Onward and Upward

Insulin_pump_in_use_2 Friends, I am absolutely giddy over all the discussion spurred by yesterday’s Open Letter to Steve Jobs. The idea was to push the issue of medical device design vs. consumer “lifestyle” design to the forefront, i.e. raise a red flag to the tech-design community that can help us, and get people people talking. I’d say we accomplished that with flying colors. Michael Arrington’s post over at TechCrunch resonated throughout the blogosphere.

There were those who disagreed:

Medical device companies would never spend that much per meter. They basically are just optimizing their measurement technique for low meter cost and battery life. iPod would not help with either of those.

The failure rate of iPods is very high. you do not want this company making a medical device unless you want to look very cool while you slip into a diabetic coma when it fails…

It is ridiculous to think that an insulin pump can be the size of a nano… Should we ask Steve Jobs to design these devices? No. Let Apple do what they’re good at and the drug companies do what they’re good at (in both cases, robbing us blind). My suggestion is to try working with Steve Jobs the philanthropist, not the designer.

And the undeniably funny:

Yeah! iGlasses, iTeeth…

As a person with Type 1 diabetes, I look at the devices on the market and I wonder if they were designed by two MBAs while out for a drink.

OK, I’ll do it… Now, if only I can find a way to sell the glucose measuring strips in the iTunes store.” (Some joker impersonating Steve Jobs)

And lots of folks who were inspired:

Our problem is that the device creators have satisfied our basic needs and then just stopped. We have Functionality and Reliability but none of the other design needs (page 106 of the book Universal Principles of Design) of Usability, Proficiency, and most importantly, Creativity.

Design matters, aesthetics matter. We assume the insides are going to work, now let’s spend some more time and energy on the outside, so that we can move beyond the pump as simply a ‘medical device’ to something larger like a ‘health and life enhancer’ for people with diabetes. Good function and good design are not an either/or proposition.

I don’t think that anyone is suggesting that we make Apple (as it stands currently) a medical device manufacturer. Only partner them with someone like Johnson & Johnson … and let’s all bask in the glow of great functionality, usability, style and comfort while not being bothered every minute by our disease.

Would this make me any healthier? Not by itself. But here’s my thought. If making the user experience more friendly, and as a result makes me want to take readings that many more times a day, then yes, it just might lead to better control, and overall contribute to better health and a longer, more enjoyable, productive life. Apple could definitely help with this.”

As a result of the letter, I was interviewed yesterday for NPR’s Future Tense nationwide radio show, which with any luck will air this evening at 5:30pm Pacific. I’ve also been contacted by Stanford’s Biodesign Innovation Program and several diabetes technology start-ups for input on “personal medical device design.”

So it looks like we’ve finally captured the widespread (but fickle) imagination of the consumer gadget/ Internet design world, and I say we should ride this wave while the going is good! Thanks for all of your varied opinions. Keep the comments and suggestions coming.

Onward and Upward…


15 Responses

  1. Scott
    Scott April 11, 2007 at 7:09 am | | Reply

    Excellent!! Perhaps … just maybe … the medical design field will actually consider designs that are both functional and pleasant (it need not be an either/or decision!).

  2. M.Rak.
    M.Rak. April 11, 2007 at 7:36 am | | Reply

    What you are talking about is product Usability and Human Factors Design (see the Human Factors and Ergonomics Society, http://www.hfes.org/ ). This is a whole field of professionals who are/work with designers to make products more usable and understandable. They often focus on the medical domain, but it is often hard to sell the benefit in this type of testing to corporations. If you want to incite change quickly, you should lobby the companies who produce the devices to increase funding for their own usability efforts.

  3. Kim
    Kim April 11, 2007 at 9:23 am | | Reply

    I think a lot of your comments yesterday were people getting function and design confused. I don’t think you were really suggesting Jobs invent a new pump that breaks down as much as an ipod or imac, but just work on the user interface, exterior design.
    I don’t use a pump so I hesitated to throw my 2 cents in, but I think it’s a fabulous idea. Jobs does a lot of charity work, medical device design could be his new pet project!

  4. David Wendel
    David Wendel April 11, 2007 at 9:27 am | | Reply

    I just want to say that I just started reading your blog. I am a type1 diabetic and have been for less than a year so I have lots to learn. I should be pumping in about 2 weeks but in the mean time I am reading everything I can.
    Your site looks very informative and I can’t wait to read more.


  5. Hannah
    Hannah April 11, 2007 at 9:45 am | | Reply

    It’s no big secret that people want more stylish and user-friendly medical devices. MiniMed has just started selling vinyl Skins for its pumps (and CGMS!) in the past year, and even look at groovypatches.com, which offers decorative adhesive patches for infusion sets.

    A huge part of having a cool design is that it will make people less shy to use something in public. Or even a smaller, streamlined design. It’s bad enough we have a chronic condition that makes us feel ugly on the inside…why should we have to settle for boxy equipment with limited options that makes us feel ugly on the outside too?

    If Steve Jobs could actually help, great. If not, well, I don’t think you ever intended for the letter to reach him in the first place–I think it was more like a far-fetched hope. (Stop me if I’m wrong, though!) I’m glad this post has reached so many.

  6. Tesney
    Tesney April 11, 2007 at 11:02 am | | Reply

    Just now catching up on yesterday’s post and all of the comments. I’m 100% with you on calling for the technical world to help out with the design of medical equipment. I feel like I couldn’t live without my pump but I’m tired of finding creative ways to disquise it when I want to wear form-fitting clothing or having to take it off all together when I wear a swimsuit. Kudos, Amy, for raising awareness…looks like it’s working!

  7. Laura
    Laura April 11, 2007 at 11:29 am | | Reply

    Great Job Amy! I’m glad we have you on our side! I’m all for smaller and more discreet ways to handle MY personal “thing”. More options with devices gives those with diabetes a choice and, therefore, not feeling so left out of technology stepping forward, as it does so often.

  8. Ray
    Ray April 11, 2007 at 11:57 am | | Reply

    Forget equipment redesign, get our government to fund stem cell research! Looks like the Brits have a cure for type 1. Go to http://www.timesonline.co.uk and look for the headline about diabetics cured with stem-cell research.

  9. BillyWarhol
    BillyWarhol April 11, 2007 at 12:13 pm | | Reply

    Amy I am really disappointed U are not getting this Incredible News on Steps towards a CURE out for Diabetes??

    Ferget about Steve Jobs + Mike “I throw c0ol Web2.0 Parties” Arrington -neither of whom is a Diabetic + Post this little Good NEWS for Diabetics that was on CNN!!

    sheeeesh – i Hope U get yer Free iPod! + go to a Blogger Party*

    I may have Great News for U Amy & all the Diabetics*

    We may not need Steve Jobs Apple or the Oranges i practised on with a Needle 35 Years ago*

    Stem cells could spell end for diabetes jabs
    By DANIEL MARTIN – More by this author » Last updated at 00:20am on 11th April 2007

    Comments Comments
    Hopes have been raised of a new treatment to free thousands of diabetes sufferers from the burden of daily insulin injections.

    Scientists revealed findings of a study which shows that 15 young patients with type one diabetes overcame their dependence on insulin after being treated with their own stem cells.

    scroll down for more

    A new scientific breakthrough could spell the end of insulin injections

    The researchers say it could herald the start of a revolution in treating type one diabetes, which affects 300,000 patients in Britain.

    Type one diabetics have to regularly inject themselves with the hormone insulin to control their blood sugar levels.

    The new research has emerged a month after it was revealed that the number of British children under the age of five who had developed type one diabetes had risen fivefold in the past 20 years.

    A team of US and Brazilian scientists gave the patients powerful drugs to suppress their immune systems followed by injections of stem cells drawn from their own blood.

    After treatment, 14 of the 15 were able to put away their injection pens after losing their insulin dependence.

    And so far, one patient has been free of insulin dependency for 35 months.

    Study leader Dr Julio Voltarelli from the University of Sao Paolo said he had rushed out his findings because of the positive results.

    He said: “Very encouraging results were obtained in a small number of patients with early-onset disease.

    “Ninety-three per cent of patients achieved different periods of insulin dependence and treatment-related toxicity was low, with no mortality.”

    Type one diabetes is caused by insulin-producing beta cells in the pancreas being destroyed by the patient’s own immune system.

    Stem cells are immature cells that can develop to become a range of different adult cells.

    In the latest trial, patients’ immune systems were suppressed using powerful drugs – to eliminate the white blood cells that were attacking the pancreas.

    The patient was then injected with a chemical which loosened stem cells from their bone marrow. These were filtered out, collected and later injected back into the patient’s bloodstream.

    Some of the 14 patients responded more quickly than others, according to the study published in the Journal of the American Medical Association.

    Researchers believe the stem cells developed into new white blood cells which did not attack the pancreatic beta cells.

    But they admit there are other possible interpretations – the stem cells could have developed into new beta cells in the pancreas. Or something might have happened to stop the existing beta cells being destroyed.

    The study only included a small number of patients between 14 and 31, and did not monitor their progress for very long.

    Because of the nature of the study, it is not known if further stem cell injections would be required at a later date.

    And unlike most medical trials there was no comparison with patients left untreated or only given drugs to suppress their immune system.

    Malcolm Alison, professor of stem cell biology at the Queen Mary School of Medicine and Dentistry in London, said: “In principle this is a cure because these people developed long-term control of their glucose levels.

    “But these patients haven’t been followed up long enough, so we cannot yet be sure.”

    Dr Ian Frame, research manager at Diabetes UK, said: “This is interesting new research that demonstrates that there may have been a substantial improvement in beta cell fundtion. However we would wish to avoid false hope based on the very preliminary nature of these results.

    “This study had a very small number of participants and importantly did not include a randomised control group for comparison of results.

    “Also, as the researchers say, those who took part have not been sufficiently followed up to find out whether or not the improvements have continued.

    “All these issues need to be addressed through more research before there are any conclusive findings in this area.”

    There have been several pointers towards this latest discovery.

    Studies have alreday shown that bone marrow transplants given to cancer patients also seemed to reverse certain auto-immune disease such as type one diabetes. Bone marrow is full of stem cells.

    Later it was found that treating patients with stem cells from their own blood could benefit individuals with a range of auto-immune diseases such as rheumatoid arthritis and Chron’s disease

  10. Wendy Morgan
    Wendy Morgan April 11, 2007 at 6:46 pm | | Reply

    Hey there!

    I just wanted to drop you a line and say I got my Minimed Minilink plugged in! Yea, CGM/pump all in one. I find this very different from my Freestyle Navigator experience, so I’m doing more blogging about that.

    I sent back my first Minimed Pump upgrade to the 722 becuase the “smoke” color looked so…institutional. I got the clear instead! Fashion First!

    Thanks for keeping interesting topics on your page. You make me think!


  11. Phil
    Phil April 12, 2007 at 6:11 am | | Reply

    Looks like your open letter was picked up on by someone at the Guardian newspaper over here in blighty.



  12. M
    M April 12, 2007 at 6:13 am | | Reply

    GREAT stuff! I love how you’ve got so much attention over this.
    Perhaps what truly matters is that our things work, but style matters too. Having stylish pumps, CGMS, and even insulin pens for those of us without all that cool technology (me included *sigh*), help us to feel like we’re not broken people. We don’t need anything else to make us feel like the odd one out!
    I’ll have a small racy-dark-red pump please (with FM radio), a zebra striped CGMS that I can send pxt from, and a matching handbag and scarf. *grin*

  13. a
    a April 12, 2007 at 7:20 am | | Reply

    I am a insulin pumping diabetic who works in usability and user experience design for a living. While I agree with amy’s gripes, there are so many issues that make good design in medical devices a challenge that don’t apply to the consumer electronics world. For instance, unlike an ipod, an insulin pump or glucometer MUST be able to be understood by both a child and an elderly person. Does my grandma know how to use an iPod? No, she doesn’t have to but if she was a diabetic, it would be a must for her to know how to use her glucometer. I can say from experience, that is it pretty rare that you will create something that both the young and old will understand and welcome with open arms.

    Another issue is the time involved in training. My diabetes educator trained me on my animas 1250 in less than an hour – there isn’t anything I can’t do on it. I am on my third iPod, work in human computer interaction and i STILL don’t understand everything my iPod can do. Now I understand that we aren’t suggesting that an insulin pump becomes an iPod, but for me, the simplicity and ease of use that I find my insulin pump already has (and I would say I am pretty critical, since it is my job), would outweigh any desire I would have for a slicker looking device.

  14. Arron
    Arron April 12, 2007 at 9:27 am | | Reply

    Another Type1 here…

    I’m curious Amy, have you heard anything in response from any of the pump manufacters? In the end, they are the ones who need to be on board with the idea.

    In regards to the comments posted by M, I hear what you are saying about the technically challanged having possible problems with all the bells and whistles…but there are already pumps on the market if you require a “simple” pump.

    Heck, I think a good first step would be to have software to wirelessly communicate with your ipod/pda/nintendo ds so you could use them as a glorified interface for your pump.

    I know my Minimed can transmit info over bluetooth/rf already…why couldn’t we see future products that would let me keep the pump in my pocket and deal with a software suite on my ipod/pda/nintendo DS?

  15. Axel
    Axel April 12, 2007 at 10:33 am | | Reply

    Congratulation again for your blog and for the Open Letter.

    You did it great.

    Let’s continue, it is worth while.

Leave a Reply