities are now aiming to change this, for example via the plastic-free towns movement.

Here at CDP, we have been working with food service providers to create plastic-free packaging for closed environments such as transport systems, schools and hospitals. This allows those in charge of these institutions the choice to remove single-use plastic, and can act as a test bed for new solutions prior to more widespread adoption.

Considering the alternatives

Many festivals in 2019 chose to replace disposable plastic cups with sturdier ones that could be reused at any bar within the grounds. However, I was intrigued to see that plastic pint glasses were replaced at Glastonbury this year by stainless steel tumblers. These cost £5 each to buy and festivalgoers could either keep them or return them for a full refund on departure. It seems that the backlash against plastic has extended beyond just single-use plastics, prompting designers to consider materials that would not have been on the table just a few years ago.

However, material selection needs careful consideration. In terms of its impact on the planet, a steel cup may need to be reused many more times than a re-useable plastic one to offer a net benefit. Good design can help with this conundrum, by creating things that are a joy to use again and again. Judging by the fact that the Glastonbury 2019 stainless steel cups are now selling for £12 on eBay, leveraging the Glasto brand seems to have worked in this case!

It helps to engage with cultural influencers

Changing consumer habits takes significant effort. But at Glastonbury this year, I lost count of the performers who lent their approval to the plastic-free initiative. From rappers to rockers, many of the artists (who could only drink canned water on stage) spoke out during their sets in favour of the plastics ban, helping it to gain traction with a captive and approving audience.

What’s more, within the festival setting, there are dozens of ways to keep the initiative in the crucial ‘top of mind’ spot for peak consumer awareness. With kiosks everywhere offering free water and selling reusable cups, a festival is a great place to pioneer sustainable practices and encourage early adopters.

To replicate this in the wider economy is less immediate but not impossible. Frequent positive reinforcement through influencers, marketing and advertising does eventually have an impact.

Taking a holistic view

One of the ways in which CDP designs genuinely more sustainable products is by analysing the impact of the product through its entire life cycle. At festivals, it can be all too easy to take the feelgood option while the real environmental implications are more complex.

For example, the widespread switch at festivals this year to disposable cardboard or wood food packaging instead of plastic may create that positive vibe – but does it have less conspicuous drawbacks? It certainly reduces plastic waste, which is a very visible problem, but equally crushing a tree down into small fibres, mixing the wood pulp into a slurry and then passing it through huge rollers takes lots of energy and water. By contrast, plastic is light, durable and its manufacture is generally not particularly energy intensive. So we may be trading a plastic waste problem for an energy and water problem.

And if we rolled out this transition globally, could our forests (which, frankly, are in need of some TLC right now) support the demand for wood and pulp? It’s important to factor this into your environmental calculations before making a knee-jerk decision to switch materials or abandon plastic packaging. As designers, we have an obligation to weigh up these impacts, because it’s not fair to expect every consumer to have the necessary expertise.

At CDP we work with major beauty product manufacturers to develop packaging and products. Often, it’s important to look at the way the product is used, as well as its constituent parts, before making changes. For example, there can be as much benefit to the planet from encouraging consumers to switch off a running tap when brushing their teeth (wasting potable water and its processing and distribution energy) as there would be from asking them to switch to a bamboo toothbrush. At CDP we look at the entire lifecycle of a product, and the context in which it is used, to get a clear view of all the impacts on the planet.

This holistic view is also the key to creating genuinely innovative sustainable products and services. As consumers grow ever more discerning and the environmental movement becomes the mainstream, this approach will be critical to successful and sustainable product innovation.

We’re off to see the wizard

September 17th 2019

Tom Lawrie-Fussey

Lucy Sheldon

Head of Human Factors

Writing an expert view for ONdrugDelivery Magazine, Tom Lawrie-Fussey, Healthcare Digital Strategist, and Lucy Sheldon, Human Centered Design Consultant, both of Cambridge Design Partnership, introduce “Wizard of Oz” testing, named after the classic novel and film, whereby experimenters can field test concepts at a very early stage by giving the illusion of a finished product, saving potential costly and time-consuming changes further along the development process.

It is a simple fact that product development cycles are always being squeezed. In all industries, the cost of an extended time to market means that pressure is applied at every step of the development process. In response, rapid-prototyping techniques have matured quickly and are able to significantly reduce these timescales. Mechanical components, such as the body of an inhaler or the lid of an injection pen, can now be quickly built, improved and refined.

In theory, digital opportunities do not suffer the same scale of risk and cost as is associated with physical manufacturing. However, in the world of drug delivery, many digital concepts are multi-user, multi-touch-point and must comply with strict regulatory and data protection constraints. This is a far cry from designing, coding and deploying a consumer app. With this complexity comes additional uncertainty and longer development times.

“In the world of drug delivery, many digital concepts are multi-user, multi-touch-point and must comply with strict regulatory and data protection constraints.

This is a far cry from designing, coding and deploying a consumer app.“

One approach to address this challenge is to use concept testing. Typically, stakeholders are surveyed to provide opinions on the utility and future value of a proposed innovation. As the innovation does not yet exist, their opinions are based on a description of what it would be like once it is made. However, this fails to investigate the user experience or, crucially, how it might influence behaviour. This is vital information in healthcare, compounded because digital services are complex and typically comprise of multiple touch-points and stakeholders.

To use an example from Cambridge Design Partnership’s own work, CDP has been working on a digital education programme aimed at increasing the level of correct inhaler usage in children. CDP wanted to find out whether videos, interactive games or even songs were the most successful way of encouraging best-practice compliance in young inhaler users. The implications go far beyond the patient’s own device. A comprehensive digital service to improve inhaler use must address a range of different drugs and devices, therefore comprising multiple front-end applications. System building blocks include a:

• Secure patient-data hosting solution
• Portal for the payer
• Dashboard for the healthcare professional
• Dashboard for the pharmaceutical company
• Back-end data analytics engine.

In this example, it is hugely advantageous that, in the same way a physical design is frozen before investment in detailed design and manufacturing begins, the digital design is also optimised and pre-validated prior to transitioning into development. If the proposition cannot be tested in a realistic way early on, then late stage changes are inevitable, adding additional, unnecessary cost and time. What is needed is an approach where each stakeholder can assess the part of the system that they will interact with, long before the design is locked down.

WIZARD OF OZ TESTING IN PRINCIPLE

One approach we use on early ideas is to create the illusion in the user’s mind that very early prototypes are in fact final products. This is the theory behind Wizard of Oz testing.

“Have you ever been on a website, seen a fantastic new product and tried to purchase it, only to be added to a waiting list? Well, this is a form of Wizard of Oz testing in action.“

The Wizard of Oz technique enables unimplemented technology to be evaluated by using a human to simulate the response of a system design. The technique is named after L Frank Baum’s novel and the classic film, in which the Wizard is ultimately exposed as a normal man sitting behind a curtain, pulling levers and successfully convincing everyone that he is a powerful magician. The experimenter, like the Wizard, creates a believable illusion of a new device or service. This is then deployed to discover how users interact with an idea and, in so doing, provokes genuine responses

For example, a user may believe they are speaking to a computer using voice recognition, when, in truth, their words are being typed in manually by an experimenter. The goal here is to observe how a user interacts with a voice recognition system, rather than to measure the effectiveness of the technology that drives it.

This method relies on the generation of what are known as ‘‘use-like’’ prototypes, which do not necessarily need to look like or work like the real thing. The ‘‘use-like’’ prototypes must simply create enough of an illusion to elicit reactions from the people using them that are completely genuine. It is the fidelity of the experience and interaction that is important, not the fidelity of the prototype. For the experiment to work, you simply need to create enough of an illusion to elicit these responses, which then identify the successes and flaws that feed back into the design process.

WIZARD OF OZ TESTING IN PRACTICE

Have you ever been on a website, seen a fantastic new product and tried to purchase it, only to be added to a waiting list? Well, this is a form of Wizard of Oz testing in action. You are faced with the illusion that you can buy an, as yet, non-existent product. In showing an intention to buy, you are added to a list of potential customers, helping the innovators investigate the potential commercial success of their product.

For drug delivery device development, there are many advantages to the Wizard of Oz approach, especially when evaluating early digital concepts. Consider again the system aimed at improving inhaler usage in children. The success of any solution is dependent on how all the stakeholders involved benefit, and when combined, how their behaviour impacts patient outcomes. Utilising “use-like” prototypes and Wizard of Oz testing can shine a light on the aspects of the system that need to be further improved and developed. Figure 1 shows a ‘‘use-like’’ prototype which was created by CDP for a Wizard of Oz research programme to help develop and refine new systems to train patients in correct inhaler technique.

Figure 1: This is a ‘‘use-like’’ prototype developed by Cambridge Design Partnership to trial inhaler use. It is the fidelity of the experience, not the fidelity of the prototype, which is important. The “use-like” prototype consists of a device which collects inhalation profile data and a training app. The app and device were used in combination for inhaler training. The device could be used in isolation to assess the effectiveness of the app and a range of other inhalation training options including current approaches to training as a baseline.

In one example of a Wizard of Oz test protocol, children or adults who are not current inhaler users are trained in how to inhale (without reference to the purpose of the training). This research design assumes that the data collected on the learnability of the inhalation technique is relevant to a first-time inhaler user. Typically, the cohort is split into two groups; one is trained in line with normal practice (to provide a baseline) and the other group trained using the “use-like” prototype and app in Figure 1. However if data on the adherence over time to the new learned behaviour is required, the study becomes more complex and requires patients to be followed and re-tested at realistic intervals in line with known training decay.

Wizard of Oz testing generates quantitative data on the relative potential of the product concept against a baseline, with a general outline of the research design. In addition, observation and interviewing uncovers what users love about the idea, as well as highlighting aspects that they may not value, features they struggle with and areas where improvements need to be made.

Given that this process does not involve administering any drugs or therapies, the approach can be undertaken ethically as market research. Appropriate ethics reviews must still be undertaken nonetheless, but these studies can be implemented relatively quickly and economically.

In parallel with patients themselves, research can be undertaken with stakeholder general practitioners (GPs). They could be presented with various “use-like” representations of information dashboards, in which realistic data visualisation options and anticipated patient scenarios are generated. Faced with believable prototypes GPs can more easily evaluate their desire for new data and researchers can tease out what is most important to them.

Further up the chain again, this research method can address the needs of the pharmaceutical company selling the drug. In the same way as with GPs, but this time a simulated live dashboard showing the market usage and effectiveness of the training programme could be used to inspire innovations that optimise marketing and sales programmes.

Wizard of Oz testing of new digital concepts is a powerful tool to optimise and learn about the commercial potential of digital concepts at a very early stage. The method enables development teams to observe customers interacting with a digital product or service, allowing direct feedback on its potential value in the real world while it is still in the conceptual phase.

It is surely far better to start technical development only when digital concepts have proved themselves in Wizard of Oz-style evaluations. It’s a smart way of ensuring that your new digital device and service will fully deliver its potential.

“Wizard of Oz testing of new digital concepts is a powerful tool to optimise and learn about the commercial potential of digital concepts at a very early stage.”

ABOUT THE COMPANY

Cambridge Design Partnership is a technology and product design partner focused on helping clients grow their businesses. Some of the world’s largest companies trust CDP to develop their most important innovations. Located in both Cambridge (UK) and in Palo Alto (CA, US), CDP specialises in the consumer products, healthcare, energy and industrial equipment markets. Its multidisciplinary staff have the expert knowledge to identify opportunities and tackle the challenges its clients face.

ABOUT THE AUTHORS

Tom Lawrie-Fussey is a Head of Digital Health at Cambridge Design Partnership, and has more than 15 years’ product development experience and is a Chartered Engineer with a master’s degree. He has been trusted by a myriad of well-known brands during his career, spanning automotive, industrial, FMCG, consumer healthcare and drug delivery. For the past 5 years Tom has specialised in helping clients to navigate their digital roadmap, providing a horizontal cross-sector capability and expertise.

Advising on connectivity and digital services, Mr Lawrie-Fussey has led the development of a number of digital toolkits to help clients to de-risk their digital innovation. One of these, the instrumented user-insights service “diialog™” has grown to serve multiple markets, with various ongoing client projects helping to steer and inform product development investment.

Lucy Sheldon is a Human-Centered Design Consultant at Cambridge Design Partnership, and has 15 years’ experience developing human-centered medical products, including the application of human factors to drug delivery devices, diagnostic tests, and surgical and therapeutic devices. Ms Sheldon’s expertise includes unmet needs exploration through observation, research and structured interviewing; usability engineering including usability testing and the development of usability documentation in line with medical device human factors regulations and IEC14971; and interaction design across physical and screen-based interfaces. Recent projects include usability testing of home-use drug delivery devices, iterative exploration and design for an award-winning low-cost vital signs monitor, and interaction design for a touchscreen surgical interface.

In packaged products, context is king

September 12th 2019

Chris Houghton

Chris Houghton leads Brand Innovation & Packaging at Cambridge Design Partnership, he has worked on an array of successful insight, design and strategic innovation projects with top consumer goods names including Arla, Carlsberg, Coca-Cola, Diageo, Nestle, PepsiCo, Procter & Gamble and Unilever.

Following his ‘Context is King’ keynote speeches at PACE in Amsterdam and AIPIA in New Jersey, he summarises five key questions brands need to answer when building an innovation pipeline.

Bill Gates famously wrote, Content is King back in 1996. His forecast…“Content is where I expect much of the real money will be made on the Internet”…

How right he was as we’ve seen the digital revolution establish over the past decade. On demand streaming services have overtaken traditional audio and video formats with gaming next on the horizon. Coupled with new business models, the likes of Uber and Airbnb have tapped into consumer demands making brands sit up and think what should we do to take advantage of this fertile digital landscape?

Context #1. Who?

Who are you designing for? Do you understand their cultural sensitivities, their customs and established rituals? Do you know their values? Their gender or generation? Their mental and physical abilities? Are they tech-savvy – do they need to be? The better you understand specific population cohorts the better your chance of successfully meeting their expectations.

Each culture and country has its own technology trajectory and utilisation levels. The worldwide average for time spent on the internet is now 6hrs 42mins which is just above USA’s average but some way short of chart toppers the Philippines clocking in at over 10hrs per day (source Digital 2019, wearesocial.com users aged 16-64).

Some categories like beauty and cosmetics are ahead of the curve with high digital engagement. L’Oreal was one of the first brands to realise this with their Makeup Genius app which allows users to compare before/after make-up and hair effects on-screen. This pre-purchase, augmented reality tool enables fast navigation of product choices to help consumers decide what to buy – within two years L’Oreal said it had 20 million users worldwide.

For decades, beauty brands have been heavily reliant on celebrity endorsements or experts in lab coats to target and assure consumers but today that paradigm is changing. Millennials increasingly seek individuals that they can relate to, building seemingly intimate relationships with those they follow on Instagram and YouTube channels, who ultimately steer their lifestyle decisions. This mix of opinions, edited evidence, facts and ‘fake news’ can confuse many consumers, so building trust is more important than ever.

Context #2. What?

What category does your brand belong? Beverages, confectionery, personal care? The answer to this is obvious, of course and you’ll invest great effort closely tracking the activities of your competitors. But that is just the start. Innovations don’t always come from your direct competitors. Instead, brands are often blindsided from an unassuming left field competitor, arriving at speed with disruptive and transformational innovations. For instance toothpaste brands didn’t expect their category to be impacted by confectionary companies making chewing gum with teeth whitening claims.

We look at the ‘what’ in a solution agnostic way using the ‘jobs-to-be-done’ methodology. In a nutshell this approach states that when consumers become aware of a job they need to get done, they look around for a product or service that they can hire to do so.

Procter & Gamble’s Tide is a good example of a brand that have extended their portfolio to cater for changing contexts. The core range is unsurprisingly traditional powder, liquid and convenient pod packaging, but more recently Eco-Box was introduced to address e-commerce shipment and improved sustainability stats. The brand has even stretched beyond products solutions with the test market launch of Tide Cleaners. A direct to consumer, digitally enabled, subscription service that targets ‘generation rent’ to simply drop/collect dirty/clean laundry. This cleverly allows the brand to reach new consumers whilst experimenting with new business models, partnerships and logistical infrastructures in a low risk way.

Context #3. Where?

Where is your product used? At home, at work or on the go? Each location may present a different hierarchy of jobs. In fragrance, for example perfumes have clearly defined packaging conventions. Consumers expect a thick-walled glass bottle, an elegant closure with a precise dispensing atomiser. This objet d’art is entirely appropriate to adorn a home dressing table. However, if on the go, this format no longer seems so practical for a handbag.

In 2017 British parfumier Jo Malone launched Fragrance Paintbrush under the brand Jo Loves. A compact perfume gel applicator that is crucially handbag friendly. This delivers an entirely different application ritual, delicately brushing quick drying fragrance onto the skin rather than the traditional perfume spritz.

In a digital, augmented world understanding the ‘where’ is crucial to enable or enhance the experience, especially when leveraging the surrounding environment. Whilst outside the packaged goods world, I find EuroStar Odyssey an insightful and charming experience to entertain children during a long train journey. Instead of uninspiring views inside a concrete tunnel beneath the English Channel, the carriage is virtually transformed into an underwater viewing gallery with dolphins and whales swimming besides you to help families kick start their vacation.

Context #4. When?

When is your product used? This can have a crucial bearing on consumer engagement levels especially regarding available time and tolerance levels. For example, a parent making up baby formula has very different functional, emotional and social ‘jobs’ depending on the time of day. Sterilizing equipment, measuring and mixing powder at 3pm is very different to 12 hours later for the 3am feed in the dark whilst you’re still half asleep, was that 4 scoops or 5?

When is a crucial dimension for digital interaction too. Many successful smart packaging examples have come from high engagement categories like alcoholic beverages and beauty where consumers make extra time for interaction and brand owners see sufficient ‘value’ to deploy cost sensitive technologies and/or content.

Context #5. Why?

Why should we choose your brand? What motivates us? What jobs are we trying to achieve? ‘Why’ ties together all of the other contextual considerations and forms the heart of any value proposition and reason to believe.

Take PepsiCo’s Gatorade brand for instance with their emotive message of #WinFromWithin. They understand people are motivated to ‘win’ especially in a sporting context. This reinforces how the brand was created in 1965 by scientists to provide athletes competitive advantage through superior hydration. Fast forward 50 years and the brand found themselves losing share with an influx of competitors big and small. To reverse this trend they identified contextual consumer jobs to cater for their needs more comprehensively. This prompted the launch of G Series, primarily a ‘When’ based product range to help athletes before (Prime), during (Perform) and after (Recover) sporting efforts. This triggered their portfolio to grow beyond solely sports drinks into food to create an ecosystem of sports fuels, from chews, bars, powders, drinks etc. More recently we’ve seen the launch of the Gx Bottle, a smart hydration system that helps individuals to customise their own products, with connected sweat tracking and variable carbs and electrolyte pods, the Nike ID of the hydration world.

So ask yourself, is your brand prepared for this revolution? Do you cater for those consumers that don’t accept one-size-fits all? Whilst Content may be King in the purely virtual, service-based world, Context is King for physical, packaged offerings where content can augment and enhance the physical experience rather than be able to entirely replace it.

CDP engineer live on BBC news

August 15th 2019

Akshaya Ahuja

Jess Carroll

Consultant Mechanical Engineer

CDP engineers were featured on BBC news yesterday evening, to offer an insight into their voluntary work for Remap, a national engineering charity that makes custom equipment for people with disabilities.

Mechanical engineers Akshaya Ahuja & Jessica Carroll explain how they help people with disabilities in the local community by combining their knowledge of product innovation with CDP’s extensive resources to offer unique design solutions.

Akshaya recently won the prestigious Wolff Award at Remap’s National Award Ceremony for creating an electronic armband with a pressure sensor, shown in the report, to help remind Sarah to correct her posture and sit upright.

User centred innovation is at the heart of Cambridge Design Partnership’s expertise. Staff also use this capability for voluntary projects, such as those with Remap, with flexible working hours and state of the art facilities to help them.

Jess, who has currently been assigned a new project says working with Remap is “a great opportunity as an engineer to see what your skills can do to help people – and how it can help someone’s life dramatically”.

For more details on Remap, visit the site.