How did you get involved in Exovent?
It was around May last year when one of the clinicians who is supporting the Exovent team, got in touch. I was fortunate to get involved quite early in the process, which allowed me to observe some of the original Exovent trials and get to know the team really well.
Through my work as a Principal Consultant for Human Factors and Ergonomics at PDD, the product and experience innovation consultancy, I’ve developed very strong relationships with the teams at University College London and University College London Hospitals.
During my career I have been involved in the research and development of over 50 medical devices, projects from home-use haemodialysis machines to infusion pump systems for intensive care. My role is to ensure that the systems are safe and usable, and that front-line clinicians have access to the types of technology that they need to do their incredibly demanding jobs.
Negative pressure therapy breathing support is an important tool that can potentially help millions, but in order to be widely adopted, it needs to be proven. When I met Exovent – a lot of great work was already under way, with pioneering early parts being developed in an aircraft hangar and a multidisciplinary team of medics, engineers, scientists & professionals that worked in extremely collaborative, agile, responsive ways.
At that time, it felt a bit like we were developing a new type of top-secret technology. Our focus was to gain the necessary scientific and engineering evidence in order to mature the technology to a point where it could be used across a variety of contexts. The energy and momentum was extraordinary, and we owe a massive thanks to the advisors and industrial partners, such as Marshall ADG (a global leading Aerospace company that were assisting exovent with design and prototyping) & those at Steer Energy who moved heaven and earth to make it all happen.
What do you think is the toughest design feature of Exovent?
For me, there is no one single design challenge that is all encompassing. I think the process of design is more akin to a jazz piece than a classical concerto – we must be mindful of the importance of solving immediate problems but we also need to take a holistic view and respect the interdisciplinary nature of the work. As a team, we never underestimate the different challenges we encounter, but we also recognise that there are different perspectives, expertise and backgrounds in the team to help us find the right solutions.
Take for example the challenge of sealing the vessel and the need to make sure that the patient is comfortable. For the medics – being able to hold the patients’ hand is really important but, at the same time, we need to think carefully about how the machine can maintain a steady state and target a given pressure profile. We also must remember that one of our key goals is to reduce the effort a patient must make in order to breathe. This means that we do not set an arbitrary negative pressure value – instead, the machine needs to be tuned for each patient ventilation.
Clinicians, scientists and engineers can sometimes take slightly different perspectives on how to navigate these challenges, so one of the strengths of our approach at PDD is to facilitate and enable cross-industry collaboration – benefiting from the diversity of knowledge of the different disciplines (e.g. aerospace and medicine) whilst, at the same time, mediating across different terminology, cultures, process and mindsets.
What is your typical involvement?
One component of the device that lends itself to this multidisciplinary approach is the Human Machine Interface or control system, which needs to be designed with the clinical context in mind including both patients and users. We need to take into account the conceptual model that those who use the technology will apply – for example, a clinician who is familiar with positive pressure ventilator technology could misinterpret some of the controls or status information, so we need to consider how the design of the equipment and user interface can mitigate the potential for this confusion to occur.
As a design scientist, I aim to make sure that we design with a degree of rigour and supporting evidence. We must align the skills, background, knowledge and capability of the users with the design of the equipment, so that the requirements that shape the design are human, and not purely technical in nature.
I am learning a great deal working with the Exovent team and enjoying the strength of knowledge, experience and expertise that the work entails. In particular, I’ve been humbled by the focus and dedication of the clinical teams, who are spending a significant part of their day working on COVID wards yet bring such energy and vision to the development an entirely new form of clinical therapy for patients in respiratory distress.
The legacy of this project is incredibly important both from the perspective of providing a new form of technology, but also by providing an infrastructure and a hub of knowledge and expertise in this area. We hope that this example will seed other initiatives in healthcare innovation as we move to a position where front-line medical staff are more involved in the design better, more usable medical technology.
Dr. Chris Vincent