Ultrasound Project Z

THIS WORK IS COVERED BY NDA. I HAVE BLURRED ALL ARTIFACTS AND TALKED ABOUT THE WORK IN A VAGUE WAY TO PROTECT THE DETAILS. I HAVE ALSO ALTERED SOME WORDS TO FURTHER CONCEAL THE WORK.

In structural heart procedures fluoroscopy is widely used. There are two challenges with this; first it’s radiation, second users can’t see the anatomy on the flouro display. So what happens is that the physicians are looking at ultrasound for anatomy and flouro for devices on a “boom” monitor. This creates a heavy cognitive mental mapping that challenges users.

The physician has a patient on the bed and is maneuvering devices in and through out the heart to see what they are doing, and deliver therapies. Their main task at that point is maneuvering the device. They use ultrasound as almost a flashlight to navigate the anatomy. Flouro can see the devices because they are metal. The physicians are looking at both modalities to perform the therapies.

Therapies include atrial septum defect closures, mitral and tricuspid valves repair and replacement and left atrial appendage closures.

Role

UX design and research
Managed stakeholder feedback
Strategy
Project manager
Early Usability studies

Team

Clinical stakeholders
Developer Engineers
Ultrasound Engineers
Product Management
System Architects
Risk

Challenges:

Our organization has a years long backlog of features and getting stakeholders organized was difficult
The fluoroscopy team also has a years long backlog of features and they were not prepared to make necessary changes
Hiring the outside designers was confusing and added cost and stalled the project
Expectations were not clear from the different modalities and this created extra thrashing on both sides.
Not many users are using this functionality and finding observations is hard
Getting user feedback is difficult without a coded prototype in a functional fluoroscopy lab

Learnings:

Figma is not always the best method of getting user feedback, observations are often more helpful
When working on designs for products, we need to keep in mind that our products are often only part of the equation. The sole focus in
these procedures is repairing anatomy of the heart so someone can live. Don’t make your feature the star of the show. It should be invisible.
Make sure everyone is working from the same white paper/project brief so that everyone knows their role
Ensure that management is aware of misconceptions of projects when big budgets and global teams are included
If working with an outside team, train them to not only understand the patterns, but how your internal process works. This can head off corporate culture clashes

Process

Collaborated

The Siemens flouro team met us in Issaquah to discuss their vision. They already had designs done from a contract designer. But those designs were in a design system that ultrasound didn’t use and it confused people a little.

Get the work into the ultrasound design system and define

I offered to the flouro team to take the work and apply our ultrasound design system and ux patterns to it so we could get an effort estimate. I worked with that stakeholder to define all of the scenarios, users, therapies, user journeys, workflow, behavior and define all of the controls.

Competitive analysis

Investigated the competitive landscape to understand what others are doing and audited the behavior

I worked with the engineering team to get an effort estimate and create the white paper

I sent the designs and documentation to them so they could provide an estimate. We worked off old requirements. The engineering team provided the effort estimate which I communicated to the flouro team.

Wait for the feature team to get on board

I was a designer with one Flouro stakeholder. We needed the full feature team to be on board to help support us.

The flouro stakeholder hired an outside contract team to design the feature

This was confusing since they had already done the designs last year. There was some miscommunication and we asked them to perform research instead. It was hard for us to do the research on our own because our budgets are so low. It required travel to multiple countries and partnerships with catheter labs to observe.

I continued to work with our feature lead to get the feature team on board

Trying to keep the feature alive, we held regular meetings, reviewed the designs against technical constraint

Feature team in place, contract designers share their research

The research was presented to the feature team and provided some additional context to the problem space. I took the work and applied the learnings to the work

We traveled to Oxford London to observe some fusion cases with KOL’s to learn if we were on track with our designs

Site: University of Oxford John Radcliff Hospital 
Why Oxford? Teaching center for Edwards Life Sciences (Device Maker), The physician, Dr. Dawkins is a proctor for Edwards. He teaches doctors at other hospitals and follows up with the after they’ve been through Edwards Training 
Participants: Physician, Radiographer, Cardiologist, three clinical development participants, a Lead application specialist
Observations Outcome:
Observed 3 procedures
Documented procedures, environment, stakeholders, therapies, anatomy, devices, equipment, pain points, workflows, light interviews

Shared learnings

Created a report of the observations to share with the feature team. Discussed the learnings and decided next steps.

Iterate on designs

We iterated dozens of times to get to something we could get feedback on. This was done with the collaborative feature team.

Got feedback on a prototype

I created a clickable prototype in Figma and performed a remote feedback session with an external clinical stakeholder who is familiar with the procedure. I gathered the feedback and created a report.