
By Jesse Darley, Director of Mechanical Engineering & Principal, Delve
No doubt, you are passionate about the impact medical devices have on the lives of the patients that need them. In many cases, devices save lives. In more cases, they extend or improve lives. At the core of most devices is a technology that solves a critical medical ailment.
Think of a specific device. Now think about how that device fits into the user’s life. Are they enduring inconvenience, pain, fear or stigma? If so, you have an amazing opportunity to make that device better, improve people’s lives, and dramatically increase adoption.
Dexcom was in this position when they approached Delve to help improve the user experience for their next-generation continuous glucose monitor. The G5 system used Dexcom’s subcutaneous glucose oxidase sensor and Bluetooth to talk to a smartphone or dedicated display. Unfortunately, to get that sensor under your skin you needed to use a cumbersome device that people feared and some found painful. Dexcom knew that once users had a better option, they would lose customers. They needed a better sensor applicator.
Delve and Dexcom could have simply read complaint logs and listened to their sales team, then Band-Aided the applicator’s most obvious flaws. Instead, our team of design researchers and engineers observed users, asked lots of questions, and dug deep to understand injection pain. Using that research, we created a set of design goals that became our North Star. We returned to these goals as our integrated team of human factors engineers, industrial designers, mechanical engineers, and manufacturing engineers dug into the details of the next-generation applicator, the G6. This North Star included these design goals:
- Automatic needle insertion and retraction to reduce fear and pain.
- Quick insertion speed to decrease pain and quiet “firing” of applicator to avoid startling first-time users.
- One-handed operation to allow self-placement of the sensor to the back of the user’s arm.
- A friendly looking applicator that did not resemble a syringe to avoid needle fear.
- An intuitive process driven by users, not the mechanical design to minimize user error, especially for new users.
Following this North Star required a large commitment of people, money, and time. Let’s focus on the first design goal—moving from a syringe to an auto-injector. This decision required Dexcom to take on a huge technical risk. Could they design an auto-injector that was insanely reliable? To achieve this goal, we applied the principle of simplexity. In this case, the mechanism has multiple carriages that have snaps to stage their motion during needle insertion and retraction. While G5 had a multi-step user experience, the mechanism was about as simple as a syringe. Another way to think about mechanisms is that they are mechanical automation, removing manual steps. You are transferring tasks from the variability of a user to a mechanism that’s made in a controlled manufacturing environment where variability can be predicted and measured. Once the mechanism’s potential was established, an army of analytical engineers looked at every element of the design to determine if manufacturing variability would impact performance and adjusted details to guarantee performance.

Our industrial design and human factors team led the charge on many design goals—focusing on one-handed operation, friendly form, and intuitive use. They created an applicator that looked nothing like a syringe and worked with the mechanical engineers to devise an injection molding strategy. Dexcom accepted a slightly higher cost and more complex mold design to emphasize the ergonomics. This can feel like a risky choice since it’s impossible to calculate the return on investment of a feature like this. It’s “safer” to eliminate these costs, but our North Star made the decision clear.
After months of iteration and testing, Dexcom launched the G6. We witnessed the impact of Dexcom’s human-centered approach immediately. Customers flooded YouTube and Instagram with kudos like, “All I felt was a puff of air hitting my skin, that’s it.” Moms who battled with their kids to get a sensor placed using G5 (including some who simply gave up) now had happy, compliant kids.
And Dexcom and their shareholders had a really great year. Sales were astronomical and the stock price followed suit. The quality of the design was recognized as well with a Silver Medical Design Excellence Award, a Core 77 Design Award, and a Silver IDEA award.
It’s easy to tell the story of a winner and ascribe a cause and effect. In this case, Dexcom’s investment in human-centered design had an amazing return on investment. Is this replicable? McKinsey recently attempted to quantify the impact of this dynamic in a very comprehensive survey of businesses and found a strong correlation. From their October 2018 report titled The Business Value of Design, “Companies that prioritize iterative, user-centered design boost their odds of becoming more creative organizations that consistently design great products and services. The prizes are as rich as doubling their revenue growth and shareholder returns over those of their industry counterparts.”
I challenge you to think about your products and services. Are you touting your industry-leading science and technology and ignoring your customer experience? If so, the moment a more friendly, painless and intuitive alternative is available, you will be left in the dust. Seize the opportunity to listen, observe, and improve your customer’s experience.
If you are interested in learning more about human-centered design and how we can help, visit www.delve.com.
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