The Karten Design team tells the behind-the-scenes stories of its most iconic products, and how research guides us in unexpected ways
by Karten Design
As designers, our job is full of surprises. We’re making decisions and bridging creative leaps based on the values and habits of a product’s end users. Sometimes we know what these things are; sometimes we think we know; sometimes we’re wrong. That’s why we do design research — for those moments that surprise us, that upend our assumptions. These are the moments when we really feel like we’re learning something. Those times when the reality of a situation is different from our initial understanding are when design research is really necessary.
Years ago, for an office book club — a lunchtime discussion on our sunny patio over tupperware containers of quinoa and roasted vegetables — we discussed David McRaney’s You Are Not So Smart, an exploration of the delusions that human minds create to help the world make sense. We read it because we want to know our minds and know our weaknesses. We want to know where we can develop a better understanding of the truth. Our goal, when we go out into the field, is to see through all the core assumptions, to find the truth, even if it does force us to humbly admit we were wrong.
These moments — where we learn a truth that contradicts or expands on our assumptions — help us learn and grow, and they’ve led to some of our proudest design innovations…or shut down the process before it went wrong. Here are some of the most illuminating moments we’ve encountered over 35 years in business.
“You just saved us millions of dollars”
Our client had hired us to research applications for urinalysis at the point of care. No more waiting for lab results — a nurse could read results at a patient’s bedside. It seemed like it could save time, empower nurses, and provide a whole new revenue stream for our client. It seemed like a good idea. That’s not what our research showed. Once we dove into the ecosystem, we found a complex order with no room for change. Overworked nurses had no time to perform another procedure; there was no code to bill for a bedside procedure. We found this out piece by piece as we interviewed nurses, hospital administrators and lab workers, but a clear picture had formed: the whole project was a no-go. Any attempt to change the system would be a waste of money. We wondered how our client would react. We couldn’t believe we were talking ourselves out of the opportunity to develop a whole line of products. But we had seen the data, and felt the need to bring it back to the client authentically. The room was very quiet as we presented our findings. There was a lot of thoughtful listening, digestion. And then the company CEO spoke up: “You just saved us millions of dollars and I’m very grateful.”
The Four Legged Patient
Sometimes the one making the decisions is not the person we expected. While researching the process of purchasing hearing aids, for example, we learned that, not only does the average person wait seven years between the onset of hearing loss and the time they actually seek treatment, but it’s usually a loved one who brings the patient into the audiologist’s office — a son or daughter or spouse who’s had to repeat themselves one time too many, and who’s seen their loved one begin to withdraw from life to avoid the difficulties of understanding a conversation. Audiologists call this “the four-legged patient.” The patient and their loved one share an interest in the solution, and make a shared investment in a hearing aid. Knowing this, we developed concepts that involve loved ones in the sales and fitting process, from appealing display tools to sound-proof booths scaled to accommodate three to four people instead of just two. Ultimately, this small insight fueled product line innovation, including accessories like a TV speaker that streams sound directly into a hearing aid and a companion microphone that can stream a targeted person’s voice into a hearing aid over the din of life, that improved communication between a hearing impaired person and their loved ones.
Who’s Really in Charge?
We usually expect that the person making a medical decision is the most qualified person — the one with the most specific training and expertise. Surprisingly, this is not always the case. Structures and hierarchies inside of the medical system put doctors in charge of patient care, supported by input from nurses and other on-the-ground specialists. This is what we found as we studied patient nutrition. We had assumed that courses of treatment were directed by a certified nutritionist when, in reality, doctors wrote the orders. We determined that access to information would empower nutritionists to communicate more effectively with doctors. By designing an interface that transformed raw data into actionable information, we helped nutritionists become more proactive advocates for their patients.
A Guardian Angel
As we researched a new line of infant ventilators, we spent a lot of time in the neonatal intensive care unit. Our research agenda focused on doctors and nurses, but while there, we became aware of an undiscovered user. Parents were a constant presence amid the hum and beep of machinery, watching the ventilator breathe for their baby and trying to decipher the data that guided care by a Respiratory Therapist. Watching parents inspired us to incorporate visual feedback into the design — a warm halo of pulsing light wrapping around the top of the machine to reassure parents that the ventilator is doing its important job. We went in looking at ease of use and came out with an opportunity to make a small change that eases the stress of parents in an unimaginably scary situation.
No, Thank You!
As designers, most of us are interested in the latest gadgets. We stand in line for the latest iPhone, tested out smart watches and sensors, and we hang out with people who do the same. Research helps us get out of our bubble and see the logistical and emotional resistance many people still have toward technology. When we went into the field to explore how patients might interact with a neuromodulation system in their homes and everyday lives, we had planned on introducing a high-tech remote control with a screen and display to adjust the implant’s settings. Patients’ response was a resounding no, thank you. “I don’t want to carry another device with me,” someone told us flat out. We began to understand how our target users saw the device. It was not something to show off; it carried a stigma — it was an outward sign of the incontinence they were being treated for. Instead, we re-imagined the remote control device as a simple key fob that blends more seamlessly with people’s lives and lets patients make adjustments more discreetly without calling attention to an embarrassing condition.
Life as a product designer should be full of surprises, even for clients who have been in their business for years and years and think they know all there is to know. That’s why we do research — why we leave the comfort zone of our knowledge and understanding, and leave our egos at our desks as we take a fresh look at the people and places we’re designing for. We want to find the truth, the uncomfortable reality.
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