The Intel Health Guide: A medical device that looks like a white good

Elderly patients want to convalesce at home, while healthcare trusts need to cut the volume of hospital admissions. So says Mariah Scott, worldwide director of sales and marketing at Intel’s Digital Health Group.

The technological solution to these two issues may appear simple: a remote patient monitoring system that allows home care for the elderly. But what is not so easy is to get the televisual and telephony technologies that already exist to ‘fit’ into the context of ‘independent living’.

To create the appropriate enabling technology, Intel Health had to come up with a product design that offers a form of literacy appropriate for a generation of people who probably wouldn’t have the need for a personal PC at home.

The end result, the Intel Health Guide, is a culmination of design, engineering and ethnographic research works spanning over a decade, and involved input from stakeholders in the US and Western Europe. These stakeholders comprised patients between 65 to 80 years old – some living at home, some living at the hospital – and also their carers and clinicians.

Looks do matter

It is no accident that the Intel Health Guide, already on sale in the UK and Ireland, has the outward appearance of a typical household appliance. “Patients don’t want it to look like a medical device. They don’t like the stigma of being perceived as ill. We have to factor in design considerations in developing the Intel Health Guide,” says Scott.

One of the major issues addressed in the design of the interface is the elderly patient’s deteriorating eyesight and lack of dexterity in their movements. The key is to have the instruction on the interface easy to read and operate.

“We opted for a touchscreen set of buttons for navigation because they are easier to use than keypads. The fonts and buttons are kept large. Elderly patients don’t have the same manual dexterity as younger people. The buttons are designed large so that they can tap the screen with their knuckle instead of the tip of their finger,” says Scott.

“The Intel Health Guide also has a limited set of icons carefully tested for usability. We were also looking for high contrast in the colour, which is why we employed blue and white as they are better for the vision.”

There is also another thought behind the soft approach towards the hardware design.

Because the device has to adhere to current medical device regulations, the personalisation of this device is fairly limited. The screen, for example, cannot display the patient’s personal photos as wallpaper or a slideshow.

“It is a medical device designed to carry clinical content which has to be verified and validated,” Scott explained. “What can be carried onscreen has to adhere to the privacy and data requirements determined by the health governing bodies. In order not to compromise the data necessity or security, and the legal and safety requirements of the medical device, the Intel Health Guide does not allow any wallpapers or slide shows to be uploaded.”

Social inclusion

Remote healthcare also means the patient’s first port of call will be the intervening patient groups and nursing workers, not the clinicians. The nature of remote communication itself means that the clinician will be once or twice removed from the patient at home.

The challenge for Intel Health is to make its Intel Guide system socially amenable, by enabling interactions among the patient, the family and friends, the caregivers such as the community matron, and the clinicians.

Televisuals are an effective means of maintaining this form of sociality, and thus, the device incorporates audiovisual communications, such as video, that can run on wired, cellular or dial-up connectivity.

The clinician’s help

Considering that the device was first designed for the US market, were there huge adjustments when retrofitting it for the European markets? Not from the patient’s side, but more on the clinician’s side.

“We expected more variations than we found on the patient side in terms of navigation and translation. However, we discovered that with regards to the interface, there wasn’t much variation preferred by the patients. They found the Intel Health Guide easy to use,” says Scott.

“The varying preferences were more on the clinician’s side – each country has a different way of maintaining patients – different programmes are employed in England compared with Spain, for example. Therefore, we can customise each programme to suit the work preferences of clinicians in each country and to address the needs of individual patients who may be suffering with one or more chronic condition such as diabetes, heart failure or chronic obstructive pulmonary disease (COPD).”

In order to understand how the device works for the clinicians, Intel’s ethnographers observed these people at hospitals to understand the workflow and the work-situated problems they faced.

Making it fit for a developing world

Will online accessibility be a hindrance when adapting this device for the developing world, where digital infrastructure is less reliable? Not quite, says Scott.

“We have considered the intermittent online access – consistent internet connectivity is an issue affecting the mature markets as well as the developing world. Connectivity-wise, the Intel Health Guide has been designed to take patients’ vital signs and have the data transmitted in batch transfer to work around the connectivity issue.”

What the company would reconsider, though, is the hardware design.

“The Intel Health Guide is designed for a mature market, where it can be put in a home environment.

“It has not been developed with developing countries in mind and so it would not be robust enough for a developing country. It would need something a little simpler mechanically.

“We would have the hardware hardened or toughened, like the robust design of the Panasonic Toughbook.”

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Salina Christmas is multimedia editor for Clinica