Design for people not awards Timothy Prestero
I’ve got a great idea it’s gonna change
the world it’s fantastic it’s gonna blow
your mind it’s my beautiful baby here’s
the thing everybody loves a beautiful
baby I mean I was a beautiful baby
here’s me and my dad a couple days after
I was born so in the world of product
design the beautiful babies like the
concept car it’s it’s the knockout you
know you see and you go oh my god I buy
that in a second so so why is it that
this year’s new cars look pretty much
exactly like last year’s new cars what
went wrong between the design studio in
the factory see today I don’t want to
talk about beautiful babies I want to
talk about the awkward adolescence of
design those dorky teenage years where
you’re trying to figure out how the
world works I’m gonna start with an
example from some work that we did on
newborn health so here’s the problem 4
million babies around the world mostly
in developing countries die every year
before their first birthday even before
their first month of life it turns out
half of those kids or about 1.8 million
newborns around the world wouldn’t make
it if you could just keep them warm for
the first three days maybe the first
week so this is a newborn intensive care
unit and kathmandu-nepal all of these
kids and blankets belong in incubators
something like this so this is a donated
Japanese atom incubator that we found in
a NICU in Katmandu this is what we want
probably what happened as a hospital in
Japan upgraded their equipment and
donated their old stuff to to Nepal the
problem is without technicians without
spare parts donations like this very
quickly turn into junk so this seemed
like a problem that we could do
something about I mean keeping a baby
warm for a week that’s not you know
that’s not rocket science so we got
started we partnered with a leading
medical research institution here in
Boston we conducted months of user
research overseas trying to you know
think like designers human centered
design let’s figure out what people want
we killed thousands of post-it notes we
made dozens of prototypes to get to this
so this is the
nurture infant incubator and this has a
lot of smarts built into it and we felt
great so the idea here is unlike the
concept car we want to marry something
beautiful with something that actually
works and our idea is that this design
would inspire manufacturers and other
people of influence to sort of take this
model and run with it here’s the bad
news the only baby ever actually put
inside the neo nurture incubator was
this kid during a Time magazine photo
shoot so you know recognition is
fantastic we want design to get out you
know for people to see it at won lots of
awards but it felt like a booby prize I
mean I we wanted to make beautiful
things that are gonna make the world a
better place that are gonna make the
world a better place and I don’t think
this kid was even in it long enough to
get warm so so it turns out that design
for inspiration it doesn’t doesn’t
really I guess I guess what I would say
is it for us for what I want to do it’s
either too slow or it just doesn’t work
it’s ineffective so really I want to
design for outcomes I don’t want to make
beautiful stuff I want to make the world
a better place so when we were designing
near nursery we paid a lot of attention
to the people who are gonna use this
thing for example poor families rural
doctors overloaded nurses even repair
technicians we thought we had all our
bases covered we’ve done everything
right well it turns out there’s this
whole constellation of people who have
to be involved in a product for it to be
successful manufacturing financing
distribution regulation Michael Free it
passes you have to figure out who will
choose use and pay the dues for a
product like this and I that’s a
question you know VC’s always asked well
sir what is your business and who is
your customer who is our customer well
here’s an example this is a Bangladeshi
hospital director outside his facility
it turns out he doesn’t buy any of his
equipment those decisions are made by
the Ministry of Health or by foreign
donors and it just kind of shows up
similarly here’s a multinational medical
device manufacturer turns out they got a
fish where the fish are so it turns out
that in emerging markets where the fish
are are sort of the emerging middle
class for these countries diseases
effluents heart disease infertility so
turns out that designed for outcomes in
one aspect really means thinking about
design for manufacture and distribution
okay that was an important lesson second
we took that lesson and tried to push it
into our next project so we started by
finding a manufacturing organization
called MTTs in Vietnam that manufactures
newborn care technologies for Southeast
Asia our other partners east-meets-west
this is an American foundation that
distributes that technology to poor
hospitals around that region so we
started with them saying well what do
you want what’s a problem you want to
solve and they said well let’s work on
newborn jaundice so this is another one
of these like mind-boggling global
problems so jaundice affects two-thirds
of newborns around the world of those
newborns one in ten roughly if it’s not
treated the jaundice gets so severe that
it leads to either lifelong disability
or the kids could even die there’s one
way to treat jaundice and that’s what’s
called an exchange transfusion so as you
can imagine that’s expensive and a
little bit dangerous
there is another cure it’s it’s very
technological it’s very complex a little
daunting
you got a shine blue light on the kid
bright blue light on as much of the skin
as you can cover how is this a hard
problem
so so you know I went to MIT you know
okay we’ll figure that out
so here’s an example this is an overhead
phototherapy device that’s designed for
American hospitals and here’s how it’s
supposed to be used so it’s over the
baby illuminating it a signal patient
take it out in American Hospital send it
overseas to a crowded facility an agent
here’s how it’s actually used the
effectiveness of photo therapy is a
function of light intensity so these
dark blue squares show you where it’s
effective phototherapy here’s what it
looks like under actual use so those
kids on the edges aren’t actually
receiving effective phototherapy but
without training without some kind of
light meter how would you know we see
other examples of problems like this so
here’s the neonatal intensive care unit
where moms come in to visit their babies
and keep in mind that mom maybe just had
a c-section okay so that’s already kind
of a bummer mom’s visiting her kid she
sees her baby naked lying under some
blue lights looking kind of vulnerable
it’s not uncommon from mom to put a
blanket over the baby from a photo
therapy standpoint maybe not the best
behavior in fact that sounds kind of
dumb except what we’ve learned is it
there’s no such thing as a dumb user
really is what we’ve learned they’re
only dumb products we have to think like
existentialist it’s not the painting we
would have painted it’s the painting
that we actually paint it’s it’s the use
design for actual use how are people
actually gonna use this so similarly
when we think about our partner MTTs
they’ve made some amazing technologies
for treating newborn illnesses so here’s
an overhead warmer and a CPAP they’re
inexpensive really rugged they’ve
treated 50,000 kids in Vietnam with this
technology but here’s the problem every
doctor in the world every hospital
administrator has seen TV you know curse
those whatever er re-runs turns out they
all know what a medical device is
supposed to look like they want Buck
Rogers they don’t want effective it
sounds crazy it sounds dumb but there
are actually hospitals it would rather
have no equipment than something that
looks cheap and crummy so again if we
want people to trust the device it has
to look trustworthy so thinking about
outcomes turns out appearances matter so
we took all that information together we
tried this time to get it right
and here’s where we developed so this is
the Firefly phototherapy device except
this time we didn’t stop at the concept
car so from the very beginning we
started by talking to manufacturers like
our goal is to make a state-of-the-art
product that our partner MTTs can
actually manufacture so our goal is to
study how they work the resources that
they have access to so that they can
make this product so that’s the design
for manufacture question when we think
about actual use you’ll noticed a
Firefly has a single bassinet it only
fits a single baby and the idea here is
it it’s obvious how you ought to use
this device if you try to put more than
one kid and you’re kind of stacking them
on top of each other so the idea here is
we say you want to make it hard to use
wrong in other words you want to make
the right way to use it the easiest way
to use it another example it’s again
silly mom you know silly mom thinks her
baby looks cold wants to put a blanket
over the baby well that’s why we have
lights above and below the baby and
Firefly so if mom does put a blanket
over the baby still receiving effective
phototherapy from below last story here
i’ve got a friend in india who told me
that you haven’t really tested a piece
of electronic technology for
distribution in in asia until you’ve
trained a cockroach to climb in and pee
on every single little component on the
inside it’s you think it’s funny i had a
laptop in the peace corps and the screen
had all these dead pixels on it and one
day i looked in their all dead ants this
sort of gotten into my laptop and
perished those poor ants
so with firefly what we did is the
problem is electronics get hot and you
have to put in vents or fans to keep
them cool in most products we decided
that okay i can’t put a do not enter
sign next to the vent you know this kind
of thing we actually got rid of all that
stuff so Firefly is totally sealed these
are the kind of lessons I mean as
awkward as it was to be a pretty goofy
teenager much worse to be a frustrated
designer so thinking about okay what I
really want to do is change the world I
have to pay attention to manufacturing
and distribution I have to pay attention
how people are actually going to use a
device I actually have to pay attention
really there’s no excuse for failure I
have to think like an existentialist I
have to accept that there are no dumb
users there’s only dumb products we have
to ask
hard questions are we designing for the
world that we want are we designing for
the world that we have we designing for
the world that’s coming whether we’re
ready or not I got into this business
designing products I’ve since learned
that if you really want to make a
difference in the world you have to
design outcomes and that’s design that
matters thank you