Applied Theory in Design: Orthopedic Braces and Supports

ORTHOPEDIC BRACES AND SUPPORTS POORVI DAS APPLIED THEORY IN DESIGN - SDES 704 PROF. MARIAH HAY SCAD, SUMMER 2014

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

CONTENTS 5

BIO

7

SYNOPSIS

11 PROJECT A: ANALYSIS Part 1 - Secondary Research

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Part 2 - Primary Research

33

Part 3 - Visual Audit

58

Part 4 - Personas

85

96 PROJECT B: SYNTHESIS 110 PROJECT C: EXPLORATION Part 1 - Reframing

110

Part 2 - Artifactual Model

119

131 PROJECT D: REALIZATION Part 1 - Enterprise Model

131

Part 2 - Realization Proposal

137

153 CONCLUSION 154 REFERENCES 155 ACKNOWLEDGEMENTS 155 APPENDIX

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

BIO Poorvi Das is a Fashion and Textile Designer. Her work experience includes garment design, textile applications for interior space, home furnishings for exports and design for the development and sustainability of Crafts. She is also a member of the FiberArts Guild of Pittsburgh, with her fiber work being exhibited in juried shows around Pittsburgh.

After finishing her Under Graduate Diploma in Fashion Design from the National Institute of Fashion Technology (NIFT) in India, she went on to specialize in Textile Design at the National Institute of Design (NID), ranked as one of the top design schools in the world by Business Week.

At NID, she sensed the importance of inter-disciplinary design and the need for designers to understand the business and management side of the process so as to come full circle and provide a better solution. This motivated her to apply to SCAD, where she is currently pursuing her MA in Design Management.

Her Portfolio can be viewed at www.coroflot.com/poorvidas.

You can contact her at poorvidas@gmail.com

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

SYNOPSIS As per the course syllabus and guidelines, the aim of the project was to “develop a plan for a new product that will change the way people think about a commodity product they care little about it.�

The research and development process followed a path of investigation, iteration and ultimately transformation into a final concept. The final solution was required to appeal and engage a new type of consumer through integrated design of the product, brand, market communications and extended retail experience.The project was about honing design skills by looking at problem solving holistically.

I selected Braces and Supports as my commodity product for the project.

Following a process of research, and insights gained from it, I narrowed my focus to braces and supports that are sold Over the Shelf in Pharmacies. A main reason for me to consider this direction was the growing trend of people towards self-care and talking responsibility of their foot conditions.

The project went through a journey of many steps which Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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resulted in the solution. After selecting the commodity product the process began with Analysis, a phase of intensive Secondary and Primary Research. It also included aVisual Audit of advertisements, point-of-sale materials and video stills of key brands to better understand the marketing messages. The analysis phase culminated in the creation of three Personas.

Next, in the Synthesis phase, all the information gathered in the Analysis was put up on a working wall, which helped connect the dots, pinpoint the gaps and have a sense of the direction further. It led to defining a wicked problem that needs a design solution.

In the Reframing phase, the wicked problem or mystery question was further refined and a set of nested value propositions were formulated. The wicked problem was then reframed by looking at different approaches towards a solution.

In the Artifactual Model of the Exploration Phase, the final solution to the wicked problem got better defined.

The Enterprise Model in the Realization Phase suggested how the design would be implemented in an organization, with the collaboration of different departments and expertise, that would come together to make it function and generate business. Based on gaps I evaluated during the Analysis and 8

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Synthesis phases of the project, my final solution aims to to guide and inform a consumer about their foot condition and the selection of an appropriate product. Additionally, it provides relevant tips on self care remedies and community support. The new design also supports recycling by publicizing the efforts of organizations that recycle braces and incorporating collection mechanisms towards this cause.

Interactive touchscreen kiosks, a website and smart device application are the primary ways in which this information is available to the consumer. They improve the way the new consumer accesses foot healthcare, by providing key benefits like ease of accessibility, convenience, speed and readily available advice for all.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

PROJECT A: ANALYSIS PART 1 - Secondary Research

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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INTRODUCTION Foot braces and supports are external orthopedic devices used in the reconstruction and rehabilitation of the lower extremities (ankle and foot). They provide immobilization, compression, protection, pain relief, support and functionality for patients following musculoskeletal injuries, disease and surgery1 . These devices are available for minor strains and twists along with heavy duty braces for post operative recuperation.

Foot braces and supports are commonly used by: people who have twisted, injured, sprained or ruptured their lower limb or ligament; patients who are recovering from an operation and need support to heal; sports athletes undergoing treatment and/or prevention of sports and exercise related injuries as well as enhanced performance; People suffering from dropped arches, tendonitis, plantar fasciitis and heel pain; People suffering from corns, calluses and foot ulcerations; 12

1 The U.S. Medical Device Outlook 2007 NiA5-54 by Frost & Sullivan

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Recurrent ankle sprains, stress fractures of foot and leg bones; Diabetes; Some hip and lower back pains which are caused due to excessive walking and standing Foot pain affects approximately one quarter of the population at any given time, is disabling in nearly half of these cases and can impair mood, behavior, risk of falls, self-care ability and quality of life.2 Depending upon the medical problem that needs to be addressed, braces and supports cover a variety of devices, which include: 1. Ankle Supports example: Elastic Ankle Support by Procare Picture Source: djoglobal.com

2. Arch Supports example: Arch Rival by Donjoy Picture source: djglobal.com 2

Custom foot orthoses for the treatment of foot pain; a systematic review;

F Hawke, J Burns, J Rsford & V du Toit; J Foot Ankle Res. 2008 (Suppl 1): O46 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562128/)

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3. Foot Straps example: Flexible splint/strap for Bunion Relief Picture source: djoglobal.com

4. Night Splints example: Exoform Dorsal Night Splint by Ossur Pic source: ossur.com

5. Edema Garments & Support Socks example: VenaFlow AES Socks and Stockings by DVT Picture source: djoglobal.com

6. Heel Protection example: Heel wedges by Aircast Picture source: djoglobal.com

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

7. Post Operative Shoes example: Squared Toe Post-Op shoe by Procare Picture Source: djoglobal.com

8. Post Operative Walkers example: Rebound diabetic walker by Ossur Picture source: ossur.com

Braces are sold both with and without prescription depending upon the complexity of the foot problem. All operative braces and complex supportive solutions are prescription products, while non-operative braces are non-prescription items and available over the counter.

Pre-fabricated braces and supports are mass produced and easily available in pharmacies, sports shops and supermarkets over the counter or by prescription and are not as expensive as custom-made orthoses.

Custom-fabricated orthoses are created for an individual, specially prescribed by a health care provider to address a specific condition. Custom-fabricated braces are further divided into ‘customized’ (where a mass produced brace adapts to one persons body shape with and ‘custom-made’ Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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(where the brace is made specially for a person using a cast of the foot for its unique shape). These are comparatively more expensive than pre-fabricated orthoses due to materials used in their manufacturing and the process cost of customization.

Manufacture and Materials: Depending upon the function they serve, braces and supports are made from carbon fibre, elastic, thermoplastic, emulsified silicon rubber, metals, fiber or a combination of similar materials.

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

UNDERSTANDING THE MARKET SEGMENTATION The foot and ankle devices market include all those devices which are used in ligament repair and reconstruction procedures including arthrodesis, joint replacement and internal fixation. The global foot and ankle devices market is analyzed by categorizing orthopedic implants and surgical devices, prosthetics and bracing and supports market.1 Bracing and support devices market is segmented into two types as soft bracing and hinged bracing. They are advised based on the type of injury such as minor strain or twist. Moreover, braces are also available for postoperative recuperation.2 The Orthopedic Devices is a part of the Medical Device segment and includes joint reconstruction & replacement, spinal surgery and rehabilitation, trauma or fixation, arthroscopy, orthopedic softgoods, braces & supports, Fig: Categorization of Braces and Supports in the Medical Devices segment

1

Nilesh K, Research Moz (https://www.linkedin.com/today/post/

article/20140709055802-170321852-foot-and-ankle-devices-market-size-2014and-forecast-2020) 2

Nilesh K, Research Moz (https://www.linkedin.com/today/post/

article/20140709055802-170321852-foot-and-ankle-devices-market-size-2014and-forecast-2020)

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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orthobiologicals, biomatetrials and growth factors.3 Some of the other sub-categories of the medical device segment include cardiovascular devices, hearing and audiology devices, endoscopy equipment, surgical, opthalmic equipment, wound care and management, etc The United States remains the leader for medical devices, accounting for about one-third of the worldwide market.

According to a report from EvaluatePharma, “the global medical device market is estimated to reach $440 billion by 2018, growing at about 4.4% per year”.4 Fig: Total Medical Device Market: Market Segmentation (U.S.), 2006 Source: Frost & Sullivan

The medical device industry is a vital and dynamic part of the U.S. economy. Its success and growth is dependent on good research and development practices so as to continuously evolve and use current technology towards innovative and well designed products which meet their functions successfully.

The industry is a mix of large and mid-sized companies with smaller start-ups testing local markets. The Industry is also dependent on the reimbursement policies as these determine the viability of a product in the market.

The orthopedics industry is highly competitive and characterized by continuous innovation and rapid technical 3

Ossur Annual Report 2005 (http://assets.ossur.com/library/6295/

Annual%20Report) 4

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Article titled ‘Analysts: Device market growth will outpace pharma by 2018’

by Damian Garde on fiercemedicaldevices.com

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

development. Competition is primarily focused on aspects, such as the range of service, education of professionals, product design and effectiveness, accessibility, and feasibility of the technology used.5 As per the U.S. Medical Device Outlook 2007, by Frost & Sullivan, the revenue was forecasted to grow from $64.44 billion in 2004 to $ 138.0 billion in.

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Ossur Annual Report 2005 (http://assets.ossur.com/library/6295/

Annual%20Report)

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Applied Theory in Design - SDES 704

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SCAD, Summer 2014

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MAIN FINDINGS ABOUT THE PRODUCT The procurement process is generally quite complex in the medical industry. The selection of medical devices depends on the healthcare system in each country. Normally the endusers do not make final decisions on what to buy, but rather certified specialists. Another differentiating factor of the medical industry is that usually the end-user does not pay for the product but a third party. This third party is normally an insurance company or a government healthcare program.1 Bracing and support products are both sold by prescription and without prescription. All operative bracing and support products are prescription products, as are more complex supportive solutions. However, a wide array of non-operative products consists of non-prescription items, which, in many cases, are distributed and sold directly through pharmacies.

Ossur’s and the newly acquired Royce Medical’s and IMP’s product offering only covers bracing and support products in the non-invasive segment of the orthopedics market.2 Given the nature of orthopedic products, the main customer 1

Ossur Annual Report 2005 (http://assets.ossur.com/library/6295/

Annual%20Report) 2

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Ossur Annual Report 2005 (http://assets.ossur.com/library/6295/

Annual%20Report)

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

groups are orthotic and prosthetic workshops, doctors, physical therapists, hospitals, podiatrists and pharmacies. The increasing complexity of orthopedic products and the stringent requirements of the regulatory environment, together with a more sophisticated industry in general, make it imperative for the manufacturer and developer of orthopedic products to communicate directly with all these practitioners.3

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Ossur Annual Report 2005 (http://assets.ossur.com/library/6295/Annual%20Report)

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SCAD, Summer 2014

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LIST OF MAJOR FACTORS, TRENDS & DRIVERS Market trends The fast-growing nature of orthopedic extremity device markets has created an atmosphere ripe for merger and acquisition activity as orthopedic companies continue to look for high-growth markets to penetrate.1 As orthopedic manufacturers struggle to maintain their share in large-joint markets, the search for growth has led to an increase in merger and acquisition activity in the extremity segment as well as in orthopedics generally. The most prominent recent event in this space was Johnson & Johnson’s acquisition of Synthesis, which closed earlier in June. “J&J’s purchase of Synthes will, with DePuy, create the undisputed leader in what is an otherwise fragmented and competitive market,” said MRG Analyst Mashkur Reza.

“Despite the sale of DePuy’s trauma unit to Biomet, the combined company will attain market leadership in the orthopedic extremity markets. But this market has a number of other strong competitors, including Arthrex, Tornier and Smith & Nephew, all of which are capable of responding with their 1

Millennium Research Group: US Markets for Orthopedic Extremity Devices

2012 (http://mrg.net)

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

own acquisitions, R&D investments and marketing strategy changes.”2

Demographics Various social changes are now occurring that influence the demand for orthopedic products. These changes include a different age composition in Western societies, increased social demands, rapid technological development, and an increase in diabetes and other vascular dis- eases. Each of these factors plays a part in the increase in demand for products, as well as the increasing demand for the greater mobility of the individual and quality of life.

• The “baby boomer” generation (people born between 1946-1964) is becoming a greater part of the user demographics. Majority of these users today is better informed and interested in managing their own health care.

They are increasingly looking for independence, comfort and functionality in the products they are offered.

• US authorities have noticed a rapid rise in the incidence of diabetes over the years. Newly diagnosed incidents of diabetes in the US increased by 41% between 1997 and 2

Millenium Research Groupt (MRG) - (http://mrg.net/News-and-Events/

Press-Releases/Orthopedic-Extremity-Device-Market-062812.aspx#sthash. hhalXQ01.dpuf)

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SCAD, Summer 2014

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2003. The increase can be partly explained by changes in diagnostics, but the American Diabetes Association says that the real change is due to an increase in obesity in the US. In 2003 9 out of 10 people diagnosed with diabetes were overweight. Older people and those with obesity issues are more prone to diabetes than other groups. The need for orthopedics products and services will grow with this increasing segment of the population.

(Image Source: www.stairliftsstair-lifts.com)

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• The percentage of the population older than 65 is rising in all OECD countries and is expected to continue doing so. In the United States alone the proportion of people 65 or older is expected to rise from about 35% in 2005 to about 55% in 2020. These increases in the proportion of the population aged 65 and above will underpin market growth as an aging society brings an increasing volume of fractures and joint instability, vascular diseases and diabetes, driving the demand for different forms of orthopedic solutions. • Lifestyle issues, such as increased participation of the general public in sports, driven by a more health-conscious population and awareness of the potential advantages of regular exercise, are further industry drivers. As the market for sports grows, the demand for different types of support products should continue to grow, due to the increased number of sports-related injuries and an increased demand for prevention products.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

*“The number of Americans at risk for osteoporosis is estimated to grow to about 60 million by 2020, leading to a corresponding growth in the use of assistive devices such as orthopedic braces and supports.� Medical Devices Group, Frost & Sullivan

Market Drivers The main drivers for the foot & ankle devices market are the rise in sports injuries, which commonly involve serious ankle injuries, increasing incidences of road accidents, and rise in rate of diabetes, which leads to the deterioration of foot & ankle area caused by large sores and infections. The foot & ankle extremity market will grow substantially in the coming decade with advances in technology.3 Market Drivers Ranked in Order of Impact (U.S.)4 1. Aging and active baby boomer population drives demand for orthopedic braces.

2. Sedentary and obese population contribute to greater incidence of osteoarthritis and higher market revenues.

(Image Source: www.usatoday30.usa.com)

3

Global Foot & Ankle Devices Market Trends & Competitive Analysis to 2017

(http://new.pitchengine.com) 4

2007 Frost & Sullivan U.S. Medical Devices Market Outlook (www.frost.

com)

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Applied Theory in Design - SDES 704

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SCAD, Summer 2014

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3. Growth in the number of sports medicine specialists increases prescriber base for orthopedic braces and softgoods.

4. Increasingly active population prone to the risk of bone injury ensures growth of orthopedic brace market.

5. Stock and bill programs allow manufacturers to bill insurers directly and achieve higher profit margins and prices for products sold.

6. Increased interest in non-pharmacological treatments, such as braces and supports, for Musculoskeletal pain and dysfunction following backlash against NSAIDs. 7. Manufacturers’ promotion of braces and supports for prophylactic and performance-enhancing benefits boosts market revenues.

8. New product innovations drive revenue growth through higher prices and market expansion.

9. E-commerce and on-line sales boost orthopedic brace and support market.

10. Increased incidence of diabetes in the united states contributes to strong growth in walkers, foot andankle braces, and softgoods.

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11. Growth in retail market for products formerly considered strictly clinical items.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

12. Increased use of higher-priced neoprene softgoods leads to higher prices for softgoods and increased market revenues.

13. Stronger sales and marketing efforts aimed at primary care providers in order to push more products through these physicians or through their referred specialists.

14. Heightened concerns over infectious agents reduce reuse and multiple-use of softgoods, boosting sales.

15. More collegiate athletic departments billing insurers directly for orthopedic braces and supports instead of absorbing costs opens market to more advanced products.

(Image Source: www.ehow.com)

16. Increased marketing by manufacturers has raised awareness of available treatments, further fueling procedure growth.5

Market Restraints Market Restraints Ranked in Order of Impact (U.S.), 200720136: 1. Highly competitive market environment contributes to price 5

Millenium Research Group (MRG) ( http://mrg.net/News-and-Events/Press-

Releases/Orthopedic-Extremity-Device-Market-062812.aspx#sthash.hhalXQ01. dpuf) 6

Poorvi Das

Applied Theory in Design - SDES 704

Frost & Sullivan - U.S. Medical Devices Market Outlook (www.frost.com)

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SCAD, Summer 2014

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erosion in orthopedic braces and supports.

2. Increasing scrutiny by insurers and managed care providers on reimbursement of braces and supports stifles revenue growth and acceptance of premium products.

3. Studies questioning efficacy of prophylactic braces deflate market demand.

4. Greater shift toward off-the-shelf bracing pulls down average selling price and limits market revenue.

5. Expansion of indications for viscosupplementation beyond knee may reduce need for braces and supports in those anatomical areas.

6. Manufacturers facing occupational health deregulation, economic woes, and opportunities for automation drive down market for occupational braces and supports.

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

MARKET SIZE The foot & ankle devices market was valued at $3.2 billion in 2011, and is predicted to grow at a CAGR of 6.0% to reach $4.5 billion by 2017.

The market also constitutes of prosthetic devices used to provide mobility to amputees who have lost their feet and ankles to war, diseases, or injuries, and bracing, which comprises of all types of support devices used to strengthen the joint area and increase stability.

The foot & ankle bracing market is also growing, particularly due to the increase in awareness about physical fitness and routine exercise, particularly in sports. The aging population is also another factor that has supplemented the foot & ankle bracing market.

Sports injuries are a major driver for the foot and ankle devices market. According to recent studies, many sports research academies have observed an increasing number of serious bone injuries among professional as well as amateur sportspersons. Ligament tears and fractures are high in number and foot & ankle injuries in sports constitute over 20% of the total sports injuries; the lower extremity constitutes over 50% of all sports injuries. Sports medicine is an increasing Poorvi Das

Applied Theory in Design - SDES 704

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SCAD, Summer 2014

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opportunity and intensely competitive market on which many key players such as Arthrex (U.S.) have their focus on.1 According to Millennium Research Group (MRG), the global authority on medical technology market intelligence, the United States orthopedic extremity device market will grow at a moderate rate to reach a total value of more than $4.2 billion by 2016. While more mature orthopedic markets, such as hips and knees, are fairly saturated, extremities are relatively untapped, and manufacturers have been investing heavily in this market, seeking growth. Orthopedic extremities include shoulder, foot and ankle, and hand, wrist and elbow

1

Millennium Research Group, US Orthopedic Extremity Device Market

to reach $4.2 Billion by 2016 (http://mrg.net/News-and-Events/Press-Releases/

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Orthopedic-Extremity-Device-Market-062812.aspx)

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

MARKET SHARES OF MAJOR MANUFACTURERS AND RETAILERS Orthopedics Market: Major Market Participants and Market Share Estimates (U.S.), 2006.1 DJ Orthopedics is the market leader in the U.S. orthopedic braces and supports market, with an estimated 30.0 percent of the market in 2006, following its acquisition of Aircast. The Company has been able to maintain this position because of its broad product line and diversified distribution structure. BIomet ranks second in market share with 15.0 percent of the share, thanks to its broad portfolio of orthopedic braces, supports, and rehabilitation products.

Ossur and Orthofix are essentially tied for third place in terms of market share of around 13 percent each. The former is reportedly developing a broader catalog of products in order to compete effectively in the hospital market, which is less familiar territory for the company beyond its traditional O&P focus.

Other 1. Active Ankle Systems, Inc. 2. Bauerfeind USA, Inc. 1

Poorvi Das

2007 Frost & Sullivan - U.S. Medical Devices Market Outlook (www.frost.com)

Applied Theory in Design - SDES 704

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SCAD, Summer 2014

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3. Bird & Cronin, Inc. 4. Bledsoe Brace Systems 5. Body Glove International 6. Breg, Inc. 7. Chase Ergonomics, Inc.

20. Mueller Sports Medicine, Inc. 21. NDL Products, Inc./DHB Industries, Inc. 22. Ortho-Care

8. Darco International, Inc.

23. OTC Professional Appliances

9. DRAFO (Brace Masters)

24. Professional Products, Inc.

10. DeRoyal

25. Restorative Care of America, Inc.

11. EBI Sports Medicine

26. Royce Medical Co.

12. Ergodyne, Inc.

27. Stromgren Supports, Inc.

13. FLA Orthopedics, Inc. 14. Frank Stubbs Co., Inc. 15. Freeman /FUTURO/ Beiersdorf 16. Hanger Orthopedics Group, Inc.

28. Swede-O, Inc. 29. The Saunders Group, Inc. 30. Townsend Design 31. 3M

17. Jerome Medical, Inc. 18. McDavid 32

19. Medical Specialties Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

PROJECT A: ANALYSIS PART 2 - Primary Research

(Image Source: www.katiehahn.blogspot.com)

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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The following categories of people were considered as part of the primary research as they were the main links (components) around the product being researched: • The Patient • The Healthcare provider • The DME (Durable Medical Equipment) Provider • The Insurer

People and services surrounding the use of a brace or support

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

INTERACTION FLOW BETWEEN PEOPLE AND SERVICES Interaction flow between people and services based on scenarios identified in the primary research: The patient experiences a medical problem (accident/ pain/discomfort) and goes to the doctor. The doctor makes a diagnosis, according to which he/she ‘provides’, ‘recommends’ or ‘prescribes’ a brace or support.

SCENARIO 1: Brace is PROVIDED In places like Urgent Care/ Med Express as well as Specialized practices, doctors provide braces and supports incase of an emergency/requirement. For this the medical facility has a tie up with a DME provider to equip them with these devices.

The DME provider could help fit the orthotic. Incase the patient feels discomfort on wearing the brace, they return to the doctors office and the office advises or adjusts the brace so as to help with the discomfort.

The cost of the procedure is covered according to the Insurance plan of the patient.

Diagram illustrating the interaction according to three scenarios identified in the primary research

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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Information and observations at UPMC Orthopedic Specialists, Murrysville, PA: • The office has a tie up with a DME Provider, who stocks up the required products in the doctor’s office. The provider also fits the brace for the patients.

UPMC Orthopedic specialists, Murrysville, PA The medical center has a tie-up with ‘Elizur’, which fits and provides the braces. Incase a patient in uncomfortable, they are advised to pad the brace with a wash cloth. If discomfort persists, the brace is resized and given back.

• Sometimes patients complain about the brace being uncomfortable because of it rubbing against the skin, especially when it is very high. In some cases patients are advised to pad the brace with a wash cloth. Otherwise it is resized and given back.

• Amongst the information pamphlets on the doctors of the practice was an information booklet about knee replacement, made by ‘Stryker’, one of the popular and big names in manufacturing medical devices.

SCENARIO 2: Brace is RECOMMENDED Incase a patient is recommended a brace/support he could: 1. be guided by the doctor on brand or DME provider; The foot and ankle care product isle at CVS Pharmacy, Monroeville, PA The isle includes ‘Zori’ and orthopedic sandal

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Poorvi Das

2. do his research and product comparison through different sources; 3. visit his local pharmacy to see the options and select which suits him/her and be guided by the staff there; Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Usually, an insurance does not come into play here as the brace is not ‘prescribed’.

Information and observations at CVS Pharmacy, Monroeville, PA: Basic foot supports and simple braces can be found over the counter at local pharmacies like CVS, Walgreens, Rite Aid, Walmart pharmacy, Target pharmacy, etc.

At the CVS Pharmacy visited during primary research, foot and ankle care products were separated in two isles:

The orthosis and shoe inserts isle: Signage helps guide product location

1. Prosthetics (including shoe inserts, gel supports, arch supports, splints, socks and stockings (including ones specially made for diabetics); Dominant brands here were Dr. Scholls, CVS and Futuro (a trademark of 3M); This isle also included ‘Zori’ an orthotic sandal ergonomically designed for superior foot support.

2. Pain related braces and supports including ankle supports, night splints for plantar fasciitis, etc. The only brand of products was Futuro.

Mostly the diversification was clear, with a few products (splints and supports) overlapping in both areas of the pharmacy. The signage overhead as well as in the product isle helped direct one to the required product.

Clear images and specifications on the product package help the customer to quickly locate the product they are interested in buying.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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Dr. Scholls heel supports and inserts

Clear photographs and graphics of the Futuro brand help find the product required

Splints in the prosthetics isle

Compression socks and stockings by the CVS brand

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Poorvi Das

Compression socks and stockings by the Futuro brand

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Information and observations at REZK Medical Supply, Monroeville, PA: This family owned DME does not make custom make braces but sells a small variety as part of other medical devices they rent and provide (like hospital beds, respiratory, power mobility, etc) as they do not cater to walk-in patients.

There was a display of JOST compression stockings which encompassed a huge variety in color, compression strength, open/close toes and length (possibly due to a higher demand of these). Patients are measured and advised socks accordingly.

The display of braces was limited but had one of each product that might be required. There were very limited brands, which the office finds is easier to deal with.

Display of orthopedic braces and supports at the entrance of Rezk Medical Supply, Monroeville, PA

The provider advertises through the internet and business cards in doctors office. They also ahve a mobile van which delivers (bigger) devices when needed.

SCENARIO 3: Brace is PRESCRIBED Incase a patient is prescribed a brace or support, he contacts a DME provider or pharmacy. He could be guided about a DME provider from the doctor’s office, an acquaintance or do his own research.

The DME provider fulfills the doctor prescription or medical necessity. He might do this by providing a pre-made brace/ support off the shelf or custom make one according to the Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

39

patients individual need. (Medicare requires that an off the shelf product be considered before custom-making one for the patient). Some braces are used for a long term on a daily basis while some are used temporarily like in the case of fractures, for about six weeks or so. The DME provider can design the type of device with different design features according to the individual patient.

Incase a patient feels discomfort on wearing the brace (common problems include rubbing of brace with skin causing pain, slight variation of fit), the patient can re-visit the DME provider for adjustments, alterations, pressure points that either need to be padded or heated (depending on the material) to relieve pressure1. Incase it is needed he will change the brace, but will need an authorization from the Insurance Company for this.

Very few DME providers have their own manufacturing facilities which mean employing more employees. The common practice is, DME providers measure and scan/ make the foot mould of the patient and send it to a different fabricating facility, thereby reducing the number of employees.

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Information and observations at a local Orthotics clinic, Monroeville, PA: (Interviewee requested that I do not use their or the companies name) Medical Conditions served:

Diabetes, Plantar Fasciitis, Metatarsalgia, Posterior Tibial Tendon Dysfunction

Products/ service provided:

Pre-made/ over the counter and custom made braces for all parts of their body including shoe inserts, diabetic shoes

Medical condition more frequently observed:

Possibly diabetes as more people are getting diagnosed

Changes in the past few years:

The way the products are being manufactured- use of scanner and CAD/CAN systems help make a perfect mould according to the patients body shape to make better fitting shoe inserts There is a wide range of choices in shoes from athletic to dress shoes for patients with diabetes. (Insurance for

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

41

shoes is typically covered for people suffering from diabetes) Materials used are much more lighter.

A lot of plastics and carbon fibres have replaced the bulky wood/leather and metal parts that were used in the earlier braces.

Developments in the future:

Manufacturers are working towards making devices more lightweight, durable, low profile (low visibility) for better cosmesis (creation of a life like part).

Focus towards the brace immobilizing only the required part of the body and not other parts, thereby making them un-restrictive and more comfortable. eg: earlier if there was weakness in the legs, the patient was required to knock their knees straight.

Now the effort is towards braces that will let the knee unlock at certain points and lock at certain points, with the use of a higher level of technology.

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Design and innovation is slowed down because of reimbursements Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

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and limitations of getting technology approvals from insurance companies. eg: electronic knee joints that sense when a person is walking, unlock and lock at certain points, enable a patient to climb up and down the stairs better are not approved by insurance’s because of the cost.

Vendors for off the shelf products

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

purchase off the shelf products from a wide variety of vendors, depending on the requirement of the patient. eg: when a customer comes in with the requirement of a brace, the orthotist measures the patient and then refers to the catalogues of manufacturers.

These usually have sizing charts or can custom make it to specific measurements. The measurements or requirements are sent by the orthotist and it is fabricated accordingly and sent back to the orthotist to give to the patient.

Big companies like Donjoy and Ossur know about reimbursement levels and are very competitive. Incase the products are comparable in comfort 43 SCAD, Summer 2014

and features, the orthotist purchases the cheaper one.

Insurance and pricing:

When the doctor runs a prescription, the insurance pays for it.

There are codes that describe a device and insurance pays according to the codes (particular amounts for particular codes).

All products are not covered by insurance and a patient might end up paying $300 for a shoe insert. Some insurance companies pay for shoe inserts, only for certain diagnosis.

For the DME provider it is about knowing how much it will cost them to make a product and conveying an appropriate price if it is out of pocket.

The remaining is contracted with insurances.

Sometime the provider loses money on a product and at other times he makes a fair profit.

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Prices could range from a $25.00 heel insert to a 3/4/5 thousand dollar brace or halo system.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

There is a small percentage of people who are willing to pay more (out of pocket) if it will give them a better quality of life. This is not applicable for Medicare and it is illegal for a Orthotist to even suggest such an option to a patient with Medicare. One has to stick to the codes and accept what Medicare pays.

Poorvi Das

What is done with returned braces?

Are they recycled?

It is ‘illegal’ to re-use or recycle braces in the U.S. Occasionally used products are sent to organizations which will send the product to ‘thirdworld’ (developing) countries. This is done by sending the used products to the main office and they handle it from there.

Challenges?

There are a lot of advancement in products, but devices can only be built if they have a corresponding code to describe it/the parts.

Sometimes people make a new product, but the only code that it would come under corresponds to a reimbursement lesser than the actual product cost. So, DME providers 45

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keep away from them and would not suggest it to the patient.

The process to create a new code through medicare is very elaborate and lengthy and it could take years to finalize on codes that make it viable for the DME provider to offer hi patient.

Sources of knowing what are the new products and innovations?

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

Certified Orthotists are required to have a continuing education; Their are magazines and journals; Visit medical device fairs (organized twice a year in USA) with large exhibits to be informed on the latest products.

SCAD, Summer 2014

INTERVIEW WITH THE PATIENT: The End User Interview With Timothy Name

Timothy

Age

60 (approx.)

Medical Condition

Diabetic since 1995, Diabetic neuropathy, leading to bruises and sores in the feet.

Sores can result from slight friction with objects like pushing the break of a vehicle.

Products used to help with the condition

JOBST stockings to keep the swelling of the leg down; Had orthopedic shoes made until a few years ago, but didn’t find them comfortable (the pressure was too much). Keeping the feet closed and restricted was painful.

Now finds present sandals comfortable as they are open toed (restricts friction) with adjustable straps (helps with swelling). Wears

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

47

these sandals most of the time including in the winter. Wears winter boots only if he has to go into deep snow, not otherwise. what is discomforting about the products?

stockings: the stockings help with the swelling in the legs. When removed the leg tends to swell up again.

Even though advised to remove the stockings in the night (for better circulation), he might keep them on some nights because of the swelling and discomfort of having to wear the stockings the next day.

Shoes are very uncomfortable.

Wearing shoes causes a lot of soreness, different sections of the foot get sore and hurt.

Information about medical condition and products?

Insurance company sends information; Feedback from the doctor (podiatrist/ endocrinologist); Ask people around; Research online

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Considerations when selecting a product

Looks for what seems to be most comfortable and suited for his foot shape and structure (big and wide / preferably adjustable sandals like the ones he presently has)

DME Provider

The product (stockings) are available at a pharmacy as well as special shops. He usually goes to one shop he has identified. The doctor suggested the brand (JOBST); His insurance (Caremark) takes care of his prescription requirements; insurance provides a list of products that he can consider

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

49

Interview With Cynthia Name

Cynthia Susan Wilson

Age

54

Medical Condition

Charcot Mid-foot collapse since October 2013 (although it is a diabetic condition, she is not diabetic, so doctors are not sure of the cause)

Products used to help with the condition

CRO Walker.

It consists of a pad in the sole (insert) that was custom made for her to keep her foot in the right position (as her arch had collapsed) and an outer boot for support.

The boot stabilizes everything and restricts her motion (ankle, toes, etc) from her knee down.

The product use is temporary (with the average user using the product from 6-18 months)

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what is discomforting about the products?

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

The CRO Walker restricts her motion

and ideally a step down version (with less stabilization) of the same could SCAD, Summer 2014

have been used so she could move

and exercise the muscles, but it is not available; The boot is heavy and hot, very uncomfortable in the summer with temperatures reaching 94 degrees.

The socks in the boots get drenched because of the humidity; Doesn’t like her condition because it has rendered her inactive. She is unable to move around and function with ease, and carry out regular tasks like going to the grocery store, doing laundry,etc; By the end of the day she is in a lot of pain and the foot is swollen, because of standing on the foot;

The CRO Walker support

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Applied Theory in Design - SDES 704

The doctor has advised to keep wearing the boot when standing and can remove it while sitting or lying down, but she prefers to wear it all day through as it is cumbersome to keep wearing it and taking it out.

Prof. Mariah Hay

Prefers to take it out at night as it is heavy (2lbs according to the patient) 51 SCAD, Summer 2014

and she is tired of being in it the whole day.

Usually, she does not need help wearing the product but lately the swelling has become worse and a family member helps her squeeze her foot into the boot and pull the straps.

Information about medical condition and products?

She is constantly on the look out for a product which would not be as restrictive and keeps enquiring with her orthotist, brother’s endocrinologist, internet research, etc.

Is willing to try out a new device which will not be as restrictive, heavy and hot as trying out a new orthotic is less invasive than surgery.

Maintenance of product?

Occasionally the sole of the boot needs to be replaced because of abrasion due to friction. She has to be on a watch-out for this, so that it does not hinder the other layers of the boot; The socks can be washed;

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The boots is waterproof and can be cleaned; Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

The custom insert/pad can be washed in warm soapy water and needs to be air dried completely. This is an important steps because a moist pad could collect mould leading to a worsening of the condition. It takes about two days for the inserts to dry, during which time, the spare set is used.

DME Provider

was suggested by the podiatrist

Insurance?

The insurance was not able to guide and didn’t provide much information.

They paid for the boot and could not deny her condition as the CT scans, MRI’s and X-ray’s proved her medical condition.

Recycle?

Is very open to the idea of recycling the product by returning it to the doctor. Has done it before, will do it again.

Cynthia walking in her CRO Walker

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

53

IMPRESSIONS FROM THE PRIMARY RESEARCH Future Trends At the office of a DME Provider I found some interesting information seeking participants for Robotic Prosthesis Research. Yet, the same orthotist informed me about fantastic innovations and developments slowed down because of reimbursements and limitations of getting technology approvals from insurance companies. Some of the challenges DME providers faced was the inability to provide an advanced product to a patient because codes of the product correspond to a reimbursement lesser than the actual product cost. The lengthy and elaborate process to create new codes through medicare, took years to finalize and make viable for DME providers to offer their patients.

With respect to future trends, I was told about manufacturers working towards making devices more lightweight, durable and low profile for better cosmesis. There is also focus on the brace im-mobilizing only the required part of the body and not other parts, thereby making them un-restrictive and more comfortable.

Insurance companies pay according to codes used in a device. Depending on the kind of Brace, a product could 54

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

range from $25- $5000. There is a small percentage of people who are willing to pay more out of pocket if it will give them a better quality of life.

Patient Discomforts & Impressions from Primary Research During my Primary research, most of the patients I met were partially or fully not convinced by the product prescribed.

For example, I met a patient suffering from Diabetes and Neuropathy. He found the compression stockings suited him well, and used them regularly. However, diabetic shoes never suited him and always caused him pain and discomfort due to their closed-feel and narrow foot width. Instead he replaced them with open toed sandals which were adjustable.

Similarly, another patient was prescribed a CRO-Walker for a condition which was still not ascertained by the doctor. While the boot addressed some of her medical requirements, it was not perfectly customized for it and wearing a standard CRO walker felt uncomfortable and too heavy to move around. This patient showed eagerness to try out a new device that was not so restrictive and yet helps her heal.

Yet another patient I met convinced her doctor to give her a removable walking brace instead of a cast after her foot was fractured. Her intention in doing this, was to be mobile for the requirements of her young children. While the cast was Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

55

prescribed for six weeks, the patient stopped wearing it in three weeks because it restricted her from driving and it was too hot to wear in the summer.

It is rarely that one finds a person very happy or comfortable in a brace. By its very nature of purpose a brace is required to support or inhibit motion, add to which, it is a foreign object.

All these make it difficult for one to physically or psychology accept the product. While companies continuously innovate to improve the comfort of a device, there will always be some level of discomfort from the requirement of immobilizing and restricting the required part of the body.

Another common thread I noticed amongst the patients I met, was the discomfort in wearing their prescribed products in extreme hot and cold temperatures, the CRO walker in summer and the open toed sandal in winter.

Of the impressions from my primary research, I feel we are at a time when we are advancing in possibilities with technology and new materials at a most rapid pace, combined with an enthusiasm to make the next impossibility a possibility. A great deal of interest is being put into bionics and exoskeletons as the prosthetics and braces of the future, but are the authorities bridging these innovations with the end user able to keep pace with it?

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I was also very interested in knowing about what happens to braces when they have served their purpose. Most orthotic Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

providers informed me that it is illegal to recycle braces in America and used braces and prosthetics are sent to ‘thirdworld countries’. This was a relatively new practice they had adopted and most were completely unfamiliar about the organizations that these braces are sent to to forward to developing countries. DME providers usually sent used orthotics and prosthetics back to their main office, which connected with organizations that send medical equipment to developing countries. Some patients were open to the idea of recycling and mentioned returning products to the doctor.

One patient informed me that they save their braces incase it is needed again. However, overall, there was very little visible information about recycling of the product.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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PROJECT A: ANALYSIS PART 3 - Visual Audit

(Image Source: www.trishfortune.com)

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

NON-PRESCRIPTION BRACES & SUPPORTS BOUGHT OVER THE COUNTER For the patient without a prescription, who visits a pharmacy to buy an over the counter brace, the package of the product is its greatest advertiser, as I witnessed while carrying out my research at the braces and support isles in pharmacies. In the short time I was there I came across two patients who felt pain in their heel and were advised by a friend to get a support for plantar fasciitis, available at the pharmacy. They did not consult the doctor, but directly came to the pharmacy.

Consumers as these were guided solely by the information on the product package, the familiarity of the brand and the product or package appeal. Price wise products were competitive, while that might also be a criteria for consideration during purchase.

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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A visual collection of packaging of different brands of braces and supports available at the local pharmacies (RiteAid, CVS, Giant Eagle & Target). Brands include Futuro (3M), Ace (3M), Mueller (Mueller Sports Medicine), Up & Up (Target), Top Care (Giant Eagle) and FLA Orthopedics.

Interestingly, some brands are using more feminine color schemes for braces for women as is shown by the Futuro wrist brace on the far right.

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

A visual collection of packaging of different brands of orthosis (supports) available at the local pharmacies (RiteAid, CVS, Giant Eagle & Target). Brands include Dr. Scholls, ProFoot, Rite Aid and Top Care.

There was a huge selection of these at most pharmacies.

Most packages allowed a person to feel portions of the orthosis.

Interestingly, orthosis for women by some brands are being packaged in a more feminine color scheme.

Sometimes, these products can be visually confusing.

Packages specifying the medical condition (e.g., the Triad Orthotic and Arthritis products by ProFoot and Dr. Scholls on the right) prove to catch the customers attention faster.

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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While doing my visual research at the Pharmacy, I came across two patients (in two different pharmacies), facing a similar kind of pain in the foot, specifically the heel. In both cases the consumer had been advised by friends and acquaintances that they might be suffering from plantar fasciitis and could buy a support at the pharmacy to help with the condition.

In the first scenario, the consumer was not aware of the products, but intended on using a heel support in combination with an ankle brace. She preferred to buy the Dr. Scholls brand over the pharmacy’s brand, despite the difference in price (Dr. Scholls being more expensive), even though the pharmacies product had a very user centric package. She preferred it as she had more trust in the Dr. Scholls brand.

In the second scenario too, the consumer was not aware of the products, but came with the intention of buying a support for ‘Plantar Fasciitis’. She eventually picked out the ProFoot Plantar Fasciitis support and I feel the package had a role to play in her decision. The colors used and the clarity of type and product detail of the ProFoot supports make them stand out in comparison to the others which tend to be a little confusing. So even though there were other products relating to he plantar fasciitis condition, ProCare made it the easiest for the consumer to locate.

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

A visual collection of packaging of different brands of compression stockings (used for diabetes, edema, circulation, etc) and socks available at the local pharmacies and DME Providers (RiteAid, CVS, Rezk Medical Supplies, Giant Eagle & Target). Brands include Futuro (3M), Jobst and CVS Pharmacy and are used by both men and women.

The packaging includes a transparent opening or window through which the consumer can get an understanding of the color of the stocking inside.

These are available in different sizes and a patient has to be measured before he buys the product. There are also open toe/closed toe as well as length options.

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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A LOOK AT ACE AND FUTURO BRANDS OF BRACES IN DETAIL FUTURO and ACE are brands of 3M and were amongst the common brands of braces I saw in four pharmacies. Out of these one pharmacy exclusively carried only the FUTURO brand while the other exclusively carried the ACE brand of braces.

Both companies aim at instilling a sense of confidence and comfort from their product in the consumer. Yellow is the predominant color of the FUTURO brand while red is used in the ACE packages. Both these colors are strong primary colors and aim at catching the customers attention.

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

PACKAGING The information on the front of the package includes a clear and well defined photograph of the product conveying a great understanding of the material, color, quality and ‘look’ of the product inside. The problem or pain area of the body, in the FUTURO brand in particular, is highlighted (by placement of text) so that a consumer finds it easy to identify. A logo of the parent company 3M is on the front of the package instilling confidence in the consumer.

At two pharmacies I found a change in the color format of the package, for a product that was directed towards women.

There was just one product with the design. Compared to the strong yellow, the colors used in this one are softer pastels and more feminine. This is an interesting way to direct a customer, although it is completely different from the original brand package format.

Around the package: The face of the package has a well defined photograph of the product, giving the viewer a good sense of what the product looks like and how it fits. One side of the package illustrates instructions on wearing the product, another side guides on size selection, the back highlights the key features about the product (with other specifications about the brand and product).

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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PRINT Where these brands go one step ahead is in the message they convey to their targeted audience. At one pharmacy, along with the braces, was kept a product guide, which could be referred to by the customer. Pages were divided according to problem area and each section opened up to an image on top and product specifications below.

Images included people doing an activity (like running, skiing, playing golf, etc) with comfort and pleasure. Wordings included sentences like: ‘you’re always up for trying something new, not to mention totally owning it’; ‘confidence is knowing you can make the play - even when it’s all on the line’; ‘the best part of your day starts when you give it a lift’; ‘the only thing that slows you down is the natural beauty surrounding you’;

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I think they hit the nail on the head by instilling a sense of understanding and confidence in the consumer. Pain in a part of the body restricts you from activities and brings a sense of deprivation as well as negative emotion of not feeling great or your best self. The images and wordings on the guide gave a sense of encouragement and confidence.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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VIDEOS In the video advertisements, the FUTURO brand targeted people facing pain or injury in day to day activities while the ACE brand targeted sports medicine.

Product videos of both brands had a similar format which included a person showing how the brace is worn and adjusted, while a narrator explained the purpose of the product, the specific design implemented on the product for the purpose, followed by other features (like materials, adjustability), instructions on wearing and finally who might use it. The video was clear with minimal graphics and disturbance, and had the characteristic brand colors yellow or red on a small area of the screen. Some product videos addressed concerns a consumer might have when using the product and explained the proper method of wearing the product.

FUTURO: https://www.youtube.com/channel/UCsxG8_ mUMdw2wchsPGEx5jQ ACE: https://www.youtube.com/user/AceBrandBandages Wordings of the ACE sports medicine supports included: ‘Protect - Compete - Win’; ‘Less pain, more gain’

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The music was energetic, strong and intense, complementing the theme perfectly.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Wordings of the FUTURO brand included: ‘Live more with FUTURO’; ‘Cease the day’; ‘Go ahead and run that extra mile, climb that steep hill, play a little harder, just click and go’; ‘I am unstoppable’; ‘I will live my life without limits’; and ‘I will not give in to everyday pain’

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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WEBSITES Futuro:The messages of encouragement and confidence are continued in the web interface, which again uses the identifying yellow and red brand colors.

FUTURO website: http://www.futuro-usa.com/wps/portal/3M/ en_US/Futuro/Global/ The home page includes well directed links, corresponding to what a consumer might be interested in knowing about their condition, targeted pain areas, the product, the science behind, offers and wear to buy. Positive images of people doing an activity, supported with encouraging words like ‘Live Comfortably’, ‘live freely’ continue the same central theme of comfort despite pain.

Links leading to exercises for Arthritis and other useful tips are brought to the attention of a viewer by good images and add another level of confidence or connectivity with the consumer. This signifies the commitment of the brand towards a consumers health and wellbeing.

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ACE: On the home page of the site, the brand helps you select your problem area by asking the question, ‘What’s holding you back? Get to the bottom of your pain problem’. Links like the FUTURO website are well directed, corresponding to what a consumer might be interested Poorvi Das

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Prof. Mariah Hay

SCAD, Summer 2014

in knowing about their condition, targeted pain areas, the product, the science behind, offers and wear to buy.

Images on the cover page include products and an interesting link to ‘Everyday Champions’, a cast of different personas based on everyday people and how they cope with pain to pursue their passions. These also include tips on daily activities like mowing the lawn, going on a camp with the family, all in a way directed to a better sense of being.

ACE website: http://www.acebrand.com/wps/portal/3M/en_ US/AceBrand/Home/

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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SALES & PROMOTIONS An interesting thing I found in one of the discount pamphlets was the presence of a medical personnel (pharmacist), in a way implying that the product is medically approved.

Various sales and promotion graphics.

(Image sources: www.futuro-usa.com, www.guardianpharmacy.net, www.riteaid.com)

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

PRESCRIPTION BRACES & SUPPORTS FROM THE MEDICAL PROVIDER OR THE ORTHOTICS & PROSTHETICS CLINICS Prescribed braces and supports are available at the doctors or Orthotics clinic while others are available off the shelf.

Manufacturers of braces and supports which require a prescription target their advertising at the people who decide on the orthotic to be give to the patient, in this case the Medical provider and the orthotist. Clinics are frequently visited by sales representatives who often leave samples, information and product brochures.

I was told by one orthotist that he uses the manufacturers catalogue to refer to a brace that might correspond to a patients size and also shows patients the catalogues at times for them to choose.

Unfortunately I was unable to collect very few of these brochures as medical clinics were busy with patients and unable to help me with much information. However, I was able to collect many examples of advertisements that manufacturers place in Orthotic magazines from fantastic resources on the internet, like ‘LER (lower extremity review) Resource Guide’ (http://lermagazine.com/) and ‘The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/).

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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STRYKER I was only able to find a printed guide by a manufacturer (apart from the ACE & FUTURO product guide mentioned earlier) at an Orthopedic clinic. The booklet was placed with the information bio of the doctors and was filled with information and diagrams in relation to Stryker’s ‘Get Around Knee’ for total knee joint replacement. It also had the QR code for ‘Stryker Hiker’ an interactive pedometer app. that could be downloaded

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

ARIZONA AFO The advertisements show a great balance between visual and textual information overall. The photographs give a clear understanding about the product. QR codes make it easy for an interested client to reach the company’s site directly.

Most advertisements introduce a new product or inform about an expanded line of products. Some advertisements highlight a strength, while another uses patients feedback a the main style (lady riding a bike).

The only one I find a little unrelated or ‘trying to hard’ is ‘More of what you need’. The only interesting thing about this advertisement is the product line towards the lower half. The remaining visual does not seem so relevant with what is being conveyed or what the product is about.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/)

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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HANGAR CLINIC: Print The print materials of Hanger Clinic are consistent in look and design. There is a good balance between visual and textual information, with important pieces of information highlighted in bold and with bullets. The visuals consist of people an tend to connect with the customer on an emotional level.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/)

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

HANGAR CLINIC: Website The look and color scheme are continued onto the website which offers a very good user interface for patience, including a list of success stories documented for reference.

Image source: www.hanger.com

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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HERSCO Although the advertisements include photographs of the orthotics being sold, the main central part of it is a smiling consultant, mostly female.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/)

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Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

BECKER The advertisements are very focussed in their communication, where one is emphasizing the quick delivery of a CRO Walker and the other a message of ‘trust’. Overall they are a good balance of visual and textual information, with photographs and details on what a product looks like.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/ advertisers/)

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

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ORTHOMERICA Most advertisements have a clear visual of the product, with detailed information corresponding to it. The information might have caught the readers eye better if it were highlighted or bulleted. Some advertisements highlight the adjustability, savings and patient convenience aspects of the product The advertisement on below left which highlights the ability to custom-make braces according to individuals tastes and preferences is particularly interesting and different from the others. It has a subtle emotional quotient to it, which is lacking in the other advertisements.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/ advertisers/)

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Prof. Mariah Hay

SCAD, Summer 2014

DR. COMFORT These products are targeted towards patients with diabetes.

There are many different add campaigns, with different approaches although the information placed towards the lower side of the add are similar in many.

Advertisements are well balanced in their visual and textual information, with great product descriptions through visuals.

Information about the ‘American Podiatric Medical Association Seal of Acceptance’; ‘American Diabetes Association’ and DJO Global render a credibility to the brand and build the confidence of the viewer. Sentences include ‘Create more positive outcomes for your patients’ and ‘our mission is quality’ (and ‘comfort’ in another add not shown here). One advertisement also conveys an endeavor towards social development.

The only advertisement which seems a little odd is the third one in the second row which almost chides a provider for recommending a compression hosiery other than Dr. Comfort!

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/ advertisers/)

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OSSUR The advertisements by Ossur focus on their commitment to continuous innovation, refinement and improvement with the central theme being ‘Life without Limitations’. The lack of any product photographs or information convey the strong confidence and hold the brand has in the market.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/ advertisers/)

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KLM ORTHOTICS The advertisements do not give too much, if any information about the product. The main line used is ‘we do everything for the foot and ankle - everything!’ Some advertisements focus on increased revenue as an incentive to the buyer.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/)

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KNIT RITE Tag lines of the product include, ‘the smarter choice in protection and comfort’ and ‘solutions that fit’.

Advertisements tend to be heavier in the textual information as compared to the visual. Some inform the science behind the product with the help of a visual diagram and lots of information.

Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/)

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Poorvi Das Applied Theory in Design - SDES 704 Image source: The O&P Edge Content Partner’ (http://www.oandp.com/edge/advertisers/)

Prof. Mariah Hay

SCAD, Summer 2014

PROJECT A: ANALYSIS PART 4 - Personas

(Image Source: www.footcareofmanhattan.com)

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PERSONA 1 From the information gathered during the Secondary, Primary and Visual research, I developed three personas to guide me further in the design process.

My first Persona is Denise Rosenthal.

Denise used to be a nurse until a few years back, when she decided to take on a desk job in the management side of her field. She had become tired of the physical requirements of being a nurse. Her present job, also in the health sector is more sedentary as compared to before.

She is divorced and is the primary caregiver to her aging mother (92), with whom she also shares an apartment. She has a shy cat who she loves to pamper. On the weekends Denise likes to visit her children and grandchildren who stay a little distance away, but not too far.

Denise’s work hours are long with her leaving for work at 8 in the morning and not returning until 8:30 pm at night. She usually buys dinner for both her mother and herself, from the hot foods bar, on the way back home.

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In the past few years Denise put on substantial weight and this Poorvi Das

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has affected her health, causing her high blood pressure and difficulty breathing. She use to visit the gym before but does not got enough time to fit it in her routine now.

She is also flat footed and walks with a limp. She had tried custom made shoes to improve her arch in the past, but these have not helped.

Denise looks tired and physically unhealthy, but wants to continue to work till she is 65 atleast. Even-though, she loves her mother and is happy they are together, she feels overwhelmed at times and enjoys the social encounters outside the house.

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PERSONA 2 My second Persona is Amy Reese Walters.

Amy is a family focussed mother, dedicated to bringing the best experiences for her kids. She loves animals and worked for a pet store before quitting to be a stay at home mother five years ago. Now her family comprises of her husband, two children Ethan (4 yrs.) and Emma (18 months), four dogs, two cats and two hamsters. (These days her son is negotiating the possibility of getting a turtle home!). She loves gardening, reading, listening to anything that is up-beat and doing things around the house Amy’s husband, Steve works for a bank, for which he travels 20 miles from their home in Carmel. While her husband is at work, Amy carries out her daily activities of taking care of the kids, including dropping and picking up Ethan from the Montessori, doing some play activities, visiting the library or park and tending to the animals at home. Emma has just started walking and enjoys exploring the world around her.

A few months back, while taking the children out of the car, Amy turned her ankle in the 1 inch step that separates the driveway from the garage, broke her bone and stretched her ligament. The orthopedic wanted her to get a hard cast, but Poorvi Das

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Amy thought that would not be suitable as Emma was still thirteen months and very dependent on her. She got a boot brace instead.

Amy was required to wear the brace for 6 to 7 weeks but stopped wearing it after about three. It was very heavy and the velcro drove her nuts! When summer came it was too hot and uncomfortable to wear. She was not able to drive with it on (as it was her right foot) and had to remove it often to take Ethan to school and other activities. As a result her foot didn’t get the rest it required to heal properly and she’s afraid it has gotten worse. She realizes she needs to visit the doctor but is very busy with the dependency the family has on her and wants to give them her best. She gets a couple of minutes everyday when the kids go to bed, to elevate, soak or apply heat/ice to her injury.

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PERSONA 3 My third Persona is Ray Johnson Ray, a 74 year old African American male, lives alone in his family house in a suburb of Atlanta. His wife passed away four years ago. His two children Jeff and Kayla, stay approximately 20 miles away from him and are busy with their lives and work.

They try to meet their dad as and when possible.

Ray has been a diabetic since 1995 and his condition has deteriorated ever-since his wife’s death. He finds it difficult to manage his condition and keep up with the restrictions and medications. His condition makes him feel hungry often and because he lives alone and has to manage his meals himself, it becomes a challenge to eat healthy and he often relies on fast food or pre-packaged meals.

Ray is also overweight and this interferes with him from getting around more easily, and causes frustration with a feeling of helplessness leading to dejection and a further

deterioration in his condition. He has tried to exercise in the past, but has been un-successful in sustaining it due to family obligations, work, inclement weather or sometimes just feeling discouraged by his lack of stamina and condition.

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Off-late his neuropathy has worsened and the slightest friction Poorvi Das

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with his feet causes a lesion or bruise which he needs to get checked often. He finds driving bare-foot prevents him from getting his feet hurt. He stopped wearing the prescribed diabetic shoes years ago because they didn’t come in his wide foot size and the closed shoe caused him a lot of discomfort.

Instead he got himself sandals with adjustable velcro straps so as to cope with his wide foot shape and the swelling in his legs. He usually drives his truck, but on a day he has to drive his mustang, he’s sure to have to visit the doctor because of bruises on his feet.

Even though he keeps a smiling and friendly demeanor about himself, one cannot overlook the hint of underlying grief and helplessness that he faces every day.

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ANALYSIS: LOOKING AHEAD The research during Project A helped me cover a lot of ground understanding about my product. While I have a good sense of the structure around my subject, I also find interesting possibilities to explore in a few gaps that appeal to me.

Some areas of interest are, better self health management and recycling possibilities for braces. I hope to explore these and more in the next part of the project.

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PROJECT B: SYNTHESIS

(Image Source: www.justrelaxandbreathe. tumblr.com)

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INTRODUCTION The research process so far, on my subject Braces and Supports, for the Applied Theory in Design course at SCAD, had somewhat already helped me classify information I had collected into Primary Research, Secondary Research, Visual Audit and defining Personas. Still, it was difficult to look at an integrated canvas of the information with files locked into separate folders confined in the space of a computer screen.

This next part of the project, titled ‘Synthesis’ aimed at addressing this very constraint, requiring one to ‘vomit’ out all the information collected so far onto a large flat surface, in this case, a ‘wall’. This information of primarily visual and some textual information aimed at creating a map and reference, which promised to unlock hidden gaps and connections on the subject.

Collecting my visuals for printing itself I was able to get a hint of the mysterious ability of this wall to organize and connect information. Even though I didn’t have the printouts in hand, my mind had already begun organizing and placing this information on a mentally constructed wall in my head, excitedly sending messages and alerts of what else I needed to add. I couldn’t wait to have the printouts in hand and set it up for real.

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THE WORKING WALL The center of my working wall was ‘Painʼ the reason why a person would need a ʻProductʼ here being the brace or support. There are ʻCausesʼ for this pain, these mainly being old age, chronic illnesses, sports related injuries, etc.

The need for a product leads to a ʻBuying Experienceʼ, including Product packaging, communication, retail and web experience. The buying experience also has to do with what the manufacturer is trying to sell, his commitment to the cause, and how he is trying to capture his target consumer.

For this I compiled a section called ʻLogos and Messagesʼ.

On the periphery of my wall I added in a little textual and statistical information of big brands like Ossur and DJO Global as a reference under the heading of Secondary Research.

A group of images, which inspire me were placed in the ‘Inspiration’ zone.

After this base framework, I added a second layer of images corresponding in some way to the categories, which included information from my previous research and ideas I came across during my process. It is fascinating how one finds clues here and there in the world around us, when living and breathing a project.

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For instance, in the hope to get some sugar into my system while studying at the library, I came across an interesting food vending machine called ‘h.u.m.a.n.’ This fantastic concept in healthy food options, contrary to what one expects in regular vending machines, made me think about my persona, Ray Johnson who is unable to make healthy food choices, despite being diabetic. What if this machine added a few options for people with diabetes and other chronic illnesses, so they had access to the right kind of food? This idea would probably have a contradictory affect to the sales of braces and supports by attacking the cause of the pain, but I still thought it worth putting on the board because of it’s inherent philosophy of health and well being.

Another layer looked at Recycling of braces, a topic that was unable to pull out enough information during Primary Research. A few DME providers told me that it is illegal to recycle these products in the US, and that they are forwarded to organizations, which send them to third world countries for people in need. Still, there was no visible information for the consumer about the possibility of handing in their product after use and this hit me as a gap that existed. Of the big companies I could only find Stryker mentioning the ‘reprocessing’ and ‘remanufacturing’ approach towards sustainability.

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I did however, find a few smaller ‘not for profit’ organizations like Operation Rainbow and EmBraced addressing this issue Poorvi Das

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and working towards collecting and distributing used products to people in need. Of these EmBraced also tries to provide products to people without means, but in need in Atlanta. I believe, in the time we live, recycling and sustainability are subjects one cannot afford to ignore.

Other layers corresponding to the ‘Product’ part of the board included gaps like the product not being flexible to extreme weather conditions and the gap that exists in innovation and the inability of the innovated product to reach the end user. Two other interesting connections to this part included the evolution of the product into a hybrid of the bandage and elastic brace, and this advertisement by Ossur showing how three products support gradual healing and motion of a person who has fractured his foot.

A large portion of my wall was filled with images relating to the Buying Experience collected during Primary research.

This portion of my board was intriguing to me as compared to others. I identified many problems like lack of in-store guidance and product confusion; with some solutions like the Product guide I had found for the ACE and Futuro brands.

The chance encounter with two consumers who had decided to buy an Over the Shelf product to self manage their health condition interested me as a good opportunity to address.

I thought a better and more informed buying experience would benefit all my three personas, especially Denise, who was keen on self managing her condition. I added on a few Poorvi Das

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ideas that came to mind while reflecting on this portion of the working wall.

The Logos and Messages section of the working wall reflected the words and symbols brands want to associate with the product. I was especially keen on looking at how big companies like DJO Global and Ossur connect with the consumer and found some interesting videos by Ossur. Their message not only focuses on the product, but looks at it from a different perspective, conveying their core philosophy and captivating their target consumer.

Along the way in putting my research together I somehow caught on to photographs of healthy and strong feet. These inspire me and give me a sense of direction where I would like to head. The feet carry all our weight, body parts, organs, thoughts, feelings, etc. They help us move, experience the world and participate in it and are beautifully created to serve their purpose. It is easy to neglect one’s feet because they are positioned way down where we don’t even get to see them. Any problem with the feet restricts our mobility and the activities associated with it. The other set of images reminded me of the human spirit and filled me with a positive perspective about people with challenges in regards to mobility.

It was indeed fascinating to see how the Working Wall magically revealed many gaps and connections, giving one 102

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an informed overall perspective of things, secretly pulling out ideas and directions to go forward. I found myself interested in three ideas particularly, which were Better Health Management applications to address the ‘Causes’ of pain better. More information on ways to recycle braces and supports; and exploring a better Buying Experience for the user.

I decided to work on exploring a better buying experience for the user. For this I went back to the two consumers I had met at the Pharmacy buying a remedy before consulting the doctor and decided to approach the problem from their perspective.

The Unit’s reading of Geoffrey Moore’s book, Crossing the Chasm, helped me understand this process beautifully.

I decided to define my Niche Segment as a consumer who wants to self-treat their pain condition, and looks for an Over the Shelf Brace for this purpose. The pain condition is mainly Occupational or Lifestyle related. The shaded portion suggests my target consumer.

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Here is a journey map of the Consumer who has decided on self-treating their condition. We will begin from the top left corner of the diagram. A cause has led a patient to feel pain.

The patient acknowledges these symptoms and may decide to visit the doctor or research this condition on her own. Our particular user has decided to research the condition on her own, for which she could ask people she communicates with, search the internet or refer to Journals and Magazines. After this the patient may have an inkling about her condition or might be certain what the problem is. Once again, she could consider going to doctor or look for a treatment on her own.

Our patient does not want to visit the doctor. So she looks for solutions and might also visit the Pharmacy for this. All this information has left her with a pool of knowledge, which has either helped clarify the situation or has led her to be confused.

The question then becomes, what confused the patient and what helped make the end decision easier. Here are some of my assumptions based on primary research.

Addressing these questions also made me see how a confusing scenario could be transformed into a convincing one.

I then thought of testing Moore’s Sample Scenario Exercise with my persona, Denise Rosenthal to see how I would think of a solution based on a situation that she encounters Poorvi Das

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Denise’s foot has been paining off and on since the past few months. Today however the pain is so intense, she is finding it difficult to move or stand. She needs to get to work soon, but is not sure how she’ll make it to work in so much pain. She would love to be rid of this pain that has been nagging her for a while, but has been busy with things to acknowledge it enough. It has begun affecting her mobility, giving her a slight limp and she hopes it is nothing serious and that she can recover from it and walk normally. Denise calls the Doctor but is unable to get an appointment for the day. She thinks about taking the day off but then remembers that she is not left with any medical leave and any more absences might cost her job, which she certainly cannot afford to lose.

The grey shaded area describes the New Approach. I will walk you through both options.

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First, the option at the extreme right: Denise takes a Painkiller.

She connects with her pharmacy through an interactive smart device app or internet. This program or application has her basic data and medical history as a record, which she has filled in as and when she encountered a medical condition.

It is accessible through a login and password pin unique to her. Denise adds in the symptoms of her condition today.

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Based on her records and the symptoms, the program makes a diagnosis and suggests effective treatments including home remedies and exercises specific to the condition.

It also offers the ability for Denise to look for the product solution in the pharmacies close to her location and compares specifications, reviews, prices and competitive offers in its results or narrow down options. Some Pharmacies also provide a drop off service and could bring her product to the doorstep if required, for a small fee. Denise places her order to be delivered and takes a print-out of the home remedies and exercises suggested by the program.

In the other new approach, Denise visits her Pharmacy and heads for the Medical Kiosk. She logs in and fills in her Symptoms. Like the program before, the Kiosk has her medical history record and other basic information that enables it to make an accurate diagnosis. This Kiosk can also be accessed by first timers and in a way takes on the role of a pharmacist or product advisor. The program suggests product remedies for Denise, comparing product specifications, prices and competitive offers in its results. When Denise selects a product she is convinced by, she is shown the exact location of the product in the pharmacy so it is easy for her to trace or, she places her order and someone picks it up and keeps it ready for her to pick-up at the store customer service area.

And yes off course, the Kiosk also gives her an option of taking a printout or e-mailing information about her reason 108

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for visit that day including suggested home remedies and exercises that will improve her condition.

With the New Approach, Denise is on her path to healing, using a quick and simple method, which helped guide her and make her product selection to improve her condition.

I have to admit, this was an intense and exhaustive process, but a very neat one at that! It not only helped connect the dots but also unraveled super possibilities, hiding in the gaps.

I am convinced that as one meditates more on the working wall, one will only be encouraged and captivated by what one learns from it.

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PROJECT C: EXPLORATION PART 1 - Reframing

(Image Source: www.blog.portopetrocolecciones.com)

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In the process of my Secondary Research, I found that the causes of foot problems like obesity, over-use injury, Diabetes and old age are on the rise and expected to grow.

In the process of my Primary Research, I found that a lot of people today prefer to find an over the shelf solution to their medical ailment themselves, if they can avoid visiting the doctor. I also found that the buying experience for such a consumer has many gaps, like • a lack of product guidance; • product confusion because of choice overload (with many brands, giving many options); • a lack of confidence in the user while selecting the product, unsure if it will work, especially because a doctor has not guided him; • a lack of information on recycling; This led me to the question: “How to help a consumer diagnose a foot problem and guide the selection of an appropriate over the shelf product?”

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From this I defined a set of nested value propositions, which formed the base of the design possibilities I explored. Core values I aimed at targeting were, • A commitment to strengthen, support, heal and improve the consumer’s foot condition, with a more long-term goal in consideration; • Lighten the dilemma of choice and product confusion, while still enabling a consumer to make an informed choice; • Assist the consumer to confidently self-manage their health condition by providing medically informed diagnosis and solutions; and • Information on recycling;

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CONCEPT 1 Better Product Display & Categorization My first concept looks at making the buying experience easier for the consumer by a more focused store display, with the ‘just right’ number of options, i.e. not too many, nor too less.

Inspired by Sheena Iyengars talk titled ‘How to make choosing easier’, on Ted, where she states better categorization to be one of the key solutions to helping consumers from getting paralyzed by an ocean of options, I feel a more defined categorization in the product display, including better signage’s, product demarcations, categorization according to symptoms, diagnosis and pain area will be useful. The displays will aslo include product comparison guides as well as pamphlets on different conditions for patients to refer to and take home.

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CONCEPT 2 Code Inside the Package My second concept looks at how to add value to a product. In this, a brand of braces includes a code inside the package.

When bought, the user can use this code to connect to a rich online resource of information about his or her condition as well as get advise on self-managing and improving their condition. This might also include one opportunity to consult with a medical practioner over a teleconference to discuss their particular foot condition and be guided. The user can also view and download relevant exercise and foot care videos.

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CONCEPT 3 Interactive Kiosk at Pharmacy My third concept plays with the idea of an interactive kiosk at the pharmacy, which helps guide a person who is not totally certain about their condition.

Placed close to the relevant products, the kiosk comprises of a touch-screen interface with sophisticated versions having a touch sensitive foot model for the consumer to indicate the problem area better, similar to how he would tell the podiatrist.

Some kiosks also have a mat or scanner to check foot arch related conditions. The kiosk can help provide a diagnosis based on the symptoms filled in by the patient, including other relevant information, which might be a cause for the condition like weight, age and basic medical history.

Based on the diagnosis, the kiosk suggests relevant products as well as other remedies like exercises and ice or heat treatments, which would help heal the condition.

The consumer is given the option of printing these out or forwarding them to their e-mail.

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CONCEPT 4 Interactive Pharmacy App. The fourth concept looks at the possibility of using an interactive Application for a smart device or phone, as an instant go-to Doctor incase of small medical queries. Similar to WebMD in diagnosing a health condition on the basis of symptoms, this App. also allows a patient to feed in their Medical History over time. As a result, the App. is able to make a better diagnosis. It also suggest treatments related to the diagnosis and in this case would suggest the use of a product according to the foot problem as well as other ways in which the patient can improve their foot condition, like exercises or using ice packs. The App. also helps look for products for the user, making suggestions according to pharmacies located close by and gives the user the ability of placing an order for it.

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MOST PROMISING CONCEPT I feel my most promising concept would be a combination of Concept 3, the Kiosk at the Pharmacy and Concept 4, the website and smart device Application.

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For reasons like, the inability to pay for insurance, lack of information about a medical practioner or just to save on a doctor’s visit, a growing number of people prefer to selftreat their health condition, making the use of over-the shelf remedies. A rising number of cases in foot problems like Plantar Fasciitis and Tendoniitis as a result of an increasing number of causes for these conditions have implications of more people pursuing a remedy, some of these visiting the pharmacy first, in search for a suitable solution. This is a great opportunity to be tapped by the pharmacy in giving a consumer a fantastic buying experience, building their confidence and winning their loyalty.

With the introduction of an information kiosk at the pharmacy, along with a website and a smart device application based on the same format, this concept will help fill in the gap in buying experience, brought about by product confusion as well as the consumers uncertainty and lack of confidence. It will address the absence of an informed guide, when buying a product.

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By including Self Management support for the consumer, through the maintenance of a medical history record, sending health related information, recommending additional all rounded suggestions like exercises, hot and cold treatment and massage ideas, etc, this concept would further strengthen the consumers faith in the service.

Finally, this concept will come full circle by informing and encouraging the consumer to participate in the recycling program.

I feel this concept would best address the goals of the Nested Value Propositions and be a promising idea to introduce for consumers who prefer to self treat their medical conditions.

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PROJECT C: EXPLORATION PART 2 - Artifactual Model

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INTRODUCTION The aim of the project was to develop a design plan, based on a set of nested value propositions for a new brand that will change the way people think about a commodity product they care little about. I selected Braces and Supports as my commodity product for the project.

Following a process of research, and insights gained from it, I narrowed my focus to braces and supports that are sold Over the Shelf in Pharmacies. A main reason for me to consider this direction was the growing trend of people towards self-care and talking responsibility of their foot conditions.

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THE GROWING TREND OF SELF-CARE Improved educational levels and greater access to information, combined with increased individual interest in personal health has led people to have a better understanding of their conditions, giving them the confidence to consider the self-care approach. The new empowered consumer is willing to address conditions such as Plantar Fasciitis, Overuse injury, compression therapy and heel pain by directly visiting the pharmacy as compared to long wait times at clinics or other health facilities. This has been supported by the availability of long-established products as well as new, effective products to ‘over the shelf’ product range.

The self-care health market has become one of the fastest growing segments of our economy, with this trend rapidly gaining momentum and being termed the Health Care Revolution or the transition from the ‘Old’ to the ‘New Health Care System’.

Walgreens (Image Source: www.walgreens.com)

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Pharmacies become an important player in this consumer driven transition, being visited directly in search of healthcare products to solve researched conditions. However, in the background of this swiftly growing trend, one finds very few, if any mechanisms that support this.

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GAPS IN THE BUYING EXPERIENCE There are gaps in the buying experience for a consumer visiting the pharmacy in search of a product for their foot condition.

For instance, pharmacists are better equipped for drug related queries while some nurse practitioners in the pharmacy address simpler health problems like a flu or fever. This leaves the consumer to rely on the sales representative for advice on a suitable product for their foot problem. While experienced and interested sale representatives are able to guide a consumer to some extent, a greater probability is of the consumer being left alone to make a decision.

The Dilemma of Choice (Image Source: www.ncsolutions.com)

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This brings us to the next hindrance in the buying experience: the dilemma of choice! Shoppers liked to have choice and manufactures responded, a little too enthusiastically. As per a news report, on the subject of Choice overload on NBC earlier this year, in 1975, average supermarkets carried around 9 thousand products. In 30 years this number has swelled to nearly 40 thousand. Pharmacies are no different, with aisles being stacked up with a maze of choices. This infographic, created by an over the counter drug startup ‘Help Remedies’, illustrates this perfectly by laying out all the options for headache pills, one typically finds at the pharmacy today. Until

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10 years ago this was a simpler choice.

Consumer reports and research concludes that when faced with so much choice, consumers get demotivated or overwhelmed and leave the purchase for later, if at all.

One might also assume that a consumer feels a lack of confidence to some extent, in selecting a product for the first time. The absence of guidance by a medical practioner coupled with the uncertainty from inexperience creates a doubt in the consumer’s mind of “will it work?” This too adds to a consumer leaving the store without a purchase or one, with which he might not be satisfied.

Info-Graphic by ‘Help Remedies’ about the remedies for a headache in the Pharmacy.

(Image Source: www.fastcodedesign.com)

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ARTIFACTUAL MODEL The design plan for a new idea for braces and supports was informed by these findings and defined by a set of nested value proposition. Providing medically backed information, guiding the selection of an appropriate product, encouraging self-care and information and collection mechanisms for the recycling of a product, were key components of the new design.

With the advantage of being in direct contact with patients, pharmacies were looked at as potential locations to introduce the idea.

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

SOLUTION A Respond to the dilemma of choice in the product aisle of the Pharmacy

In this solution, the shopping aisle of the brace and support section is better designed to make the dilemma of choice less overwhelming.

Products on the shelf are just the right number to allow the consumer the option of choice, while not making that choice overbearing in any way. Products are categorized clearly according to problem area, symptom and diagnosis. There is an emphasis on ease of visibility and ability to demarcate through good graphics and visual communication. A button close to aisle when pressed connects with the pharmacist or sales representative for assistance.

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Prof. Mariah Hay

SCAD, Summer 2014

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SOLUTION B Add in Information for Self-Care

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In addition to a better designed product display as described in Solution A, the aisle now has information for consumers like product guides, information pamphlets on different foot conditions, information flyers on related medical facilities, physiotherapy facilities, massage therapy parlors, relevant communities and self-care options. These help the consumer compare products as well gain information about their foot condition.

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

SOLUTION C Interactive Touch-Screen KIOSK

The information guides, pamphlets, flyers and booklets are consolidated into an interactive touch screen kiosk for the visiting consumer. Placed close to the product aisle, the kiosk can be used by the consumer to browse through the store’s full range of products as well as be guided on the selection of a relevant product through knowledge of the diagnosis.

Incase the patient is not certain of his diagnosis, he could use the kiosk to get a better idea of his condition by entering information about his symptoms, triggers and other relevant details. WebMD is a good example of such a feature becoming convenient and successful.

The kiosk is also an information hub for consumers to find out more about their foot condition and provides self-care options including the ability to print self-care remedies and information on related communities and medical facilities. A barcode scanner and credit/debit card reader enable the consumer to purchase a product directly from the store or select from the wider range online.

Sophisticated versions of the kiosk have a touch sensitive foot model for the consumer to indicate the problem area better, similar to how one would tell the podiatrist. Some kiosks also have a mat or scanner to check foot arch related conditions.

(Image Source: www.hytechnology.net)

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SCAD, Summer 2014

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The Kiosk also has information and a little collection box for consumers who would like to recycle their brace. Incentives like a discount towards their purchase could be a part of it.

The kiosk will be especially useful for people who do not have access to the internet, a smart device or a doctor. Studies show that lower income people are less likely to be wired.

For such a situation, one can consider the placement of the kiosk in other accessible locations in addition to pharmacies.

The kiosk could direct the consumer to available products in the pharmacies close by, include a vending machine or give the option of purchasing online.

The addition of a kiosk will improve the way the new consumer accesses healthcare. The key benefits of such a solution will be convenience, speed, readily available advice and a wider choice of products. Up to date and easy to access information along-with automatically updated and engaging content will create a seamless and interactive in-store experience, assisting staff in making sales in the pharmacy.

While this solution will require an initial investment and subsequent up gradation and revision of content, it will eventually save the cost of labor, employee time and improve the utilization of employees. It will also attract new consumers to the pharmacy.

Images Sources: www.clipartguide.com, www.footdearch.com, www.cdc.gov, www. andrusmorgan.co, www.williamlevybuzz.blogspot.com, www.cebit.de, www.vectors4all.net, www.etc.usf.edu, www.illustrationsof.com.

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Prof. Mariah Hay

SCAD, Summer 2014

SOLUTION Q Expand into the Opportunities of the Digital Age

In addition to the kiosk, an information platform to guide the patient about their foot condition, relevant products and selfcare techniques and opportunities will be accessible through a website or smart device Application.

The consumer can custom set these by feeding in their medical history over time, so as to get more accurate results in the diagnosis. The customer can also link their particular pain or injury conditions so as to have access to product information, self-care programs and goal oriented methods in improving the triggers or causes of their condition as well as be sent relevant and current information pertaining to their conditions and the products around it.

The website and application will link up to pharmacies close by so as to check the availability of a product with the ability to place an order for pick-up directly. The website and App will also connect the consumer with relevant health communities, another growing trend in this sector.

(Image Source: www.sites.tufts.edu)

Poorvi Das

Finally, in keeping with the responsibility towards society and the environment, the website and application will provide information about programs related to the recycling of braces and supports as well as information on drop-off points for the same.

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CONCLUSION As more and more people obtain health information from the web, as a basis of making decisions, the internet is becoming an influential force in reshaping the health care industry into a consumer driven collaboration between patient and provider.

With the advantages of up to date information and great connectivity, it provides an important opportunity for patients to become actively engaged in their own care. A website and Application enabling consumers to better understand, monitor and care for their condition through the use of appropriate products as well as other treatments has the potential to excel in this rapidly transitioning scenario.

(Image Source: www.vanityfair.com)

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The addition of a kiosk will transfer access to foot care in a pharmacy or other environment, making it available to all.

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

PROJECT D: REALIZATION PART 1 - Enterprise Model

(Image Source: www.easyvectors.com)

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INTRODUCTION The initial processes of Analysis, Syntheses and Exploration resulted in the identification of interesting trends as well as gaps.

Guided by my findings I worked on a design plan for a new idea for braces and supports, defined by a set of nested value propositions.

The purpose of this new design is to guide and inform a consumer about their foot condition and the selection of an appropriate product. Additionally, it provides relevant tips on self care remedies and community support. The new design also supports recycling by publicizing the efforts of organizations that recycle braces and incorporating collection mechanisms towards this cause.

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Interactive touchscreen kiosks, a website and smart device application are the primary ways in which this information is available to the consumer. They improve the way the new consumer accesses healthcare, by providing key benefits like ease of accessibility, convenience, speed and readily available advice, up to date information, self care support, product guidance and ease of purchase. The addition of a kiosk to a pharmacy or other suitable environment will make this information accessible to everyone.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

ENTERPRISE MODEL Building a knowledge pool is one of the key functions of the enterprise. It is also where the process begins. Information is collected and analyzed in relation to the Condition, Product, Self Care remedy, Recycling and other related areas. This is carried out by a group of medical professionals and information gatherers as part of the Research and Analysis function.

After careful research and analysis the information is filtered and sent for Content Creation and Development. This team comprises of Medical Professionals or advisors, writers and editors, Designers and IT professionals. On receiving the information from the Research and Analysis team, the Content Development team reviews the information and develops it creatively with a focus on making it user friendly.

Content is developed for the Kiosk, Website and App. interfaces. The Design team along with IT professionals work on communicating the content in the best way possible through designing store appropriate kiosks, building the brand and creating a great interface that makes it easy for the consumer to use and enjoy the product.

Poorvi Das

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house the kiosks as well as collaborates with therapy related services in the area. The Design team supports the Marketing teams efforts by strengthening the brand image and relevant details around it.

This phase is also crucial for gathering feedback from the consumer, through surveys and analytics, about acceptability of the product, it’s strengths and weaknesses, which once again go back to the cycle of research and analysis and is filtered through in the form of an up-gradation or new feature.

The website and Application is also set to gather feedback by surveys from the user as well as tracking the features users prefer, ignore, etc. This too goes back to the research and analysis team and is filtered down for improvement.

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SCAD, Summer 2014

ORGANIZATIONAL CHART The main departments are Technology & Operations, Medical, Design, Marketing, Finance, HR and Legal. They all participate in the functions carried out by the organization.

The Medical Department carries out the research and analysis function primarily. The design team can be a part of this to have an earlier understanding of trends and decipher the problem areas from it, which could become design solutions eventually. The Marketing and Operation Teams give feedback based on their experiences in the field, vis a vis the product and trend.

The IT, Medical and Design team work collaboratively towards the development of content. The Medical team is the advisor for the content, the design team is the creative spirit. Along with the IT department, the Design team works towards effectively communicating the researched content to the end user through the Kiosk, website and Application. The Design team is also crucial in the kiosk design here.

Organizational Chart

Poorvi Das

In the dispersal phase, The Design team is key in managing the brand appeal as well as user interface. The Marketing team ties up with appropriate locations best suited for the kiosk. It also communicates with therapy centers in the area for possibilities of collaboration. The IT and operations team 135

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overlook the proper functioning of the products, addressing issues of up-gradation and troubleshooting as and when they arise.

The Enterprise is pro recycling. It assists organizations, which collect and send braces to developing countries, by publicizing their efforts and providing collection bins for consumers to donate their brace. In collaboration with the pharmacies which house the kiosks, the enterprise provides shipping labels for the bin to be directly shipped to the recycling organization.

The finance department raises invoices, makes payments for procurements and manages the accounts receivables for the enterprise. It also deals with taxation and ensuring the enterprise is compliant with all financial regulations The HR department takes care of people related issues, is responsible for creating an environment which is conducive to productivity and creates incentives which attract and retain talent required to grow and sustain the company Since the company is in the healthcare field it will be subject to a lot regulation making the legal department one of the most important. The legal department will provide disclaimers to ensure that the company is not under litigation from misuse of information provided through them. It will also whet the content before it is published to ensure that it complies with all the rules and can be legally defended in case of litigation.

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

PROJECT D: REALIZATION PART 2 - Realization Proposal

(Image Source: www.corefocuswellness.com)

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INTRODUCTION The aim of the project was to develop a design plan, based on a set of nested value propositions for a new brand that will change the way people think about a commodity product they care little about. I selected Braces and Supports as my commodity product for the project.

Depending upon the medical problem that needs to be addressed, braces and supports cover a variety of devices, which range from edema and compression stockings for diabetes to heavy duty braces for post operative recuperation.

Operative braces and complex supportive solutions are prescription products, while non-operative braces are nonprescription items and available over the counter.

While I looked into a wider scope of prescription and non prescription braces and supports in the initial phase of my research, I later narrowed my focus to braces and supports that are sold over the shelf in Pharmacies, having identified interesting trends and intriguing gaps.

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Prof. Mariah Hay

SCAD, Summer 2014

THE SOLUTION My final solution aims to to guide and inform a consumer about their foot condition and the selection of an appropriate product. Additionally, it provides relevant tips on self care remedies and community support. The new design also supports recycling by publicizing the efforts of organizations that recycle braces and incorporating collection mechanisms towards this cause.

Interactive touchscreen kiosks, a website and smart device application are the primary ways in which this information is available to the consumer. They improve the way the new consumer accesses foot healthcare, by providing key benefits like ease of accessibility, convenience, speed and readily available advice.

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PROCESS OF ARRIVING AT THE SOLUTION During my research, I came across two consumers visiting the pharmacy to self treat a similar foot condition. They were both looking for a solution for pain in the heel and had self diagnosed it to be plantar fasciitis. Both consumers had been advised by friends or had done their own research. Still, it took them a while to look over the available options at the pharmacy and select a product. In the process of talking to them, I suggested some home remedies like using ice in the pain area, rolling their foot on a golf ball and exercises they could research on the internet. I found that they were happily surprised by my frankness and grateful for the advice. This experience guided my project in many ways.

I came across a growing trend towards self-care with people diagnosing and looking for solutions to their foot conditions themselves.

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The new empowered consumer, informed by the internet amongst other sources, is willing to address conditions such as Plantar Fasciitis, Overuse injury, compression therapy and heel pain by directly visiting the pharmacy as compared to long wait times at clinics or other health facilities. This has been supported by the availability of long-established products as well as new, effective products to ‘over the shelf’ product range.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Pharmacies become an important player in this consumer driven transition, being visited directly in search of healthcare products to solve researched conditions. However, in the background of this swiftly growing trend, one finds very few, if any mechanisms that support this.

For instance, pharmacists are better equipped for drug related queries while some nurse practitioners in the pharmacy address simpler health problems like a flu or fever. This leaves the consumer to rely on the sales representative for advice on a suitable product for their foot problem. While experienced and interested sale representatives are able to guide a consumer to some extent, a greater probability is of the consumer being left alone to make a decision.

(Image Source: www.kdhnews.com)

Another hindrance I found was the dilemma of choice!

Consumer reports and research concludes that when faced with so much choice, consumers get demotivated or overwhelmed and leave the purchase for later, if at all.

I also assumed, that a consumer feels a lack of confidence to some extent, in selecting a product for the first time.

The absence of guidance by a medical practioner coupled with the uncertainty from inexperience creates a doubt in the consumer’s mind of “will it work?� This too adds to a consumer leaving the store without a purchase or one, with which he might not be satisfied.

The reaction of surprise and gratitude by the two consumers

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visiting the pharmacy, when given advice related to their

condition, also left an impression in my mind and I decided to address it.

Following this experience, I created a journey map of the consumer who has decided to self treat their pain condition instead of visiting the doctor. This helped me break down the steps in the process and reach the resulting questions of what confused the patient and what convinced him. Interestingly, addressing these questions also made me see how a confusing scenario could be transformed into a convincing one.

(Image Source: www.celesio.com)

On the basis of this, I was able to define my Mystery question for the knowledge funnel and formulate a set of nested value propositions that I aimed to incorporate in my new design.

I also thought of testing Moore’s Sample Scenario exercise, mentioned in Crossing the Chasm, on one of my Personas, Denise Rosenthal. Undertaking this exercise magically revealed fantastic solutions based on intuition and the research carried out so far and was the main breakthrough towards my final solution.

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

KEY POINTS OF RESEARCH As part of my secondary research, I found that geographically, the foot and ankle devices market is segmented into four regions, with North America being the largest. However, emerging global trends are expected to impact the sustainability of manufacturers and suppliers across the United States.

There are a number of factors driving the growth of this market, many of which are contradictory in nature.

Image Source: www.1-800homeopathy.com)

(Image Source: www.stairlifts-stair-lifts. com)

Poorvi Das

(Image Source: www.usatoday30.usatoday. com)

One finds that now, people are more conscious about staying fit and there is an incline in physical activity as a means of disease prevention. This has also led to a substantial rise in cases of overuse injuries (like plantar faciitis, tendonitis, etc) caused due to exercise and sporting activities, especially running.

Simultaneously, there is an alarming rise in conditions like obesity, diabetes, osteoporosis, arthritis and other vascular diseases which often impact the lower portion of the body, especially the limbs and particularly the feet. The “baby boomer� generation is quickly becoming a big part of this demographic, which is expected to grow in the coming years.

This aging population predicts an increase in the number of cases of vascular diseases, diabetes, fractures and joint instability.

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One also finds that people today, are better informed and prefer to manage their own health. Often products are used as precautionary or performance enhancing measures and users are particular about comfort and functionality. One finds growing options in off the shelf products, the use of which is expected to negatively impact the sales of custom-molded braces.

Improving technology and product innovations with a focus in developing cost-conscious treatment methods (so as to make it viable), interest and excite the user, driving revenue growth through higher prices and market expansion. E-commerce and on-line sales provide alternative purchasing venues, enhancing the manufacturers exposure.

My primary research revealed a few scenarios which depict the interaction flow between people and services. I found that in the case of prescription braces, there are a number of people associated with the purchase of the brace. These include the patient, the doctor, the medical insurance provider, and the Durable Medical Equipment provider or manufacturer.

In non-prescription braces, people associated with the purchase of the brace are fewer including the patient, the seller (mostly pharmacy or shops selling the product) and sometimes the doctor.

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During my process of research, I was also very interested in knowing about what happens to braces when they have Poorvi Das

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SCAD, Summer 2014

served their purpose. Most orthotic providers informed me that it is illegal to recycle braces in America and used braces and prosthetics are sent to ‘third-world countries’. This was a relatively new practice they had adopted (one provider had begun doing this three years ago) and most were completely unfamiliar about the organizations that these braces are sent to to forward to developing countries. Some patients were open to the idea of recycling and mentioned returning products to the doctor. However, there was very little visible information about recycling of the product. One patient informed me that they save their braces incase it is needed again.

(Image Source: www.embracedatlanta.org)

(Image Source: www.embracedatlanta.org)

Poorvi Das

(Image Source: operationrainbow. org)

This hit me as a gap that existed. Of the big companies I could only find Stryker mentioning the ‘reprocessing’ and ‘remanufacturing’ approach towards sustainability. I did however, find a few smaller ‘not for profit’ organizations like Operation Rainbow and EmBraced addressing this issue and working towards collecting and distributing used products to people in need in developing countries. Of these EmBraced also tries to provide products to people without means, but in need in Atlanta. I believe, in the time we live, recycling and sustainability are subjects one cannot afford to ignore.

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‘A-HA’ MOMENTS I really enjoyed exploring over the shelf braces during the visual audit. I visited a couple of pharmacies to scan their brace and supports aisle, with the intention of dissecting the visual vocabulary of the packages. Meeting two consumers at the store, I realized that, sometimes knowledge of a brand takes precedence over a product, while at other times, the lack of loyalty towards a particular brand, gives the product a chance to win the consumer over by appeal or mind-reading their questions and concerns.

The ACE & Futuro brands of braces, belonging to 3M, got me very curious. At two pharmacies I saw these products being sold exclusively. I also found that their packaging was very smart, used bright colors and clearly mentioned the problem area with a crisp visual of the product and how it is used.

At one pharmacy, I also found a reference product guide for the ACE & Futuro brands, designed to help the consumer choose their product. It was well designed with pages divided according to problem area and suggested product solution.

Positive images and wordings conveyed a sense of pleasure and comfort.

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I was impressed by the company’s approach of instilling a sense of understanding and confidence in the consumer.

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

(Image Source: www.futuro-usa.com)

(Image Source: www.killerstartups.com & www.prreach.com)

(Image Source: www.braceshop.com)

Poorvi Das

Understanding, that pain in a part of the body restricts you from activities and brings a sense of deprivation as well as negative emotion of not feeling great or your best self.

And confidence by the use of positive and encouraging images and wordings on the guide. I found that the brand kept their message consistent across all platforms of video advertisements and website, signifying the commitment of the brand towards a consumers health and well being, thereby winning their confidence.

Another interesting service I came across as part of my research was a food vending machine called ‘h.u.m.a.n.’ This is a fantastic concept in healthy food options, contrary to what one expects in regular vending machines. It reminded me of my persona, Ray Johnson who is unable to make healthy food choices, despite being diabetic. I wondered, with the addition of a few options for people with diabetes and other chronic illnesses, they would have access to the right kind of food.

This advertisement by Ossur, was another clever idea I came across. Here, Ossur has shown three stages of healing with the use of three Ossur products.

Some of the other ‘a-ha’ moments I had were when a hunch during Primary Research was confirmed by articles and reports during Secondary Research. For example, I came across many interesting articles about the Dilemma or Paradox of choice and some great videos on TED by Sheena Iyengar

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and Barry Schwartz. I also chanced across this captivating info-graphic by ‘Help Remedies’ about the number of options one finds in the pharmacy for a headache and the interesting way in which the start-up approached this problem.

(Image Source: www.fastcodedesign.com)

(Image Source: www.lovelypackage.com)

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Yet another ‘a-ha’ moment was when I went chasing the observation of consumers preference to self-treat their conditions. I was met by many articles that confirmed that the self-care health market has become one of the fastest growing segments of our economy, with this trend rapidly gaining momentum and being termed the Health Care Revolution or the transition from the ‘Old’ to the ‘New Health Care System’.

A result of improved educational levels and greater access to information, combined with increased individual interest in personal health has led people to have a better understanding of their conditions, giving them the option of considering this approach.

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

THE JOURNEY BEHIND THE SOLUTION The project went through a journey of many steps which resulted in the solution. After selecting the commodity product the process began with Analysis, a phase of intensive Secondary and Primary Research. It also included aVisual Audit of advertisements, point-of-sale materials and video stills of key brands to better understand the marketing messages. The analysis phase culminated in the creation of three Personas.

Next, in the Synthesis phase, all the information gathered in the Analysis was put up on a working wall, which helped connect the dots, pinpoint the gaps and have a sense of the direction further. It led to defining a wicked problem that needs a design solution.

In the Reframing phase, the wicked problem or mystery question was further refined and a set of nested value propositions were formulated.

The wicked problem was then reframed by looking at different approaches towards a solution.

In the Artifactual Model of the Exploration Phase, the final solution to the wicked problem got better defined.

Poorvi Das

The Enterprise Model in the Realization Phase suggested how the design would be implemented in an organization, with the collaboration of different departments and expertise, that would come together to make it function and generate business.

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THE FINAL SOLUTION

+

KIOSK (Image Source: www.cebit.de)

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The final solution for a new design plan, that will change the way people think about over the shelf braces and supports, is an organization committed to providing medically backed, timely and credible information, to guide and inform a consumer about their foot condition and selection of an appropriate product. Additionally it provides self care remedies through reference materials on relevant subjects, support and services, as well as goal oriented tools to improve the triggers and causes of the condition leading to the foot problem. The organization also supports recycling and to that extent, assists Non Profit Organization’s by publicizing their efforts and having a collection mechanism for brace recycling.

+ WEBSITES (Image Source: www. downloadclipart.net)

Kiosks in pharmacies and websites as well as smart device applications are the mediums of translating this to the consumer.

APPLICATIONS (Image Source: www.sites.tufts.edu)

The Kiosk, placed close to the product aisle in the pharmacy, can be used by the consumer to browse through the store’s full range of products as well as provide guidance on the selection of a relevant product through knowledge of the diagnosis. Incase the patient is not certain of his diagnosis, he could use the kiosk to get a better idea of his condition by entering information about his symptoms, triggers and other

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

relevant details. Sophisticated versions of the kiosk have a touch sensitive foot model for the consumer to indicate the problem area better, similar to how one would tell the podiatrist. Some kiosks also have a mat or scanner to check foot arch related conditions.

A barcode scanner and credit/debit card reader enable the consumer to purchase a product directly from the store or select from the wider range online.

The kiosk is also an information hub for consumers to find out more about their foot condition and provides self-care options including the ability to print self-care remedies and information on related services and support communities.

The Kiosk provides information and incentives for recycling braces and has a little collection box for consumers who would like to recycle their brace.

The kiosk will be especially useful for people who do not have access to the internet, a smart device or a doctor. Infact, one can consider the placement of the kiosk in other accessible locations in addition to pharmacies. The kiosk could direct the consumer to available products in the pharmacies close by, could include a vending machine or give the option of purchasing online.

(Images Sources: www.clipartguide.com, www.footdearch.com, www.cdc.gov, www. andrusmorgan.co, www.williamlevybuzz.blogspot.com, www.cebit.de, www.vectors4all.net, www.etc.usf.edu, www.illustrationsof.com)

Poorvi Das

The website and smart device application will have features parallel to the kiosk, with the possibility of customization.

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The consumer can create a medical profile by feeding in their medical history over time, so as to get more accurate results in the diagnosis when required. With the ability to link their particular pain or injury conditions, they will have access to product information, self-care programs and goal oriented methods in improving the triggers or causes of their condition.

The website and application will link up to pharmacies close by so as to check the availability of a product with the ability to place an order for pick-up directly. The website and App will also connect the consumer with relevant health communities, another growing trend in this sector.

Finally, in keeping with the responsibility towards society and the environment, the website and application will provide information about programs related to the recycling of braces and supports as well as information on drop-off points for the same.

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CONCLUSION: THE POTENTIAL OF THE SOLUTION As more and more people obtain health information from the web, as a basis of making decisions, the internet is becoming an influential force in reshaping the health care industry into a consumer driven collaboration between patient and provider. With the advantages of up to date information and great connectivity, it provides an important opportunity for patients to become actively engaged in their own care.

The solution will improve the way the new consumer accesses healthcare.The key benefits of such a solution will be convenience, speed, readily available advice and a wider choice of products. Up to date and easy to access information along-with automatically updated and engaging content will create a seamless and interactive experience, in-store or at home.

The inclusion of a kiosk will transfer access to foot care in a pharmacy or other environment, making it available to all. While this solution will require an initial investment and subsequent up gradation and revision of content, it will eventually save the cost of labor, employee time, improve the utilization of employees and often assist them in making sales. It will also attract new consumers to the pharmacy.

(Image Source: www.vanityfair.com)

Poorvi Das

A Website and Application enabling consumers to better understand, monitor and care for their condition has the potential to excel in this age of digitalization that is rapidly transforming the Health Care scenario.

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REFERENCES • ‘Creating the Perfect Design Brief: How to Manage Design for Strategic Advantage’, by Peter L. Phillips.

• ‘Internet Based Patient Self-Care: The Next Generation of Healthcare Delivery’ (www.ncbi.nim.nih.gov)

• ‘Wicked Problems in Design Thinking’, by Richard Buchanan.

• ‘Self-Care: The Growing Trend Toward Self-Responsibility for Health: Part 1 (www.healthy.net)

• ‘Crossing the Chasm’, by Geoffrey Moore.

• ‘The Role of the Pharmacist in Self-Care and SelfMedication’ (www.apps.who.int)

• ‘The Design of Business’, by Roger Martin.

• Evidence: Helping People Help Themselves. A review of the evidence considering whether it is worthwhile to support self-management; • Sheena Iyengar: How to make choosing easier (www.TED. com) • ‘Help Remedies’ (www.helpineedhelp.com) • Protouch Kiosks for Lloyds Pharmacy (www.protouch. co.uk) • ‘Consumer Reports: Supermarket Choice Overload’ (www. archive.9news.com) • ‘10 Megatrends shaping healthcare’s next 10 years’ (www. lexology.com) 154

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Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

ACKNOWLEDGEMENTS A Special Thanks to, • Prof. Mariah Hay for her guidance, encouragement and being available to answer my queries always. I have enjoyed doing this project thoroughly because of it; • My peers for their valuable feedback and support; • Timothy, Cynthia, Allison, Daniel and Rose for their patience and willingness to answer my questions about their foot problems; • Dan of DeLaTorre Orthotics for giving me many minutes of his lunch hour to answer my questions in detail which really helped me understand more about my subject; • Union, Hanger and DeLa Torre Orthotics; • Dr. Hanika Gupta for answering medical queries related to the project; • The Monroeville Public Library; and • last but not least, • My family, who has supported me through my project, whether it being my two year old being OK about mummy being gone for the whole day to school (aka the library), my five year old patiently waiting to get her first pet, a fish, once mummy finishes her quarter, my parents in law visiting from India who have taken over house and children responsibilities comepletely in my absence and my sweet husband who helps me understand the ‘Management’ bit of things when I just don’t get it!

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APPENDIX

156

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

157

158

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

Poorvi Das

Applied Theory in Design - SDES 704

Prof. Mariah Hay

SCAD, Summer 2014

159