Innovation for Business Growth

As an engineer, I was trained to understand a problem, classify it, break it down, and then solve it. I did this over and over, and over again on a variety of different problems in Statics, Dynamics, Machine Design, Thermodynamics, Control Systems, and Fluid Dynamics. Some of the times, I even solved the problem correctly.

This training became even more valuable working in Product Design, except the problems were different, and what I needed to understand and breakdown weren’t engineering problems, but a combination of technology and human behavior issues that sometimes seemed related, and sometimes did not. Rather than a pure engineering problem and solution, I now faced a complex juxtaposition of unknown variables where the solution set was unknown and could be solved in a variety of ways. Welcome to product design- where many companies can acquire the same information (consumer data, etc), but classify, analyze, and come up with different solutions- some wildly successful, and some not.   

Take the case of the Swiffer floor cleaning system. A product concept developed at Design Continuum, my alma matter from 1985-2007. Continuum too had a process to classify and breakdown a complex problem in order to create a solution. During the Swiffer project (“to reinvent floor cleaning”), we looked at all 125+ steps it takes to clean a floor using a mop and bucket. Using this approach, we developed a radically new concept in floor cleaning. The concept of the Swiffer floor cleaner was no accident- we used a well-defined process executed by some very bright and diverse people who know how to solve complex problems in a unique way. The most amazing thing about Swiffer was that people had been looking at this same problem for years, and we were the first to radically change the paradigm!   

What I didn’t realize was that this thoughtful approach learned in engineering school could be applied not only strict engineering problems, not only product design problems, but to the design of a new business.    

When I founded National Sleep Therap, a durable medical equipment company providing CPAP machines to people diagnosed with sleep apnea, I created a business model that was unlike most other companies already in the marketplace. The traditional mission of a CPAP supply company was- “how do we get more doctors referrals and sell more CPAP machines.” This seemed an obvious approach for a new business- how do we get more customers and sell more stuff.  While this is the ultimate goal, our mission was different- our primary mission was to raise the compliance level of our patients and make it easier for doctors to care for these patients. Take better care of the patient first, and our business would grow as a result. Customer first, business second. At least this was the theory. Not only did we prove it to be correct, the company quickly grew to become one of the leading CPAP companies in our region nearly overnight.  

Based on this fundamental [patient-first] vision, we designed the business model to match. Our business model was completely different than other, more established companies that had been in the business for 20 years or more. Other companies drove all over the region and visited doctors begging for more referrals, while we developed deeper strategic partnerships with doctors and hospitals so we could provide exceptional patient care and streamline their paperwork process. 

After the initial “sale”, patients of these other companies never heard from them again, but they heard from us a lot. We became their partners, not just their CPAP supplier. And just like we did for Swiffer, we broke down every step “in the life of a patient” looking not only at the mechanics of the process, but the emotional state of the patient at each step. We defined how we wanted the patient to feel at each point along their healthcare journey and designed the business model and all the patient touchpoints to enable it. Every call, every email, every form, every word, every image, every everything was considered and designed to create the patient experience we wanted.   

We executed this radical business model by designing every touchpoint of our company- from the literature, website, language, vocabulary, to the way we ran phone-based CPAP support groups each month. Everything we did was carefully designed and orchestrated to build a consistent message of trust, support, and helping our patients live better…and making it significantly easier for the doctors to manage their patients. Unlike most other companies providing CPAP and chasing referrals, we were a partner to the patients and physicians making both their lives easier, not more complicated.   

When reimbursements went down, our services went up. When others cut costs, we invested. Our business model was designed to engage patients and help them achieve better success with their CPAP therapy. Whereas the national average is about 50%, our patients averaged over 80% compliance. This means more people sleeping better, fewer with high blood pressure, and many more well-rested truckers behind the wheel. With more happier patients, who do you think they told. Yup- everyone.   

Engineering school prepares you well for business. It teaches not to assume to know the answer, but to solve for it looking at all the various solution sets. My 23 years in design taught me to always remain open to being surprised. Designing a business is a classic design problem and using some of the same techniques used in engineering and product design can have a major impact on the success of a business.    

About the Author: Eric is a recognized leader in consumer and health technology with more than 30 years of experience developing products that create new consumer experiences using new technologies and healthcare behavior models. His long and successful career in new product innovation and development combined with his first-hand knowledge of patient care and industry-leading patient engagement methods plays a critical role in developing new products and services in the consumer and wellness markets. Eric invented the Reebok Pump, and was instrumental in growing Design Continuum, the largest private design company in the US. He co-founded National Sleep Therapy, one of Fortune magazine’s 5000 most rapidly growing healthcare companies, and Otis Venture partners, a company that brings new product ideas to fruition. His unique approach to healthcare helped his patients achieve a 60% increase in therapeutic compliance vs. the national average. Eric is a competitive cyclist and holds a degree in mechanical engineering. He’s always excited to meet people doing interesting things. You can reach him at ecohen@otisvp.com 617.281.5330

No one can deny that Tom Brady is an exceptional athlete and quarterback. And he works very hard at it. He has a strict diet, he practices his throws, and watches tapes of himself and his teammates to make his motions instinctual. He’s literally, one in a million. If I followed the “Tom Brady” process- ate what he ate, trained like he trained, and did what he did, would I be tied for the best quarterback in the NFL? I don’t think so.

Similarly, having been in product development and innovation for over 30 years, clients often started the conversation with “We want a breakthrough product like the iPhone- something people just can’t live without and are willing to pay a lot for it.” “Sure, when do you want it?” was usually my reply, knowing the difficulty of the challenge. We’ll just follow the magical innovation process and “Voila” out will pop the most innovative product ever! 

I only wish it were that easy.

As I tour the country speaking with many of the country’s best companies, I’ve come to realize there are innovation consultants nearly on every street corner promoting the latest agile, scrummified, and war-room inspired “Innovation process” that will make your organization a more innovative and free-thinking culture. Guaranteed to make everyone in your company a fountain of ideas. The process is as easy as following a recipe from a Martha Stewart cookbook; first, there’s consumer research, then brainstorming, concept testing, iteration (fail early, and fail often!), concept development, more testing, and finally, the easy part- product development. By the end of this process you’re guaranteed to be more innovative! What could be easier? 

Those of us who have been in the innovation trenches know that while a good process is important, it’s the people on the team that make the difference. Time has shown that many of the greatest innovations where a result, not of some formulaic process in isolate, but because of a few highly insightful and intuitive people who are able to see patterns and connections that others just don’t. To see an opportunity where others do not, and using the Tom Brady analogy- to make a touchdown pass no one else could. Innovation does not happen by rote process, rather it happens (and not with 100% certainty) by creating the environment that truly insightful people can, but for a brief moment, wear their special innovators glasses allowing them see patterns and connections others can’t, and with absolute clarity. What they “see” with such clarity may surprise you.

What great innovators see isn’t always the solution or an idea, but a problem- reframed in a way no one else has. Take the development of the Swiffer floor cleaning product line. While at Continuum, I was fortunate enough to witness world-class innovation and in particular, the creation of an entirely new category in a product area that hadn’t changed, well… since the invention of the mop. I watched a team of anthropologists, people with degrees in drama, design and architecture, and engineers watching and observing, and methodically breaking down the process of floor cleaning. Did they immediately start brainstorming ideas? No! Because first, they had to realize what is the problem they were solving. As many had tried before them, they could have watched people clean floors and immediately started brainstorming ways to make the mop better.

But this group of innovators knew better. Instead, they observed, calmed their minds, and let go of any preconceived ideas or expertise. These were not mopping experts, yet. Instead they focused on the root emotion of the task- “How do I clean a floor and do so quickly, and without getting dirty myself?” And from this, a new direction in floor cleaning innovation was born. Woven within the innovation process are a creative bunch who are wired to ask the questions others couldn’t. Wired to see things others didn’t. And the skills to connect the dots and articulate an observation or notion that can drive ideation in a revolutionary new direction. The ability to have these insights and breakthroughs does not come automatically by process, but by highly skilled and insightful people who are inherently wired to reframe problems and create unique solutions. 

While it’s a worthwhile endeavor to help raise the awareness and create an innovation culture within an organization, don’t be fooled that by implementing an innovation process, building a room with crazy colors and beanbag chairs, that your company will magically become more innovative. It might look good on marketing brochures and internal HR posters, but you’ll be better served attracting a core group of real innovators that know just how hard innovation really is, and how both process and unique skills are required to develop your company’s latest and greatest “iPhone.” It’s the Tom Brady’s of innovation, not those crazy beanbag chairs that will get you over the goal line.

About the Author: Eric is a recognized leader in consumer and health technology with more than 30 years of experience developing products that create new consumer experiences using new technologies and healthcare behavior models. His long and successful career in new product innovation and development combined with his first-hand knowledge of patient care and industry-leading patient engagement methods plays a critical role in developing new products and services in the consumer and wellness markets. Eric invented the Reebok Pump, and was instrumental in growing Design Continuum, the largest private design company in the US. He co-founded National Sleep Therapy, one of Fortune magazine’s 5000 most rapidly growing healthcare companies, and Otis Venture partners, a company that brings new product ideas to fruition. His unique approach to healthcare helped his patients achieve a 60% increase in therapeutic compliance vs. the national average. Eric is a competitive cyclist and holds a degree in mechanical engineering. He’s always excited to meet people doing interesting things. You can reach him at ecohen@otisvp.com 617.281.5330

As we all know, Google Glass cracked open the door into augmented and virtual reality in the business, healthcare, and consumer setting.  As the novelty of the Google glass has worn-off, and the product discontinued, what is the current status of the augmented and virtual reality technologies. Both industries are currently in their infancy, with respect to hardware technology, content, usability, and acceptance. Here we will focus on AR and VR in the medical field, with particular focus on its application with medical devices.

As quick background, Augmented (often also called “Mixed”) Reality blends the real-world with computer generated imagery so that the user can see this imagery “overlaid” or super-imposed onto the real-world. In virtual Reality, the user is completed blind to the real world and can only see in their goggles, a fully simulated environment without any visual cues from the real-world.

For the most-part, virtual reality, due to its 100% immersive nature and lack of real-world awareness is currently and primarily used for education, training, and “closed circuit” remote viewing of a surgical procedure.  Medical Realities (http://www.medicalrealities.com), a UK based firm claims the first “Virtual Reality” surgical procedure was performed in 2016. The procedure was nothing more than a surgery with overhead cameras livestreaming to a website whereby users with a cellphone-based VR headset could watch the procedure. 

While novel, this VR experience was simple and did not harness even a fraction of what AR and VR has the potential to do. Other VR companies are creating specific content for education and training that allows students to experience the human body and its anatomy in a totally new and immersive way. Travel down the aorta, watch nerves fire, and see a tumor growing as if you’re a microscopic observer injected inside the human body. For training and educational purposes, VR and its specially designed content seems well poised to add real value for the student learning about medicine for the first time, or for the surgeon training for a new procedure.

For the medical device company looking at AR/VR technologies in the pre-op, intra-op, and post-op environments, Augmented Reality can offer some astounding capabilities to help surgeons improve workflow, reduce radiation exposure, standardize procedures, and hopefully improve patient outcomes as a result of a more accurate and consistent surgical procedure.

Recall that Google glass projected simple information in one eye that appeared to the user as a small computer display about 28 inches away. The information was simple number and letters showing patient data, notes, and perhaps some vital statistics such as heart rate, etc. With the advent of new glass or heads up display technologies, the content and control of the content can be exponentially more complicated and useful than the now simple Google Glass. A few main players have emerged in the “glass” industry, and even so, these are small companies, usually venture funded, and with a sporadic production supply of product. Some of the vendors making AR glasses include:

Osterhouse Design Group (ODG)- US based, sunglass format

Lumus- Israel, light engine can be integrated into various formats

Microsoft Hololens- head mounted, stereo, integrated into a “shield”-like display

Vuzix- US, sunglass format

Meta- US, similar format to the Hololens

The only major company in this list is Microsoft, and its Hololens device is very different than the other players listed. Hololens offers holographic projections located anywhere in space. The others are basically a computer screen located at a fixed focal length. Typically, glasses will consist of one or two light engines that take a computer display signal and create the image seen by the user. Different glasses use different light engine technologies. This primarily impacts the screen resolution, Field of View (FOV), and brightness- the three main attributes that set glasses apart and can make or break a solution. Glasses also embed sensors and outward facing cameras that can not only detect objects, but perceive the position and pose of the user. Inertial Measurement Units (IMU’s) are small devices inside the glass assembly that track the users motion using gyro meters and accelerometers. 

Some systems like the Hololens will have multiple cameras and IMU’s to help improve accuracy. A system that is not very accurate, or that processes the visual and spatial location data slowly will be insufficient in the surgical environment and could potentially cause motion sickness for the user. In the surgical arena, cameras, IMU’s, and computer processing speed must be state-of-the-art and most of the current glass offerings listed above fall short of this requirement. Therefore, some augmentation of technology, specifically in positioning, motion-tracking and CPU is currently necessary to provide sufficient horsepower to these systems for use in the surgical suite. 

As the typical operating room becomes more complex and is host to many new technologies in surgical navigation, imaging, robotics, and other equipment designed to maximize OR efficiency and support a wide variety of procedures, tools that can simplify the actual procedure and help the surgeon perform more complex activities with less training, and less radiation exposure are crucial advancements. Augmented Reality technologies can help us provide these benefits. 

Let’s look at one example:

Scopis is a spinal implant company using a Hololens with reflective markers that can be detected with standard outside-in surgical navigation systems such as the Northern Digital (NDI) Polaris system. The Scopis system uses the Hololens to overlay reference guidance dimensions in graphic form onto the actual patient, giving the surgeon visual guides for more accurate surgical targets for screws and other devices. A video of the system can be found here: https://youtu.be/xvbWE4OsKxY

The Scopis system, for example, shows a surgical procedure that enables:

• Surgeon uses Pre-op planning computer guide tools to define the correct lengths and positions of pedicle screws

• This pre-op plan is rendered into a heads-up-display that will be worn by the surgeon during the procedure. The image is re-rendered based on the pose and location of the surgeons head as seen by the NDI cameras

• During the procedure, the tools used to insert the screws are tracked by the surgical navigation system with a high-level of accuracy

• In the surgeon’s glasses, she can see the pre-op plan reference guides super-imposed on the actual patient, all perfectly registered to the tools, patient, and pre-plan dimensions. These guides, visible only to the surgeon, show her exactly where to place the screw and at what angle and depth.

• The surgeon can now do their work and visually see that everything is being done per the pre-plan dimensions and the final result exactly what they had intended.

In “Minimally Invasive Surgery” (MIS) there is no ability to visual confirm the location of tools and surgical instruments, and the surgeon must rely on camera scopes, or surgical navigation systems. In these MIS scenarios, it is common to take a large number of intra-op scans (x-ray or fluoroscope shots) to ensure the procedure is going according to the pre-op plan. These multiple scans subject the surgeon and staff to very high doses of radiation over time. Reducing exposure is an immediate and pressing goal for all surgical procedures and hospitals. Using the AR system as described, the surgeon can “virtually” see inside the patient and eliminate many of the scans typically performed.

The concept of “registered overlay” is not new, but the technology to enable it is now becoming available. Various research institutions and universities are working on the concept. In the US, the University of Akron has reported that they will have a commercial device in 2019. The main technical hurdle for any solution is the precision for which tool and surgeon tracking can be performed and the speed for with the computation can be done. This computation and positional horsepower is critical because as the surgeon moves, what they see in their glasses must be instantaneously re-rendered for the image to remain perfectly aligned to the patient in 3D. If the surgeon, for example, walks around to the other side of the patient, the image they see must now coincide with their new view. It would be simple if nothing ever moved, but surgeons (and patients) move.

A low latency solution is also critical for any solution to be successful. Those developing such technologies must be proficient not only in motion tacking and predictive algorithms, but software development for computational efficiency and speed. 

As Augmented and mixed reality technologies become more accurate, have higher processing speeds, and can be integrated into more medical procedures, expect the technology to spread into both skeletal and soft tissue applications.

About the Author: Eric is a recognized leader in consumer and health technology with more than 30 years of experience developing products that create new consumer experiences using new technologies and healthcare behavior models. His long and successful career in new product innovation and development combined with his first-hand knowledge of patient care and industry-leading patient engagement methods plays a critical role in developing new products and services in the consumer and wellness markets. Eric invented the Reebok Pump, and was instrumental in growing Design Continuum, the largest private design company in the US. He co-founded National Sleep Therapy, one of Fortune magazine’s 5000 most rapidly growing healthcare companies, and Otis Venture partners, a company that brings new product ideas to fruition. His unique approach to healthcare helped his patients achieve a 60% increase in therapeutic compliance vs. the national average. Eric is a competitive cyclist and holds a degree in mechanical engineering. He’s always excited to meet people doing interesting things. You can reach him at ecohen@otisvp.com 617.281.5330