Key takeaways
- Human-centered design at Medtronic uses patient, caregiver, and clinician insights to make medical technology easier and more intuitive to use.
- Medtronic applies human-centered design to technologies including Micra™ pacemakers, Altaviva™ bladder control implant, LINQ™ cardiac monitors, and the Hugo™ robotic-assisted surgery system.
- Designing medical devices around real-world human needs can reduce physical and cognitive burden, improve the care experience, and help patients participate more actively in their care.
To an engineer, pressing a button may seem like a simple way to change a medical device setting.
For the patient with Parkinson’s disease holding it in their hand — and even their caregiver — it can be anything but.
Zane Thimmesch-Gill, a human factors expert at Medtronic, recalled such an encounter with a patient, tears welling up in his eyes. When the patient couldn’t grasp how to adjust a setting on her device, her caregiver turned to Thimmesch-Gill’s team and said, ‘You don’t understand, she used to be an engineer.’
A sometimes devastating diagnosis matched with complex therapy “just makes the experience that much worse, and we’re really trying to go the other direction,” he said.
Addressing that disconnect — of how scientific minds think the patient will interact with a medical device and how they actually do — is driving a growing body of work at Medtronic called human-centered design.
“We’re leading with the patient in mind,” said Danny Gelfman, a senior distinguished designer at Medtronic who leads the company’s human-centered design community of practice. “It’s tech, but the patient and the human being are brought along throughout the whole process.”
The approach has implications far beyond usability, Gelfman said. Done well, it may improve patient outcomes, speed development, and help patients take a more active role in their care.
How human-centered design improves the patient experience
At Medtronic, Thimmesch-Gill has applied human-centered design principles across conditions, from Parkinson's disease to pelvic health.
One example is the Altaviva™ bladder control implant, a device for patients with urge urinary incontinence. About the size of a flash drive, it’s implanted near the ankle during an outpatient procedure.
Many patients live silently with symptoms for years before seeking treatment, Thimmesch-Gill said.
"They can drive themselves to the clinic, they can drive themselves home," Thimmesch-Gill said of the Altaviva™ device. "It gives doctors such a powerful tool to be able to say, 'This is something we can do for you, and you can go pick your kids up from daycare afterward.'"
The result was a treatment shaped not just by engineers, but by the people expected to live with it.
“It was important to me that it was inconspicuous,” said patient Sandra Watt of her Altaviva™ device.
Watt said she was contacted by teams at Medtronic who wanted to learn from her experience with the device so they could incorporate patient feedback into future innovations.
“I had an interview, a FaceTime interview with someone that did precisely that, collected information from my experience so they could design better in the future,” she said.
The heart of human-centered design
The Micra™ leadless pacemaker, the world’s smallest pacemaker, is implanted directly into the heart. Therapeutically, it works similarly to a transvenous pacemaker, or a device that’s guided to the heart through veins using thin, flexible wires called leads, Gelfman said.
Removing leads from the heart not only eliminated a potential complication, but the Micra™ leadless pacemaker is also small enough that patients don’t have a visual reminder of the device on their body, like a bulge or scar on their chest.
“For the people at the center of the experience, where do we have the opportunity to provide more value?” Gelfman said. “That might mean there’s nothing new with the therapy or the diagnostic itself, it just might be making things easier. That’s the concept of the Micra™ pacemaker in a lot of ways.”
Designing healthcare technology for the real world
Human-centered design doesn't end with patients. In many cases, it means understanding everyone who interacts with healthcare technology, including the clinicians responsible for delivering care.
As part of his role in upstream marketing at Medtronic, Steven Nelson spends a lot of his time figuring out how market-leading technologies like the LINQ family of insertable cardiac monitors, can continue to meet both patient and clinician needs. The Medtronic LINQ ICM is a small device about 1/3 the size of a AAA battery that continuously monitors the heart for up to several years to detect abnormal heartbeats.
His team approaches their work with curiosity first. They spend time understanding how patients, doctors, and nurses interact with healthcare technology, identifying points of friction, where time is wasted, and where people get lost in complex software.
"We might have the best solution in the world,” said Nelson, a product consultant in the Electrophysiology Therapies business at Medtronic. “But if we don't understand how this is going to fit into the world of the person we're trying to give it to, we've missed the mark entirely."
One of the team’s most interesting revelations is that the primary user isn’t always who you’d expect. Doctors may choose a cardiac device for a patient, but nurses lead much of the day-to-day work of patient care, working in platforms like the Medtronic CareLink™ Network, a secure remote monitoring platform that enables clinicians to receive and review data from compatible Medtronic cardiac devices, helping them manage patients between office visits.
In one example Nelson shared, nurses sifted through pages of heart monitor data for a single patient every day. They felt obligated to review every line, Nelson said, searching for red flags like arrhythmias.
Once Nelson’s team spent time in hospital settings and learned of their headaches, they brought their findings back to the internal team at Medtronic where employees are investigating new ways that clinicians can review heart rhythm data and prioritize the most actionable insights first.
The takeaway was recognizing the reality of the customer – that every minute matters, and that’s where his team needed to focus their attention, Nelson said.
Medtronic launched the AccuRhythm™ AI algorithms on the Reveal LINQ and LINQ II ICMs that have proven to save clinicians hundreds of hours of false alert review.
You can’t design for people you’ve never met, Gelfman said. Understanding human behaviors around healthcare technology is a lot different from understanding human behaviors around consumer products, Gelfman said.
“If you work for a big box store and you want to know how people buy dish soap, you just go to the store and talk to people in the dish soap aisle.”
Understanding healthcare experiences requires deliberate effort — empathy doesn’t happen by accident.
Reducing physical and cognitive burden in the operating room
Understanding strain on healthcare professionals laid the foundation for engineering the Hugo™ robotic-assisted surgery system, a soft-tissue robot by Medtronic.
Clinical and human factors engineers and industrial designers started the design process by analyzing operating room workflows and asking questions like, “How many people will be in the room at one time?” “How do doctors need to access the patient?” and “Where are the people and equipment in the room located?”
Not to mention, surgeons spend years training for highly specialized procedures, yet many face physical strain in the operating room from repetitive motions, long hours standing, and complex technology interfaces.
Joe Cesa, who leads the User Centered Design Team for the Surgical business at Medtronic, said the team that designed the Hugo™ system had to accommodate users between 4’11" and 6’2" and consideration was also given to whether surgeons were left-handed or right-handed, and whether they had physical impairments like hearing or vision loss.
“Humans are not designed- engineered systems,” Cesa has said. “We are completely unpredictable. Trying to design something that behaves the way a human would think is a really hard thing. But that's why our team exists — we try to anticipate how people are going to respond to our technology based on knowledge of human behavior.”
Hugo™’s design incorporates small details like where buttons are placed, their color, and the sounds they make to larger features like ergonomic support and helping teams communicate in the operating room.
Why empathy matters in healthcare technology design
Whether it's helping a person with Parkinson's disease navigate a device adjustment, reducing the burden on an overworked nurse, or making a long day in the operating room easier on a surgeon's body, human-centered design begins with the same premise: innovation starts with understanding people.
"You can watch all the videos you want to watch. You can listen to a lecture. You can hear a report out," Thimmesch-Gill said. "But until you see someone who's really sitting there and struggling through something, you don't understand the weight of what is being put on their shoulders."
That understanding is what Medtronic human-centered design teams are ultimately working toward. Not better products for their own sake, but better experiences for the people who depend on them.
"The materialization is not the goal," Gelfman said. "The goal is people's lives, how they live and how they work."