More research, more investment, and more excitement — and perhaps more hype — have surrounded mobile healthcare technologies than ever before.

The ubiquitous nature of smartphones provides a new technology platform for innovative interventions geared towards clinicians and patients.

But if the technology is hard to understand, who will use it?

That’s where design comes in–this is what makes products like the Apple iPhone stand out and leap far ahead of the competition. The design of technology is key to the success of any product.

Mobile applications lack a designer’s touch. For that, many turn to firms like IDEO, a world-renowned international design firm and innovation consultancy. IDEO is ranked as one of the most innovative companies in the world, has won numerous design awards, and is a pioneer in many industries. Specifically within healthcare, the company has designed hospitals, Medtronic devices, user interfaces for Applied Biosystems, and Walgreens’ community pharmacy. IDEO has also launched OpenIDEO, which has partnered with institutions such as Mayo Clinic, Oxfam, and Nokia for past mobile technology and healthcare technology contests.

iMedicalApps recently interviewed Stacey Chang, Associate Partner and Director of Health & Wellness at IDEO, on what he sees in mobile health technologies and what healthcare professionals — physicians, dentists, pharmacists, and even medical students — should ask themselves when crafting their own apps.

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Do a lot of healthcare providers come to IDEO with ideas?

Stacey Chang: It’s interesting. I married a physician. We’ve had 7 physicians over the years, and 2 currently. They all enter medicine with a notion of what they’re going to do for others and they all get really frustrated because they’re forced to be super efficient, they don’t get a chance to be creative in the discipline and they sort of become trained monkeys. That’s the primary frustration. So often times, [when they do things] like rounding, every once in awhile they latch onto a problem that encumbers them, and then they come to us and think they have a product.


Stacey Chang, Associate Partner and Director of Health & Wellness at IDEO

What are some of the most common questions healthcare professionals ask you about their app design?

Stacey Chang: The conversation becomes interesting. Sometimes they are fantastic ideas. In other cases, they are very narrow. You might see a problem relevant to you and you should still work on it, but the complex thing about healthcare is that you can’t just fix one thing, because it ends up becoming a Band-Aid upon a Band-Aid. Part of the understanding is going to the root cause or origin of the ecosystem. So the conversation with physician inventors is about the idea itself, and about the ecosystem…and the root cause they’re trying to solve.

You probably see a recurring theme in a lot of their issues, then. Any questions they should ask themselves before they come see you?

Stacey Chang: Have you gone to see if this is a commonplace problem too? You’re an n=1. We’re the last company to ask you to get an n=100. But by going to n=3 or n=6, you see a commonality of the theme of the problem. Have a conversation with 3 or 6 other physicians. The question we ask is, do you understand the common underpinning theme to address a larger population than you?

For a long long time in healthcare, it was sufficient to do something to create a better outcome. But now that’s not enough. You want to create a lower cost point. There’s very little room to make things more expensive. As a US healthcare system, we have tremendous technology virtuosity. We don’t need to create that much more technological virtuosity…sure we need to solve cancer, but one person [proposed to me a device that] can see at a microscopic level if there are negative margins around cancer [cells] to remove. “We have an interesting device that can harvest the leftover cancer cells.” But I said, “That’s kind of ridiculous. Half an hour extra in the OR is very expensive.” There are other ways to create larger margins. A lot of times we get a lot of proposed solutions that make an incremental difference.

It’s not enough to solve the problem, because there are so many stakeholders, and people focus only on what they can effect, and it’s a challenge for entrepreneurs.

So innovation will happen in the area of creating a lower cost point.

Stacey Chang: In large vertically integrated health systems, that’s where much of the change can occur. They are trying to save costs, so that closed loop feedback is very important. If you take a hospital system like Sutter Health, they’re not an insurer. They’re incentivized to spend more to charge the insurer, which doesn’t have an incentive to spend more. Vertical hospital systems [like Kaiser, capitation models, and accountable care organizations] are better to try innovation. And outside of the US, it’s better, like in the NHS, or any large centrally managed government-mandated health system.

What should healthcare professionals read, then, to get ahead of the competition when it comes to creating apps or products?

Markers, Post-It notes, and design boards feature prominently at IDEO’s offices to mark up ideas in brainstorming sessions.

Stacey Chang: Well, they shouldn’t necessarily go to business school. They should just read a book  called Business Model Generation. Super straightforward, and helps you understand, how do I change the business model and flow of things? That’s a very useful exercise. You begin to understand the business context of developing new products (like apps). And you understand, are you creating a new product, or just moving existing things to an app?

How about design?

Stacey Chang: Don’t underestimate the value of design. The example I give is that the iPod and Zune [digital music players] functionality were the same. One understood the value of usability, desire, design, the systemic solution, like iTunes. Zune missed all of that and missed the user experience. You need to understand what people are [looking] for and design solutions for those needs. You also see a lot of apps, like Candy Crush Saga, where they created a lot of game mechanics to motivate [players]. Now, I wouldn’t say gamifying things is the only solution, but it is one solution. I would also recommend IDEO’s own books, like Tom Kelley’s The Art of Innovation and Tim Brown’s Change by Design.

The design school at Stanford [University] has executive workshops that look at design-centered approach [rather] than analytic-centered approach. Doctors are some of the world’s better analyst thinkers. When you think about differential diagnoses, you’re trained to be very discriminating to think about the solutions in your back pocket. I have an unknown problem, and you’ll think of a toolset to apply to that. Design thinking is not analyzing what I see, but interpreting what’s underneath.

In our next article, we continue with the interview and discuss the art and design of mobile health, and what physicians, pharmacists, dentists, optometrists and other healthcare practitioners should do to incorporate sound design principles in their products.

Steven Chan, M.D., M.B.A., is a resident physician at the University of California, Davis Health System, researching mobile technology, psychiatry & human behavior. Steve previously worked as a software and web engineer as well as creative designer at Microsoft & UC Berkeley. Visit him at and @StevenChanMD.