Improving the lives of people with intimate healthcare needs

About the projects

Reflections of my experiences working at Coloplast
Type of work: Design research and some aspects of service design
Date: August 2016 – present
Extent of the projects: From 6 months to several years, full-time

If you came here to see an example of an actual project, I'm afraid I have to disappoint you as that's not what you'll find here. This is somewhat of a different animal. The truth is that I cannot really say much about what I am and have been working on at Coloplast. I often joke that 'although medtech isn't quite as bad as pharma, I'm NDA'ed up to my neck rather than my ears'. So, instead of showing you what I've been working on, I've decided to share some reflections about what it's like working at Coloplast and what I've learned.

Please note that these are highly personal reflections and based on my own personal experiences.

The life of a design researcher

Coloplast’s business encompasses stoma care, continence care, wound care, and urology care. I work as part of a User Research (or User Insight if you prefer the correct legacy term) team, and we are the user advocates within innovation projects. We bring different backgrounds to this work, but have all started out in design in some way, e.g. industrial design, design research, or design engineering. For now, though, I’m the only service designer in the team. I'm also the only one from our team who work within our intermittent self-catheterisation business — and that's about as much as I can say about the actual work.

One of the stories I love to give, which I think summarises some aspects of our day-to-day work very well, is the one about airport security. It's the story of me flying home from Chicago after a long research trip. I'm exhausted and keen to get on that plane and fall asleep. But, as it so often goes, I get pulled aside at the airport security by a stern-looking, buff guy. He asks if he can go through my luggage, to which I of course reply: 'Sure! But... Just to warn you in advance; I work for a company developing urinary catheters and you will find some models of the lower body parts in there' (and to make sure he got it, I also provided him with a visual hint as to what I was talking about). He didn't seem very impressed and simply muttered: 'Nothing I haven't seen before'. Judging by his facial expression when he did get to the models, well, let's just say he was wrong. He didn't say a word after that and was stuck with a bewildered, mystified, and part-scared, part-intrigued look on his face. Once he'd wiped everything as he needed to, found that I carried nothing dangerous, and had repacked my suitcase, I could hear him murmur one last sentence to himself: 'My colleagues won't believe this...' I laughed to myself. I think it's fair to say that I understand why Coloplast is a Danish company and not a British one; most Brits really wouldn't know how to act around these matters.

Not too long ago, one of my colleagues working on a male-specific innovation project was joking that back in the day, his primary school teacher had told him that he wouldn't grow to become of anything if he kept drawing penises in his books. And as he says, while laughing to himself; 'look at me now!' Yes, you can quite easily become culturally conditioned to think that the lower body parts are normal inventory in office environments and that pee and poo are normal lunch conversation topics. As researcher and designer, though, I am constantly reminded and have to constantly remind myself that the world isn't so.

But it's not all fun and play — and rightfully so. Myself and my colleagues may well be used to it, but lots of people we meet certainly aren't. To many, suffering from urinary problems or having a stoma is embarrassing and taboo and something they might not talk about with anyone. I truly wish it wasn't so, but that I cannot change on my own. Having these difficult conversations about taboo-ridden topics is far from easy and it's my job to make sure I connect with people so they let me in. The better we understand them and their lives, the better our innovations will become. I truly believe that.

As was once said, 'the problem with market research is that people don't think how they feel, they don't say what they think, and they don't do what they say'. And let's face it — we're all guilty of that. In my line of work, I simply need to ensure we uncover the truths and manage the ambiguity. I sometimes think of us as professional strangers. We cultivate purposeful curiosity and use this to drive the business forward.

User Research tools Research process

Our research process from setting it up all the way to leveraging what we learned.

Our User Research team's efforts in 2018

We've been busy in 2018. This is our collective team efforts in User Research.

Synthesis Journeymapping

One of the many journey maps; this one on a zoomed-in product level (blurred text and illustrations removed - sorry!)

Our genital models

The challenges I meet

I was hired for my service design skills, although admittedly I use only a portion of that skillset: That which relates to the early phases. I’ve strategically started introducing myself as a user researcher with a service design background, but most people still don’t understand what I’m saying. That being said, I have met a few kindred spirits, who understand or have heard of service design, but this is still highly uncommon.
“Design” to most people in Coloplast today still means industrial design — and to most people only CMF or beautification: Changing the looks of the physical product. I think that’s a problem and something we’re working on changing, both for the design team (yes, that means product design only!) but also for us in User Research. I'm not a product designer nor have I any aspirations to become one, and I've come to realise that my mind is wired in a different way - or rather, it's been trained to think very differently about solutions, namely through intangibles such as systems and experiences. Occassionally, it's somewhat frustrating that none of that is recognised as design and we're stuck with a very outdated notion of what design is.

Working in such a product-focused company can be a challenge for a service designer. Within my first months of being at Coloplast I was extremely surprised to find that some people would still utter sentences such as 'but we're a manufacturing company!' when clearly we have grown to be more than just that. In some ways, Coloplast is pretty unique, especially for a medtech company: It’s rather expensive to fly us all over the world to talk to users, and a company really needs to believe in the value we bring to spend that money, and then take note. And we all know that proper research from the field can kill a ‘sacred cow’ project. But Coloplast does listen if you carefully craft your communication right. However, occasionally when the research shows that we need to ‘think services’, we come up against this ‘product-first mindset’.

And then there are the gatekeepers... At Coloplast, we are in a somewhat unique situation with what I’d refer to as gatekeepers. If you imagine a "delivery" line between us and our end-users, there are two main gatekeepers on that way: The first one is the reimbursable healthcare system, or the payors, as we like to call them. The payors effectively decide what products will be available for the healthcare professionals to prescribe. This leads us nicely into the other gatekeeper: The healthcare professionals, who — as well as also being users of our products to some extent — additionally are gatekeepers for the end-users as they need to prescribe the products in order for the end-user to get them.
Without going into detail, it’s fair to say that the reimbursement system and the way it's set up is one of the biggest showstoppers we encounter. This reimbursement system and their categories force us to think in line with specific, existing products — not about the experience we wish to bring the users. This can be a huge challenge and kill some otherwise really innovative ideas. Something we try to constantly ask ourselves is how we ensure the best user experience regardless of gatekeepers. Unfortunately, this isn't something we have the full answer to yet.
Last year, when I was speaking at the Service Design Fringe in London about our work, someone asked me if I thought the reimbursement system needed redesigning. YES is the answer to that question. Please let me know if you ever do.

Oh yes, and touchpoints don't mean touchpoints in Coloplast. The abstraction level of this word didn't quite reach that of service designers. Here, touchpoints refer to places where you quite literally touch the physical product.

These are merely a couple of thoughts that I'm able to share with you. There are plenty more where it came from, but I'm afraid some of our challenges are also confidential. For a little bit more information, please keep an eye out for the Design On the Inside podcast that Sarah Drummond from Snook will be releasing soon.