Bridge has been designing user interfaces for medical

products for 20 years, and more recently medical

apps and web-related informatics.

Our work ranges from “consumer medical” products

destined for home use, to surgical devices wielded by

expert specialists. We often design for a wide range

of stakeholders (that may include patients, clinicians,

pharmacists, technicians, family caregivers...) and are

skilled at uncovering their needs.

We are driven to put technology within reach of users,

whether they are newly diagnosed patients or skilled

professionals, to help knock down barriers to better

care and outcomes.

IRay® Treatment UI

Patient setup on the IRay® system requires a trained technician to perform many steps ensuring precise alignment for treatment. Bridge worked with Oraya to design a user interface that balances procedural guidance with key treatment feedback, maximizing comprehension and ease of use. By defining key steps and grouping information intuitively, the UI provides a quick and low-stress experience for both technician and patient.

IRay® Patient Management UI

FreeStyle Insulinx Meter UI

Freestyle InsuLinx puts powerful new features in easy reach of diabetes patients and busy clinicians. Unlike most meters, Freestyle InsuLinx not only tests blood glucose but also helps patients determine correct insulin doses. FreeStyle InsuLinx’s user-friendly UI helps patients of varying levels of experience feel confident about using the device to better manage their disease, and is quick and easy for clinicians to set up for a range of therapy types.

Nanotab PCA UI

The AcelRx ARX-01 Sufentanil Nanotab system delivers a tiny opiate PCA tablet under the tongue. Bridge developed the user interface for this new device type, one of the first devices to use integrated RFID to identify drug, patient, and nurse.

The UI must guide nurses through the use of RFID and maintain medication safety, and was subjected to intense FDA scrutiny. Design research user testing guided iterative adjustments to sequences, language, and graphics, ultimately leading to smooth and predictable formative and summative testing.

Click on the demo thumbnail here for an interactive setup demo.

Nanotab PCA UI

Device screens address patients or clinicians depending on use mode.

Both users need screens they can understand at a glance: patients are likely to be woozy from drugs and procedures, relying on this device to alleviate their pain. Busy nurses managing multiple patients and devices need error-free comprehension of a device that delivers narcotics and is critical to patient comfort.

Design for compromised attention

Nanotab PCA UI

The design explored a number of options for representing dosing history over time in a way quickly grasped by nurses, who need to know not only dose history, but dose requests in order to assess patients’ level of pain relief.

Final Design

The small screen presented challenges for information representation.

The UI serves as patient and nurse training in this new device type.

Smiths Solis Ambulatory Infusion Pump

CADD-Solis pump is designed to deliver pain management drugs safely and effectively. Bridge’s design research, involving visits to observe and interview the stakeholders in the chain of product users, unearthed potential design enhancements leading to our work on a ground-up redesign of the pump user interface as well as new ergonomic features.

Cozmo

Bridge’s UI for the Cozmo insulin pump revolutionized the industry in 2002, creating a product with which all competitors had to catch up.

Up until that time, insulin pumps had a cryptic, DOS-like interface focused on pumping parameters using scientific terms. Cozmo turned this around to communicate with users in plain language, and in the way they thought about eating and insulin dosing.

Within 1 year of introduction Cozmo took 10% of market share from a dominant, entrenched market leader.

Cozmo Design Research & Strategy

Bridge’s early exploration of potential features for Cozmo helped the team identify user types based on varied lifestyle approaches to managing diabetes. Ultimately this enabled the team to empathize with users, identify the right problem to solve, and solve it. The result was a groundbreaking product.

Case Studies

SAFETY-CRITICAL DESIGN

Bridge redesigned Smiths Medical’s CADD-Solis PCA pump, the next generation of Smiths Medical’s flagship ambulatory pain management pump, to reduce medication delivery errors and advance “smart” medication delivery.

Pain narcotics and infusion pumps both represent areas where safety is paramount and devices are under increasing regulatory scrutiny. Research with stakeholders in the chain of product users unearthed potential design enhancements that lead to a ground-up redesign of the pump user interface, including a PC-based medication management system for programming the pumps.

Smiths Medical CADD-Solis Case Study

Invented in the 1970s, PCA (patient controlled analgesia) pumps gradually became more sophisticated in their programming of doses and limits. Multiple routes of administration were developed (intravenous, epidural, and peripheral nerve block), and the number of available drugs and concentrations proliferated.

By the early 2000’s, regulatory groups such as JCAHO (the US Hospital auditing body) and watchdog organizations such as ISMP (Institute for Safe Medical Practices) noted a significant number of safety incidents with PCA pumps. They identified a set of contributing factors, which included many relating to the design and programming of the pumps. These included drug labeling and concentration mixups, pump mis-programming, incorrect route of delivery (a safe dose intravenously can be fatal epidurally), incorrect transcription of prescriptions into pharmacy computers, and calculation errors when determining the patient’s dose or rate of infusion.

From these safety reviews and the information gathered from the stakeholders--including pharmacists, hospital administrators, pain doctors and nurses, and ward nurses--it was clear that to improve safety, the whole system would have to be tackled. How can the pump that is just on the delivery end achieve this? The design solution was to treat the pump and its programming as just one piece of a medication error reduction system and create a new systematic approach to PCA medication safety.

The Dangers of Pain Medication Delivery

Therapy-Based Programming For Safety

Solis provides a framework that is customized by the hospital. Using PC software, the hospital builds intelligence into its approach to PCA medication safety by creating a customized library of therapy protocols.

A therapy might be named by route of delivery, further defined by a qualifier such as patient age and condition, and finally associated with a limited set of drugs and dosing selected for the protocol. The therapy protocol library is downloaded to all the Solis pumps in the hospital.

The pump’s user interface is designed to reduce medication errors as well as greatly simplify and shorten the time it takes to set up a new patient and modify pump settings.

The approach makes the user take into account the context of care. For instance, at the bedside, the clinician can see if a patient is pediatric or adult. The pump screen changes to a color associated with the selected therapy, providing a further check on the user’s therapy choice.

To set up a patient for drug delivery, the user steps through a sequence of three questions. Only a limited set of safe choices are available at each step during programming, based on the therapy protocol selected. Once a protocol is selected, the user can adjust delivery parameters only within predetermined safe limits.

This brief video steps through pump programming.

Therapy-Based Programming For Safety

Design Research Tools

StoryboardsDesign Research Tools

Pump and Meter are connected to form one unit

Pump can be used without the meter

Meter/Pump Combo

Testing

Please wait....

Blood Glucose

108 mg/dl

NextBack

21

3 4 5

apply blood sample to stripReady

Apply Blood to Strip

Back

Meter only works with pump connectd to it!

Combined system can be worn on a belt

Bolus to AdjustBG 50 mg/dl

Deliver

0.55 uCancel

DeliveringBolus 0.55 u

0.35uHome

DinnerLunchBreakfastStandard

Home Select

Bolus Menu

The Pump Knows:

Your target Blood Glucose (BG).

Your Sensitivity Factor to correct it to target (units per mg/dl).

Target BG 100 mg/dlfactor: 1 unit per 50gm/dl factor: 1 unit per 50gm/dl

Concept StoryboardsDesign Research Tools

Surgical ObservationsDesign Research Tools

Quick Concept ModelsDesign Research Tools

Field ResearchDesign Research Tools

Video & Interactive DemosDesign Research Tools