Pedro Couto e Santos

How to make sense of a strange world, and deliver high value results

(Originally posted on Medium — Feb 28, 2019)

A bit of our history with healthcare

At Impossible, we’ve long worked in the world of healthcare, with clients ranging from Babylon Health, that aims to connect doctors and patients through technology, to Samsung, running specialized medical protocols through wearables, and especially Roche Pharmaceuticals, who are on the forefront of advanced medicine digitalization.

Impossible’s projects with Roche have been many, and multifaceted, some in the field of clinical medicine, and others in the field of medical or pharmaceutical research. In this article I will focus more on the research side of things, which is not to say you can’t get something out of it even if you’re not even working in the healthcare space.

Medical research is a very deep and complex field, and the majority of people have no idea of what is being done by people who work tirelessly to try to advance healthcare and, ultimately, improve the lives of millions. Not only is it complicated, it’s also secretive, for obvious reasons. I will be very careful with the information I can dispense.

Because things at this level need to be extremely accurate and scientifically proven, they are also extremely slow. We all wish for breakthrough cures for all our ailments, but there isn’t a process out there quite like that. What we have is a painstaking approach to trial and error investigation, that puts researchers’ ideas to the test. These processes take years before anything is even brought close to human testing, which is one of the final and more visible steps of research.

And this is exactly why technology has such a massive role to play in these fields. Because the process needs to be conducted with a level of rigour and protocol which most of us have never experienced even in the most serious job, every part of it that can be accelerated through software and hardware that automates steps or makes the lives of scientists easier, will have enormous impact.

Through the years, we have impacted many of Roche’s software platforms, creating entirely new user interaction models to not only accelerate work, but also, reduce error. While it may be new and shiny to do UX for a cool startup, it’s a completely different game to work for a big healthcare institution with no margin for error. And I, for one, find that more exciting.

How we design in the depths of complex healthcare systems

Starting out a project in this “Deep Healthcare” can be a daunting prospect. In some fields you can sort of come prepared, there’s research you can do online which you can trust enough to get you started, but it may not be the case when you’re dealing with human tissue specialists in an underground lab somewhere. So you need to absolutely turn off your ego and be humble.

Find your teacher

In our experience, there is always that one person that loves to teach. A lot of scientists are also teachers and they love nothing better than a fresh brain. Find those contacts through your client, and start with a kick-off session with them. You’re looking for the basics: what does the field you’ll be working on entail, what is the big-picture workflow that takes things from hypothesis, through testing, to publication?

Try to understand who are the key people involved in this process, there will be dozens of people, but you can’t possibly reach them all. Who are the key people at each stage that can tell you about the roles of others, besides their own? You will need to move on to talk to those people next.

This teacher figure is your return contact, you need to build a great relationship with them. In certain cases, we found that Product Managers at Roche were highly educated bio-scientists and they were our lecturers, building up our knowledge so we could go into those later interviews with stakeholders, know what to ask, and understand the answers. Other times, those Product Managers would know just who in a lab could help us get started, and just help start building that bridge.

Become a “layman’s expert”

Don’t take this knowledge as expendable, it is essential. You may think: “I’m a designer, not a doctor”, and while that may be true, your design work will only be as good as your understanding of the world you’re working in. Pay attention, learn something new with each interview, take notes and study. Catch a term you haven’t heard before? Make a note, look it up later. That online research may not be useful in the beginning, but you can get really deep with it if you’re searching for specific knowledge.

If you let yourself be immersed in the world with full dedication, you will become a “layman’s expert”. Obviously not a scientist, but with enough knowledge that you can really become an asset in solving deep issues that befall the specialists working in research every day.

Sure, you could just do some usability testing, rearrange those buttons, create nicer icons, that would help. But if you reach the full potential of your brain in understanding the scientific context, you will be in a position to really improve entire processes and workflows.

For example, by being in tune with everything that was going on around a certain software project we were designing, we ended up mapping the processes of the entire lab, which led to an internal discussion and a complete overhaul of those processes. While we could have still made UX improvements to the research software, we ended up having a positive impact in the entire lab, exactly because we understood how it worked.

Find a technologist

Not everybody is crazy about digital technology. In healthcare, it’s very common to find people who are very cautious of adopting software and hardware solutions that replace their current methods. And there’s good reason for it, and no point in treating those people as the enemy. If you take a look at a digital image of a biopsy or look at it under a 30-year old microscope you’ll quickly realize the microscope is far superior in image quality.

So, never cast aside users who resist tech, instead, you need to understand their reasons and offer them counterweight to the advantages they find in their current methods. Image quality is higher, but how fast can you retrieve a certain sample from storage? Can you share what you’re seeing with a colleague straight away? Is it easy to mark a portion of the image and return to it in a week?

Even though this is a good strategy, we find it’s always easier if you find a technologist or two within the workgroup. These are better suited people to carry those messages to the less open ones.

Like your first-day teacher, this tech-inclined person will be someone who is perhaps a step ahead of the colleagues and has a clearer view of the advantages of new software and hardware systems that will make things faster and more accurate in the future. Maybe this tech enthusiast is the same person who first taught you about the science.

And, please, never ever make the mistake of thinking age is the defining factor in technology enthusiasm. Many factors can contribute to this, and sometimes it’s older, more seasoned professionals who have a wider view of the whole process and better understand the advantages of things like automation and digitalization.

Planning is as important as designing

Planning your design, understanding its impact and knowing how to implement it at the right time is as important, if not more, than the design solutions themselves.

Remember what I said in the beginning: this is a slow-moving field. Not because it’s outdated, but because it’s methodical and careful. It takes time.

Coming in with a better design will help. Everything that doesn’t really need to be slow, should be fast, and only the biological, chemical and even ethical parts of the process that need to be slow, should be slow.

But implementing a radical new solution might not be faster. In fact, it will probably slow things down before speeding them up. Because this is not the consumer market, no one’s looking for the new shiny app, they are looking for the new more efficient app. The easier to use, faster to process and quicker to learn.

This is where planning comes into play. Once you’re deeply embedded into the realities of the field you’re designing for, you’ll have a sense of how to phase your impact in order for it to be the most efficient.

There are always multiple design opportunities in every project: can you improve existing information architecture? Are there user interface adjustments that would make processes smoother? What are the minimum viable changes and the major overhauls?

Plan execution according to impact versus disruption; this is not the startup world, you want to keep the first high and the latter as low as possible.

In conclusion

1. Stay humble, if you know nothing of the scientific field you’ll be working on, ask for a point of contact willing to teach you. Ask them for a big picture view of the whole process and key people in each step.
2. Talk to those key people, you should have some vocabulary now, find out what they do, and how; what they know about what others around them do, and how all those tasks connect.
3. Map processes: The main workflow, secondary flows, user journeys, application architecture. Draw visual maps, print them out, go over them, show them and ask questions until they’re complete.
4. Find a tech-minded ally, they should be briefed on designs first, and help you fine tune to better pass them along to others less tech inclined.
5. Understand the impact of your design and plan to implement it for the least possible disruption with the most possible gain in efficiency for the user.

And if you want, you can go back and re-read this text under many other contexts, and it will still make sense. To me, this is the essence of a designer’s work. Happy learning.