SELVI OLGAC

The Sandbox - Patient prediction in the OR

Envisioning anesthesia in 2032

HUMAN-MACHINE INTERACTION


 

Details

University: Umeå Institute of Design

Duration: 10 weeks, fall 2017

Team: Minh-Huy Dang, Selvi Olgac & Toby Whelan

Collaboration partner: Maquet, Getinge Group

 
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Introduction

Anesthesia nurses play a vital role in the sensitive operation theatre environment. However, many of them are not familiar with the anesthesia machines full potential because of the complexity of these machines. In addition, the anesthesia nurses have limited opportunities to explore the full potential of the machines as they always are connected to the patient and no mistakes can be made that might harm the patient during surgery. This project explores the possibility for the nurses to experiment and deepen their knowledge concerning the anesthesia machines during the surgery autopilot phase, usually a more calm phase, without jeopardizing the patient.

Concept

Our product, the Sandbox, is a patient prediction device to be used in the operation theatre. With Sandbox, an interface proposal, anesthesia nurses can simulate drug adjustments, during the surgery autopilot phase, and predict individual responses of the patient before executing the alternative final changes onto the patient

 
 
 

THE DESIGN QUESTION

How might we create a learning environment for exploration during autopilot phase, without losing the focus on the patient?

 
 

A safe learning environment

The Sandbox allows the nurse to explore different alternative parameters of the anesthesia drugs and their effects on the patient before executing changes. When the nurse adjusts the parameters, the patient’s values will be displayed as they are getting affected. In this way the nurse can have a safe learning environment to explore and fail in the system, without harming the patient. This allows the anesthesia nurse to use the autopilot phase more efficiently, by for example preparing the landing phase in advance.

The collaborative partnership

The Sandbox concept is based on the collaborative partnership between the nurse and the machine; each party learns from the other. As the machines are getting more automatized, the nurses are running the risk of losing their manual skills. For example, today an anesthesia nurse can check out breathing rate with only their fingers, a tacit knowledge important to keep and include in the future. Furthermore, the new data achieved through the Sandbox could be united in a national and global cooperative network system for further research.

 

FLOWCHART

 
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The different modes in the Sandbox

1. Sleep
Sleep mode is indicated by a lone ring on a black screen. This feedback signifies that the Sandbox is on and ready for use. As the nurse picks up the Sandbox and touches the screen, it will change into the next mode.

2. Adjustments
When adjusting parameters, simulated patient readings appear individually as they are affected, when tapping any of the 7 readings to highlight them in the central area. Once highlighted, more information is displayed.

3. Executing changes
When executing changes 4 fingers are placed at touch points on the outer edge of the Sandbox and holding on for 3 seconds, to avoid accidental changes to the selected values. The product provides the nurse with feedback through haptics and a green completing ring. 

 

4. Feedback to the system
In the final stage the nurse submits the observations of the patient's physical responses to the changes executed. In this stage the tacit knowledge of the nurse and the knowledge from the machine are united into the cooperative network system.

 

 

The design process


 
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Hospital visits

3 different hospitals were visited during our research phase to explore how anesthesia nurses worked and how the facilities differed between the hospitals.

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Attending surgeries

6 surgeries were attended by our team. Here we had the possibility to observe the nurses workflow and how the anesthesia machines were used in practice. 

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Interviews with anesthesia nurses

During our visits we had the opportunity to interview 9 anesthesia nurses in the different hospitals. We used ethnographic methodologies to learn about how they experienced their role as a nurse and how their tasks could be improved.

 
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Analyzing screen information

During one of our hospital visits we analyzed the screen of the anesthesia machine together with one anesthesia nurses. We focused on what information that was most important for the nurses in their daily work.

The nurses' workflow

When visiting the hospitals we studied how the nurses work flow looked like, both before, during and after a surgery. Most of their work takes place before surgery. This work includes preparation of medical drugs and learning more about the patient through their journal.

Learning about machine settings

As the anesthesia machines are very complex and have a lot of different modes, we explored the machines' settings and the navigation of the system to learn more about the possibilities and the technical parts.

 

"Everyone has different lungs, breathing and settings"

Anesthesia nurse

 

Mapping out findings

With our knowledge from research, interviews and hospital visits we structured and grouped our findings in order to search for patterns, problem areas and possibilities to get a starting point from where we could improve our design.

 
 
 

Research workshop

After collecting information and mapping out our findings, a workshop were organized together with our collaboration partner, colleagues and teachers. Based on our research findings we arranged different activities for them all to participate in. This gave us new thoughts on how to develop our material further.

 
 

Design opportunities

 
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No scope for exploration

Currently the nurses do not know the full capacity of the anesthesia machines because of their complexity. There is also limited time for further exploration of and learning more about the machine during surgery.

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Double checking screen and patient

The nurses need to double check their readings against two sources, the patient and values and numbers from the master screen. 

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Less active during the autopilot phase

The autopilot phase is usually the less active part of a anesthesia nurses during surgery. Most of their work is carried out during the take off and landing phases.

 
 

IDEATION

Design sprints and concept development

 
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Short sprints were made through quick drawings based on different keywords. Some of the sprints were made individually together with brainstorming on a whiteboard by the whole team to facilitate building on each others ideas. Further we used various methods to develop and test both concepts and interactions.

 
 

Creating scenarios

With paper puppets and a cardboard box we created different scenarios of a surgery with a nurse. Our aim was to do a first tryout of our ideas as well as discovering new possibilities. 

Role-play with nurses

In workshops with nurses we used role play as a method to test some of our first concept thoughts. The purpose of the workshops were to brainstorm possible scenarios of how the operation theatre in the future might look like, also to discover how the nurses interacted and used our prototypes in different situations.

Developing interactions through prototypes

Another step in the process were to test different interactions by using lo-fi prototypes. In this way we were able to communicate our ideas and also see how our concepts affected the nurses' workflow.

 
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Physical & digital prototyping

To visualize our ideas of the final concept we created simple prototype variations with cardboard and paper, to facilitate testing different interactions, sizes and colors.

 
 
 
 
 

The tactile feeling of precision

During our research process we understood the crucial role of the knob of the current anesthesia machines, from which navigations, settings and confirmations are made. With this knowledge as a starting point we saw the potential in translating the expression of the knob into our final concept. In addition we were inspired by a camera lens for its tactile feedback of precision.

 
 

Transforming information to our interface

When deciding what information to include in our interface we used the analyzed screen from our research material. We contacted the nurses for further developing which patient values to include in the product and how to organize these values hierarchically. 

Testing interactions

We tested different interactions with focus on the tactile feeling of precision. It was important for us to make the product easy to navigate between the different values and parameters, as well as holding it in your hand simultaneously. 

 
 

FINALIZE CONCEPT

User testing interface & form

We tested different sizes and interfaces of the product with both nurses and students at our school. Some of the results indicated that color differences between the values made it easier to read the interface. In addition the users mentioned the importance to understand the disposition of the values and how to read the span of the target values, current values and how the values were affected while adjusting the parameters.

 
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The existing master screen

The existing master screen

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Visual identity of the interface

To create a clear connection between the readings on the existing master screen, we transferred the visual identity into our interface, with the intention to ensure a comparison between the simulated and live patient data. The patient’s values are organized hierarchically, based on feedback from the anesthesia nurses on how they rank the importance of each reading. The sleep and pain levels are values that can be read through brain waves, a parameter that could be connected to the anesthesia machine in a future scenario.

 
 
 

MY ROLE AND LEARNINGS

In this project I was an active participant during the whole process, from research to execution, including field work, workshops, ideating, prototyping and the final model. 

Entering a for me completely new area as an operation theatre and understanding the complexity of the anesthesia machines, and the nurse profession as well, was very instructive for me. Other learning outcomes that I want to emphasize are the usage of design ethnography including professional-user observations, and insights in physical and cognitive ergonomics.

 
 
 
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Co-work

Improving the waiting period for refugees during their asylum process

SERVICE DESIGN


 

Details

University: Oslo and Akershus University College of Applied Sciences

Duration: 16 weeks, spring 2016

Team: Ingvild H. Kalsnes, Selvi Olgac & Robin Vinje

 

Introduction

In 2015/2016 a large number of refugees arrived in Norway. This caused long waiting periods and stress among the refugee seekers due to the delayed asylum process from the Norwegian migration authorities. The refugees were often placed in isolated asylum centers outside the cities with limited opportunities to contact with the Norwegian population. The lack of social platforms and activities caused high levels of stress, passivity and even mental illnesses among many of the asylum seekers. In addition regular work permits are not allowed during the asylum seeking process. This project focused on improving the waiting period by engaging the refugees in integrating into the Norwegian society. 

Concept

CO-work is an application service that allows asylum seekers to apply for voluntary jobs or internships while waiting to complete their asylum process. The service offers an opportunity for the refugees to expose their competences and qualifications as well as providing a possibility for companies to contact them. CO-work offers refugees the opportunity to have a more meaningful life while gaining work experience and knowledge about Norwegian language, culture and society. As many of the asylum seekers are highly educated and experienced this can also be a valuable resource for the companies involved.

 
 
 

THE DESIGN QUESTION

How might we help the refugees to feel more useful and valuable during their stay at asylum centers?

 
 
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How the system and the service work

A refugee creates his or her personal profile including education, previous work experience, language skills or interests. After entering this information the service expose jobs relevant for the competences of the refugee. The companies enter their profile with descriptions of voluntary jobs available and are exposed to employees available. Both refugees and a company can then contact each other for further information and a possible cooperation. 

 
 
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The design process


 
 

GOING INTO DEPTH

Ethnographic field research

During our research process we visited different asylum centers and had informal conversations and open interviews, as well as workshops with refugees. We also observed the physical localities of the centers including dormitories, dining rooms and the surroundings. Considering the vulnerability of the refugees, we payed much attention to respect the integrity of each individual that we contacted.

 
 
 
 

6

Different asylum centres.

2-8

Hours were spent at each visit.

50-500

Residents at each centre.

 
 
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Field note templates

Templates were developed in advanced by the team for the field notes and the questions to ask refugees and professionals during our visits to asylum centers.

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Participatory observations

Several participatory observations were made in the centers with the intention to profound our understanding of the situation of the refugees.

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Communicating through workshops

Different workshops were used as an easy-going tool for communication with the intention that nobody would feel any pressure to perform.

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Interviews with refugees

Interviews with refugees from Afghanistan, Syria and Iraq, as well as with professionals working with refugees were carried out.

 
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Exploring the surroundings

Together with the refugees we explored the surroundings around the asylum centers that were usually situated in isolated forest areas.  

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Informal activities

Some of the activities during our visits consisted of playing games and doing leisure activities with some of the refugees trying to reach a more reciprocal relation between us all. Sometimes language barriers occurred, which made communication through body language and gestures important for our mutual understanding.

 

"We don't have anything to wake up for."

A refugee

 
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Workshop together with the refugees

Using mapping as a method and communication tool, we asked the refugees to write down their thoughts on certain themes related to their situation, themes that we had gradually identified during previous visits.

Analyzing material

While analyzing the material from the workshops we were able to discover some of the thoughts, experiences and feelings of the participants on their situation in an asylum center. 

 

Problem identification

 
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High level of passivity

We found a high level of passivity among the asylum seekers, due to a lack of activities and stimulation in the centers. In the long run the asylum system is thus running the risk of producing social welfare cases.

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A desire to contribute to society

A majority of the refugees expressed a strong desire to contribute to the society and a wish for meaningful activities.

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Freedom and independence

While staying in the asylum centers with their restricted way of life, many refugees expressed a need for more freedom and independence in their lives.

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Stigmatization of the refugees

Some of the refugees mentioned the feeling of being stigmatized as an asylum seeker in the society.

 
 

DEVELOPING THE PLATFORM

The smartphone as a bridge

As a result of this lack of activities, the refugees spent a lot of their time awake on their smartphones talking to friends and family back in their home country, playing games or learning Norwegian. Because of this the smartphone seemed to be their most valuable object for many and an important tool for communication with the world outside the asylum center. Our team therefore decided to develop an application service to open the possibility for more activities through voluntary jobs.

 
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Structuring the content

By using post-its it was possible for our team to discover what features to include in the service, but also to understand how to structure the content and navigation.

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Sketching wire-frames

Sketching wire-frames provided a good overview over how to create the navigation through the service to facilitate its use for both refugees and companies.

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Creating preliminary user flow

 
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User testing with refugees and experts

To improve our first user flow we carried out user testing with some of the refugees and experts. Two main aspects that were addressed by the users were to include a map to facilitate finding the potential company and make it easier to return to the "start page".

 
 
 

MY ROLE AND LEARNINGS

In this project I participated actively in the whole process, from research to execution, including field work, facilitating workshops, ideation, logotype, analysis and report writing.  

From this project I got a deeper understanding of the process of taking a current problem in society as a point of departure as a designer, and participating in the process of developing a product. Another learning outcome was an increased awareness of how transcultural communication can take place through a service, further more the importance as a designer to reflect upon cultural diversity and to search for an intercultural approach.

 
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THE WEIGHT SCALE

CONCEPTUAL DESIGN

 

 

INTRODUCTION

Today we use a weight scale to read our weight in numbers. But how much information does those numbers give us and how do we know if they are positive or not? To make sense of all those numbers, we need to know how to translate them into more detailed information. During this short workshop we wanted to explore what would happen if you could feel your weight and how to relate this information to your health situation. And what if you could be strong for just a moment, and use that moment as your motivation?

 

SOLUTION

The idea of this concept is to offer the possibility for an individual to enter a zone where you can experience how your body would feel if you were healthy and in good shape. As soon as you step out of the zone you will return to your original situation, but now with the possibility to feel how it would be in a more healthy stage. For each time you enter the weight zone, you would be able to feel if you are progressing. 

DETAILS

University: Umeå Institute of Design

Duration: 24 hours, fall 2017

Team: Ivan Kunjasic, Selvi Olgac & Carolyn Wegner

 
 
 

What if you could translate your weight into a feeling?

 
 
 

PROCESS


 
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Brainstorming & storyboards

To explore different ways of how to weigh yourself, we did brainstorming on cardboards were we used sketches and keywords to communicate our ideas. Afterwords we created scenarios of how these ideas would work for the user and how to improve the experiences. When we picked our final concept, we drew out a storyboard and planned how to film the experience. 

 
 
 

My role

I was involved in the whole process, from brainstorming to execution, during this short project.

 

Learning outcome

It was very instructive to be able to work on a conceptual level with focus on the experience and producing a result within such a short time span.

 
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Contact

University: Oslo and Akershus University Collage of Applied Sience

Duration: 8 weeks, fall 2015

Team: Shahad Hassan, Selvi Olgac & Robin Vinje

Learning outcome: To design a product that will facilitate the users everyday challenges. The main focus was on the relationship between the user and the function of the product.

A plate made of porcelain covered with silicion at the back to provide a protection against heat for the user. The ribbed back of the plate contributes to a better grip. In addition the back has two inward outcuts to fur ther facilitate the balance of the plate for the user. Especially useful for waiters/waitresses as well as persons with limited grip ability.

 

 
 

PROCESS

 

Problem identification

 
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1. Heat

Warm plates with warm food cause a lot of burns.

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3. Stress

Carrying just a few plates each time demands more work to be able to work effectively.

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2. Balance

The plates are hard to control, both weight and stability.

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4. Grip

Carrying multiple plates simultaneously is complicated.

 
 
 

User testing

As we created different prototypes we wanted to test them together with our users. To be able to play with the shape of the plate we did our prototypes in foam. 

 
 
 
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Improving daily asthma management

SOUND DESIGN


 

Details

University: Umeå Institute of Design

Duration: 10 days, spring 2018

Team: Gabriel Uggla & Birnur Sahin

Awards: iF Design Talent Award 2018 - Best of the Year, BraunPrize 2018 - Student Silver Award

Introduction

For many asthmatics the daily routines of asthma management can be a complex process entailing monitoring the condition, logging results and inhaling the medicine in the right way. This project of short duration was an interdisciplinary collaboration between product and interaction designers. The goal of the project was to design a product or service with a strong focus on sound design, in our case related to asthma management.

Concept

Our solution (Otto) merges monitoring, logging and medication into one product experience with the aim of facilitating the daily life of an asthmatic. The product helps the user to track their personal breathing curve and to adjust the dosage depending on the current situation. By using sound and light feedback, Otto is guiding the user through the whole process.

 
 
 

THE DESIGN QUESTION

How might we improve asthmatics' daily routines by facilitating the medicine inhalation process?

 
 
 
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This is Otto

Otto works by exhaling through the mouthpiece to take a peak flow measurement. The medicine dosage is adjusted automatically based on the measurement and is then inhaled through the same mouthpiece in spray-form. The lights work as silent indicators of progress, while the sounds function as confirmation and attention-grabbers; in tandem they unite the process feedback. The measurements are logged automatically and sent to the patient’s digital journal when Otto is charging, allowing experts to get a deeper understanding of the conditions of each individual.

 
 

Interaction flow (00:32)

 

User flow

 
 
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Shake

Shake Otto to activate it and in order to mix the medicine.

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Exhale

Exhale through the mouthpiece to take a peak flow measurement. The dose of medicine is adjusted based on the result.

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Inhale

Inhale the dose. Lights indicate time for inhalation and holding breath. A confirmation sound informs you when the process is terminated.

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Log & charge

Measurement data is logged into the back-end of the product and sent into the personal digital medical journal when Otto is charged.

 
 
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1. Activate Otto
An alert wake up sound confirms that Otto is ready to use after shaking.

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3. Inhalation completed
A chord sound confirms the process completed. 

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2. Peak flow reached after exhalation
An increasing confirmation sound indicates when the peak flow meter test is completed.

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4. Connected to charger
Two tones sound when charging has started.

 
 
 

Medicine delivery
By utilizing a new type of medicine delivery that is activated by inhalation (rather than pressing a button), we removed the step of having to time the spray-release with inhalation, a step still necessary in the asthma medicine management of today.

 
 

Two membranes
Using two membranes directed in opposite directions we could use the same mouthpiece for both measuring exhalation values, as well as inhaling the asthma medicine.

 
 

Sustainability
Otto can be re-useable as the mouthpiece can be separated and cleaned, and in addition the medicine canister can be changed when opening the lower part.

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No buttons. No app. No screen. Just breathe.

 
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The design process


 
 

LEARNING ABOUT ASTHMA

Current asthma treatment process

Asthma is a chronic inflammatory disease in the airways of the lungs and is triggered by multiple factors; allergies, pollution, sickness, exercise or even the weather. The unpredictable nature of these triggers makes it hard to predict when and where an asthma attack may occur. 235 million people have asthma worldwide and 250,000 people die annually from the disease. When starting this project, we researched how and where people are using their asthma inhaler and how the asthma treatment process currently works.

 
 
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MONITORING - Peak flow meter

Asthma medication is monitored and usually adjusted twice a year by a doctor by measuring the condition with a peak flow meter. It is a hand-held analog device which measures a person’s lung capacity. 

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LOG - Peak flow diary

Patients with serious asthma problems have their own peak flow meter and regularly write down their results in a paper diary. The diary is brought to the doctor who evaluates the condition based on the results and changes the dose if necessary.

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MEDICATE - Inhaler

Through a spray or powder form asthma medication is inhaled through an inhaler. There’s one for emergencies and one for daily use.

 
 

Interviews with asthmatics & expert

To get a deeper understanding of the experiences of living with asthma, we did interviews with people suffering from the condition. We learned more about the usage and function of different inhalers, what the interviewees find as the biggest challenges in their daily routines and how asthma affects their emotional and physical well-being.

 
 

“It is difficult to know for how long you must inhale and for how long you need to hold your breath. You don’t know if you’re doing it right.”

Asthmatic

 
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To be able to understand the challenges and wishes from an expert’s point of view, we visited the local health care centre. Together with the expert we tried out and discussed the existing products and learnt more about what makes a product functional or not.

 
 

Design opportunities

 
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Infrequent medication adjustments

Today the user must visit a doctor to adjust their medication approximately twice a year. Then an optimal adjustment frequency of the medication for the daily inhalation is regulated. 

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Difficult inhalation process

We learned that 70-90% are using their asthma inhaler in the wrong way; shaking the inhaler, timing spray with inhalation, and making sure the medicine stays in your lungs are all crucial, but often done incorrectly. Over- and under-medication – which can make the health condition worse – is common due to the fixed medicine dosage and the uncertainty if you inhaled correctly.

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Lack of feedback

How much medicine do I need today? Did I inhale correctly? Is my condition improving? These are important user requests that are currently not met.

 

CONCEPT DEVELOPMENT

Creating the product & the experience

Understand the user

To get a closer understanding of living with asthma, we experimented using trying to breathe through a straw, experiencing the sensation of panic having restricted access to air.

Looking into existing products

We looked into existing products on the market today to be able to analyze details and functions of both the peak flow meter and the inhalers.

Ideation phase

With our knowledge from the research process and interviews we started to brainstorm and map out our findings, looking for crucial aspects to include in our device. 

 
Sketching and form exploration

Sketching and form exploration

 

Structuring the user flow

To create a holistic picture of the user flow, a flow chart was structured with the aim to understand each step in the guiding process. The intention was to provide a seamless transfer in between each step for the user.

Creating the sounds

We produced our own sounds with a synthesizer to match the form expression of the product. Our wish was to create sounds that felt precise and uplifting, yet subtle. All sounds were supposed to stay within a coherent sound family and reinforce the identity of the product.

Feedback with lights

To test how the lights work together with the sounds,  different versions of light feedback were animated. Both sounds and lights were merged into the animations to provide increased understanding of the development of the final product.

 
 
 

MY ROLE AND LEARNINGS

I was involved in the whole process of this project, from research to execution, with a main focus on the interactions including lights and sounds and how they work together as feedback for the user. I also edited all the sounds. 

Working with two colleagues from the Advanced Product Design program, I witnessed how our different expertise complemented each other in a fruitful way. Another important learning outcome for me was how sound can influence our experiences of a product and how to combine form, sound and light into a whole experience for the user. 

 
 
 
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