Leah Heiss On How Human Centred Design Methodology Can Create Social Impact

Leah-Heiss-Australian-human-centred-design

Leah Heiss is a Melbourne-based designer working at the nexus of design, health, and technology. Her practice traverses device, service and experience and her process is deeply collaborative, working with experts from nanotechnology, engineering and health services through to manufacturing.

Her health technology projects include jewellery to administer insulin through the skin for diabetics; biosignal sensing emergency jewellery; and swallowable devices to detect disease. Facett, the world’s first modular hearing aid that Leah designed for Blamey Saunders hears won the 2018 Good Design Award and the 2018 CSIRO Design Innovation Award. In total she has won five Good Design Awards and her design work is part of the Museums Victoria heritage collection. Leah’s work has been exhibited at the Melbourne Museum, Gallery of Modern Art in Brisbane and at other galleries locally and globally. She teaches through RMIT’s Masters of Design Futures and the Interior Design honours program. Her teaching practice traverses embedded practice in cancer care and transdisciplinary design focused on health sector innovation.

Leah discusses the power of prototyping, shares tips on communicating within interdisciplinary teams, and key insights into the future wearable technology may have in creating positive social impact.

Highlights from the interview (listen to the podcast for full details)

[Mikaela Stephens] - To kick things off Leah, could you please share a bit about your background and what led you into the world of healthcare product design? [2:48]

[Leah Heiss] - So, my background is in a Communication Theory degree and then I did Interior Design and after that I did a Master's through the Spatial Information Architect Laboratory through RMIT (Royal Melbourne Institute of Technology). As part of that I designed garments to sense and transmit heartbeat over distance for people who are, like all of us, having these terrible long distance friendships and relationships, and really suffering from not having good communication. So my ‘empathy vests’ and ‘ether beat’ garments were really around whether we could have an embodied experience of empathising while we were also on the phone. So that was my Master's. Then after that, one of the pivotal experiences in my career was being artist in residence with Nanotechnology Victoria in 2007 and 2008. That was when I started to focus on technologies for healthcare with the scientists at NanoVic. I worked on diabetes jewellery, and also on a range of vessels and jewellery pieces to remove arsenic from drinking water for people who live in countries where arsenic is prevalent. So the amazing thing about being in NanoVic was that they have these 40 extraordinary technologies that I was able to work across and I felt a really strong emotional pull towards the healthcare technologies.

You have essentially specialised in ‘wearable’ technology, and won several ‘Good Design’ awards for those healthcare devices. From smart heart health jewellery, to your recent first self-fit modular hearing aid. How do you see this world of wearable technology evolving and its ability to create positive social impact? [4:17]

I'm really passionate about the role of human centred design in the development of wearable health technology. However, I'm also realistic about what the common market is doing in that space. And so we have a lot of wearable health technologies that are ostensibly for the worried well, so lots of biofeedback devices and bracelets and trinkets that you can wear to reinforce the fact that you actually are well and healthy person. And what I'm really interested in, is the people that aren’t well and healthy, the people that need the monitoring, that don't have a choice about monitoring basically. So they need to either have diagnostic technologies, drug delivery technologies, that they have to wear on a daily basis, but they have very little control and say in what those devices look like.

In terms of understanding the difference in market, how important is that for you?

I think it's incredibly important to me that I'm focusing on the emotional needs of people that have to use wearable health technologies, and whether that is devices for disability, sensory augmentation devices. So if we think about, for instance, the hearing aid. That's a space that I feel very passionate about because untreated hearing loss leads to Dementia and Alzheimer's, isolation and loneliness. But still many people put off using hearing aids because they feel the stigma of age or they feel embarrassed by them.

Could you please share how human centred design can best be used to create positive social impact and how you utilise it in your design process? [6:06]

Human centred design is such a big area and it's also a big buzzword.

Empathy is a really big buzzword, human centred design is a big buzzword. But to me they're more than buzzwords, they're ways of living and practicing.

And so what I didn't mention about my Master's; my Master's was in empathy and in what happens in the brain neurologically when you empathise with another person. And so that kind of knowledge, which is, what is empathy really about? Really going deep into these things is quite critical for the way that I practice.

So in terms of human centred design, the space that I've carved out for myself, is that I have a very particular way of practicing. And that's really the foundation of the PhD that I'm finishing at the moment; how can we humanise wearable health technologies through human centred design processes? And I have my three ways of doing this. That human centred designers need to be at the table with the engineers, with the mechanical engineers, the signal processing engineers throughout the duration of the technology development

That role of the designer in the entire design and product development journey, including manufacturing and modelling it... How should that process evolve to ensure that the consumer or the customer or the core user is considered the whole time, through that end to end process?

So, the only way that I've come across, and that I've lived in the last few years is that...

if you have a human centred designer at the table for the bulk of technology design, then they are representing the emotional needs of users.

Because otherwise what happens is that you hand over your models, you hand over your drawings to the engineering team. And I love engineers, I work with engineers all the time. But then a whole lot of decisions are made that are about efficacy, cleanliness, cleanability, whatever it might be; design for manufacturing. And often those decisions will be made and they will have impacts on the human experience of the product.

With the designer not at the table, it really means that those things just go through and by the end of the design process, we have a technology that doesn't necessarily gel with its user group.

So in that sense, the designer is essentially the advocate for the user and that human centred designer throughout the whole process.

That's right. Yeah. And I think of it as, you're there to bring the emotional experience of users to the table so that at the same time as considering signal processing strength, we're also considering feelings of embarrassment and shame or feelings of joy and wonder. So we're bringing all of that stuff to the table and it's becoming part of the design, the design decisions.

Throughout the whole process, they're gathering at the start and ensuring that it's reiterated every stage along the way. Your work as a designer and as a facilitator on the projects that you've worked on, what are some of those challenges that you typically experience and how do you work around them? [8:59]

There are lots of challenges in working in interdisciplinary teams. And so the teams that I work with, so the most recent team was on the design of Facett. And that was with electronic engineers, mechanical engineers, signal processing experts, audiologists, marketing people.

All sorts of people were in that room and I had a seat at the table for the, for 37 weeks of the design process, which is amazing. That's what makes such a great outcome is that we work together from the beginning all the way through technology development, rather than just six weeks at the beginning.

So every single day there are complexities. And what those things tend to centre on, is that people have ideas about how things should work, how they should look, how they should feel, how technology should function. And the way that I helped to find consensus in those interdisciplinary groups is that I have an iterative design process. I call it in my research, it's the power of prototyping. And so, not just as a, 'let's make a model and move on.' Actually I’m prototyping every single week.

Those prototypes are more than just material artefacts. We think of them as boundary objects between disciplines and they enabled people to come together and make decisions and move on, and get over things.

Whatever the hurdles are, we look at the model, then we try it on, we put it behind the ear, and we'd talk about it, and then we make a decision, and we move on, so we call them small wins in the design process.

In that sense of the process, the prototype becomes a language between those different people, and enables that process to move forward.

Yeah, that's right. It's a language. The other thing that's interesting about prototypes, so, I worked on a project called ‘Smart Heart’, which is a necklace to replace the cardiac holter monitor. And we did a whole lot of woven prototypes and these operated as a language form between the engineers and weavers. So we talked around the prototype. I think of them like a campfire. We come together around the prototype and also the prototypes are really powerful for working with users. So what we do, is we share the prototypes with users in focus groups and they try it on, they put in their handbags, they put it in their pockets, and I've observed that and they emotionally get really involved and invested in the design process through those prototypes

Were there any other essential tools for design thinkers within the health industry that you think design thinkers could utilise, and break down those assumptions about people who suffer disability or health concerns? [12:00]

Yes, I have many, many thoughts on these things. So the other kind of key tenant of my practice and way of working is about emotional engagement. And that's going beyond the user interview as a way to observe people interacting with the technologies or analysing habits and behaviours and then compressing that information into, you know, journey maps, customer experience diagrams. So all that stuff's fine, but what I find with that is that it tends to squeeze the emotional content out of things. But I think if we think of them, I think that these are emotional engagements. So what I tend to do, is I convene focus groups with small groups of technology users and I think of those as an opportunity to understand and engage with the emotional experience that people have in technologies. So it's not about function and form as much, but it's about really empathising and spending time trying to understand the difficult stuff.

The difficult stuff is the embarrassment, shame, stigma, difficulty, isolation, awkwardness. And if you can really spend the time listening and absorbing and understanding that information and then taking that into the design process, then you build a great reservoir of respect.

And so what that means, is that the users that have been in my interviews are really invested in the design process and when it gets to the product launch they're as excited as you are, because they were part of that piece.

So using that process, engaging with the community, and I guess utilising that tool kit of empathy to break down the stigma...

Yeah, and actually the way that I do this is, is that I'm quite inspired by Sensory Ethnography, which is a book by Sarah Pink. I'm a spatial designer as well, but it's to think about the entire condition for engagement. And that goes down to: we need to create an environment of comfort so that, you know, people laugh at me about this, but it's like, and that's about the smell, the olfactory, you know, the smell of freshly brewed coffee. The kind of cakes; that they're not the crappy cakes, they're the good cakes. But what's on the table, that they have something to play with and touch and to become involved in the design process.

That there aren’t flashing cameras around them, that there's not too much hierarchy. So whoever the big company leaders are, that they leave the room and you create this space of intimacy and sharing stories.

Do you find that you get the most valuable feedback when people, I suppose let down that wall and they’re most vulnerable?

Yeah. And again, the power of prototypes; if you've got things that people can touch and hold and play with.

So in my workshops, it's all about haptic and tactile engagement as a way to develop intimacy between myself and the participants. But that also happens in a technology design space. You give people the agency to do what they want with the prototypes and it’s really lovely what happens.

As opposed to, you know, do this action and let me observe you doing that action. Then there's no imagination in that. I just think if you can let people imagine the technology into their lives, there’s richness of the outcome there.

How have you seen the design industry and health industry, especially wearables, transform over the years and where do you see design and health technology be able to impact social innovation and social impact into the future? [16:19]

I feel like we have peaked in these kind of diagnostic technologies for daily life type of things, and I hope so, because I feel like that's been a distraction in some ways from some of the really big things that we should be focussing on. And so what I hope, is that some emotional content starts to come into it, particularly wearable technologies. So that it's not just me saying it's really, really important how people feel about this. Because conversations that I have with people that happen to have a disability, is that there seems to be an assumption made by big companies, that if you have a disability you no longer have any aesthetic say.

Yeah, the medical beige.

Yeah the disabled beige. So it's like, you know, you suddenly have an impairment, and we will all have an impairment in time, and it's like aesthetics go out the window. As opposed to thinking, well, it's exactly the same person who has the same wants and needs and interests and a sense of self identity, and wanting to be engaged and connected to particular social groups.

And this disability is just a part of them, ability, disability, whatever it is, and we should be designing things that reflect people's sense of identity and sense of self.

So that's where I really want things to go.

So rather than, yes, you've got the diagnostic, we know how well you are, or we can understand your disease inside out in terms of numerical data. But how do you then move forward into the technology of the lived experience and ensure that it's not impacting that daily routine in that sense? [18:05]

That’s right, and actually I've done quite a bit of research in aged care, and I find it really interesting the way that people talk about the two different ways that people talk about things. So I always go into those aged care environments and I'm interested in people's relationships with wearable technologies, and people's relationships with jewellery. And the way that people talk about wearable technologies, they say things like, 'oh, well it's a bit clunky, but you know, I guess you need to use it,' about a falls monitor. As opposed to, 'oh, this amazing piece of jewellery that I love that belonged to my great grandmother, and it makes me feel really warm.'

It's very easy for us technologically now to combine those two things, but there’s just not the corporate will.

What are some of the local or global initiatives that you've come across in your work that you believe might be successfully tackling those problems whilst creating opportunities to provide social and health benefits for the community? [19:06]

There's a whole lot of really interesting projects that are happening across service device experience. Recently at the Good Design Awards, Meld won a fantastic award and recognition for their work with the Queensland Government. And that was about really manifesting human centred design across the whole of Queensland Government. So all of the decisions that are made, go through this sort of human centred design lens, which is really ambitious.

Then there's another; we're doing a whole lot of work with Matiu Bush, looking at end of life experience, and with Marius Foley through the Masters of Design Futures (RMIT). And so we're looking at whether, death as a design space, whether we can start to kind of open that up and think about ways that we can innovatively and creatively engage with end of life experience. In a way that recognises people's whole of life contribution if they get to the end of life. Similar work is being done in the UK and in America. So I think they're really interesting kind of design projects that are looking at these really knotty issues.

Very heavily stigmatised issues.

Yes, absolutely. Just the idea that designers can address difficult issues in a human centred kind and empathetic way, we just need to break them down into lots of little tiny bits.

So the strategy of tackling the wicked stigmatised problem is being able to understand the empathy behind it.

Yeah, this idea of the small win is for me.

It's a way to address a wicked problem; to break them down into tiny little pieces.

And that's how I address every problem, every design issue, and design space.

So what is some advice that you would give to the budding social entrepreneur or designer interested in health, who might have an idea but they need to take action to get their initiative started? [21:16]

So the first thing is to prototype it. Think of the prototype as more than just a material outcome. So the prototype is the thing that can build relationships between you and collaborators, and you and clients. If you can start to build those prototypes (and I know Dyson made like 500 models, and a lot of those were mechanical models), but I'm thinking of the prototype as what's the smallest thing that I can do today, that will enable me to have a conversation with someone who might become invested in my idea. And that might not necessarily be about money, but that might be about developing a friendship with someone who can mentor me, or that I can share with someone, so they start to become part of the narrative of the story. And the second thing is using those prototypes as a way of building narrative and building story. I think a lot of budding entrepreneurs are really good on social media.

The advice I have for my students is, every time you do something, make sure it's got three outcomes. So if you make a model, then turn the model into film, and the film into an online engagement. So just multiply everything that you do at least three times, and then you kind of multiply your impact.

What are some of the countries that you believe are leading the charge when it comes to support and implementation of social innovation programs that can transform communities, and what could we learn from them? [22:48]

I think this isn't going to be a very unique answer, but I think the Nordic countries. They are the leading countries for healthcare especially. And they're doing really interesting things. So the Karolinska Institute in Sweden, you know, really these huge projects that are looking at end of life experience, but not just in a palliative care or just healthcare technology way. They're bringing in artists and researchers and writers. So really interdisciplinary projects that take on these big issues and recognise the complexity and I think that's something that there is a tendency or a temptation in our service design models, or the experience design models, to reduce the complexity out of issues. Because we are solutions focused, so I think some of those, particularly at the Karolinska Institute, some of those projects, they really sit with uncertainty and they sit with complexity quite beautifully, and they recognise that it is a really big issue. So we're not going to try and squeeze it into a 20 page report. We kind of recognise that it's going to take a lot of different skills at the table to make improvements.

To finish off, could you please recommend 3 great books that you think would inspire our listeners?

[Leah shares the books listed below.]