Article Focus:

• Older physicians and patients drive medtech design changes
• GUIs and PUIs present opportunities
• FDA focuses on usability

Every day10,000 professional caregivers, patients, and future patients—in other words, the general population—turn 65. This will continue for the next 19 years, meaning in just two decade’s 72 million Americans will be 65 or older¹.

As of this year the American Medical Association (AMA) reports 63% of all physicians are aged 45 years and older, with 20.7% of that group already aged 65 or older². Additionally research shows that “older” (50 years or more) registered nurses are on the rise and comprised 44.7% of the total RN population in 2008, compared with 41.1% in 2004 and 33.4% in 2000. Further the percent of RNs, 60 years old or more, increased 1.9% between the years 2004 and 2008³.

No other industry will be impacted as greatly by our aging population than healthcare. Medtech companies designing everything from surgical equipment to in-home monitoring devices must consider this population segment as they develop devices of the future.

The challenge for medical device designers is clear: create tools and devices that accommodate evolving physical and cognitive abilities while developing a deeper understanding of older user needs. Within this challenge there are competitive opportunities to be mined and better products to be created.

While age-related changes such as worsening eyesight are obvious, others are not. And it is to the provider’s and patient's benefit to mitigate the negative effects while retaining the positive. Coupling the diminishing physiological faculties shown in "Older RN" illustration with a keen understanding of the clinical environment and intended use of a device offers designers a great opportunity to create safer, more intuitive devices.

Graphical user interfaces (GUIs), which are among the worst design offenders for aging caregivers, and product user interfaces (PUIs), which could be the buttons, knobs, handles, and levers that need to be touched to operate a device, are great opportunities for designers to improve upon.

When it comes to GUIs, users desire a simple and relevant interface that controls or displays the states of use. However, current devices and software architecture often focus on the technology or technological advances rather than user needs. Nurses programming IV infusion pumps having to grab for their reading glasses while making inputs because the fonts are too small or not displayed brightly enough for the use environment is one result of such ill-conceived designs.

For clinicians having to deal with terminology that varies from device to device, the need to read information accurately and quickly is critical as is the need for the de-cluttering of information available at any one time on the screen.

And we've learned through our research the importance of intuitive task flow. For example, nurses working on infusion pumps find it disorienting to have a single programming screen and be expected to program multiple parameters. Instead, they want each task to have its own distinct screen in a step-by-step manner so they feel confident they are methodically going through the process.

This intuitive task flow is as critical, if not more, for in-home devices. Such devices will be used by patients and untrained caregivers. With the FDA focusing much attention on device safety for at-home use, it is more important than ever to develop products that address this segment's specific needs.

Key elements to consider when designing a GUI for older users

• Readability should be considered within the use environments
• Appropriate terminology should be used versus technology-based language
• Device must be parsed for cognition and simplicity
• Higher contrast is appropriate of displays and inputs particularly in low light settings
• Familiar pictographs and clear text messaging aids cognition
• Intuitive navigation through the operation of a device is critical
• Feedback when selected settings have been implemented (such as bolding of function label) must be clearly understood
• Prioritizing information on screens based on criticality is critical