The Art of Opinionated Products
or, how to keep your product from killing people
Imagine yourself as an emergency room physician. (If you are one, imagine you’re there right now. If you’re there right now, don’t you have something else you should be doing?)
A patient comes in on a stretcher, grey, unconscious, and barely breathing. His license gives you his name and date of birth, and the ER nurse pulls up his records up on the screen while you try to stabilize him. The guy has a pretty “thick” chart: a laundry list of chronic conditions, medications, and ER visits. Will that syringe you’re holding stabilize him or make him worse? Can you see in the chart if the patient is allergic to the medication in it? Will it interact with one of his other medications? Did he already get it in the ambulance? What do you need to know right now and where can you find that information?
Now imagine yourself as a product designer. (If you are one, I’m hiring.)
If you’re designing the medical record application that will be used at that hospital, you need to give those physicians and nurses the tools they need to make split-second life-and-death decisions. That syringe the physician is holding — will that medication stabilize or kill the patient? Is the patient allergic to it? Does it adversely interact with one of the many other medications he’s taking? Did he already get it in the ambulance? As a designer, you have to make choices that verge on clinical decisions—choices about the workflow that the physician will follow, choices about what functionality or information to emphasize or prioritize.
Your product needs to have an opinion.
In a situation like this, designing with an opinion is a tricky proposal at best. On the one hand, we as designers need to guide the physician’s attention and focus toward the most important information. On the other hand, in deciding which information to prioritize, we need to avoid supplanting or preempting the physician’s clinical judgment. So how do we design a product that strikes the right balance, one that has the right opinions and the right priorities to empower and enhance the practice of medicine?
The traditional approach to product design emphasizes research and the construction of representative user personas and scenario flows. It prizes large sample sizes to reduce variability and eliminate outliers—the goal being to distill down to the common elements among the user population. Product designers have brought this approach from mature domains outside of healthcare, but have so far been unable to create the kinds of world-class products that those techniques have enabled in consumer applications.
I believe the reason we haven’t seen world class products or breakaway design leaders coming out of healthcare is that in medicine, our target users are so highly specialized and extensively trained that these generic techniques result in lowest-common-denominator solutions. These solutions don’t have an opinion, or don’t have the right priorities, and completely fail to support their users beyond replicating paper workflows. The products coming out of these shops are defined by limitless configuration options, loosely-defined workflows, and poorly-established relationships between features and information.
These products simply don’t have an opinion about anything, and it’s not hard to understand why. When you’ve defined your user as generally as “doctor” or even as granularly as “surgeon”, you’ve eliminated the differences between the disciplines that, in healthcare, are of equal or greater importance than the commonalities. As a result, the shops that produce these products fall dramatically short of crafting a product that genuinely enhances the practice of medicine for, say, a cardiothoracic surgeon or a pediatric nurse practitioner.
As healthcare product designers, if we want to create stand-out products, we need to break ranks with traditional, high-volume, quantitative research models, and re-envision our partnership with the user community, focusing on lean design practices and intimate partnerships with a small set of carefully-selected users.
I’ve integrated this principle into my team’s DNA at Alere. We work with a small group of active clinicians who help us custom-tailor products that many of them will then use themselves. The risk, of course, in working with a smaller sample size is the potential of creating a pigeon-holed product—a solution that works only for a few select individuals—and that’s where careful selection of the representative group is supremely important.
In this model, the composition of the user group can mean the difference between yet another undifferentiated product, and a breakaway leader in its category. Our partners need to be the perfect balance of veteran practitioners and forward-thinking early adopters. They need to know “the box” of healthcare inside and out, but also need the rare ability to step outside of it, objectively evaluate its flaws, and imagine ways of making it better.
These partners don’t come from a survey or a focus group; they’re relationships built over months and years, and this is probably the most important element of what makes our design process at Alere so successful. We know our selected partners personally, and we work with them on a daily basis and throughout the entire design life cycle. From defining the roadmap, to scoping out features, to whiteboard sketches, and through the final design, they are as much a part of the team as the designers or the engineers. Each of our partners gives our team the benefit of a specialist’s point-of-view that we could never have otherwise unless we all went to med school, evaluated patients, and performed surgeries for a decade. This gives us a close, personal view of how real practitioners approach medicine—their commonalities and differences—and allows us to design a product with an opinion and a set of priorities that match the real world.
I think this model will emerge as the most successful way of approaching product design in healthcare and similarly specialized fields: opinionated products designed in close partnership with a small team of carefully-selected, actively practicing professionals. A lot of time and care goes into curating and engaging with that team, but the quality of the relationship, the effectiveness of the collaboration, and the world-class products that come out of it speak for themselves.
