Taking a close look at needs
Taking a close look at needs

Today one of my co-workers aptly said “this design process is about learning how to decide where to use your time.” The first part of that decision comes in finding “needs.” The design process he was talking about is the “Biodesign” course here at Stanford University that we (a team of two physicians and two engineers) are using to design medical devices.

In our first month my team members and I did a small design project, which I wrote about in my last post. Now in our second month, we traveled around Stanford Hospital and clinics looking for real clinical opportunities: issues that affect patients, physicians and the hospital as a whole. These are often, but not exclusively, medical problems. They’re problems that have a partial solution or no solution at all. My favorite are what we termed the “Geez needs” —  when the practitioner says “geez” because they’re unhappy about a problem or about the solution that they use to solve the problem.

Why are we looking for problems? And why is this one of the most important parts of what we’re doing all year? Because, I learned, one should assume that very smart people have thought of most things that you, or any other innovator, has thought of. In such an environment, you’re only chance of having a truly unique solution is if you develop a truly unique way of looking at the problem. This new perspective is why non-physicians like me are so important to an innovation team.

So, we were on a problem hunt. And we started where the problems happen: the hospital operating rooms, and more importantly, its clinics. We came up with 360 “needs statements.” These statements identify the opportunity and space in which we want to innovate. The statements are simple. They are like mad-libs: a fill-in-the-blank story. The statement starts with “A way to” followed by a verb, which is generally “increase”, “decrease” or “prevent”. Next, you specify the complication (disease) you are trying to address, and finish with the (patient) population that your solution, if you ever get to one, will affect. For example, “A way to prevent excess skin formation after rapid weight loss in patients who undergo bariatric surgery.”

You can go “up the needs tree” to a superseding need that will eliminate the need you had identified, such as “A way to create slower, more controlled weight loss in obese patients.” Alternatively, you can go down the needs tree to a more incremental need that is less complicated, such as “A way to reduce the scarring associated with excess skin removal.” As we found out later, the need itself is not sacred; the need should be in a constant state of flux as you learn more about the problem.

We spent one month in the hospital and identified 360 opportunities for improvement, while missing many others. We then had to prioritize and decide where we want to spend our time. For the first cut we eliminated opportunities we had no interest in. That took us to about 130 needs. Then we went to more objective measures. We researched numbers for the market size associated with each problem and determined the impact we would have on any given patient if we solved the problem, grading the impact between one and five. Finally, we tried to determine if the solution to the problem was an incremental innovation, a blue-sky innovation, or an innovation that was mixed (not super simple, but not crazy hard). From this we pulled out our top 50.

Presently, we are looking into the top 50 in a much more thorough way. We are investigating the disease, market and stakeholders in more depth. We are researching the current solutions to the problem and the emerging technologies. We are attempting to answer what is likely the true determinant for achieving success:  do we have a different way of looking at the problem?

The moral of this month: problems, and therefore opportunities, are abundant. The key is to identify a new way of looking at the problem.

Again, questions or comments welcome! I am a student on this journey, so I’d love your insight.

Joelle Abra

Joelle has a background in chemical engineering, business and law. Joelle has led two successful entrepreneurial ventures and recently completed the Biodesign Fellowship in medical device innovation at Stanford University. She now works at Stanford providing business and IP strategy consulting to the most promising biomedical research and provides a “View from the Valley!” See more…