Bridge Design Blog

Bridge's Bill Evans reports current state of medtech venture investing for MX magazine

Tue, 22 May 2012 20:28:00 GMT

This article was published on Medical Device and Diagnostic Industry on May 16, 2012.

There is a stark contrast to a fact apparent to anyone close to medtech over the last decade or so: the costs of bringing products to market have escalated significantly. These state of affairs has been quantified and publicized in a survey titled FDA Impact on U.S. Medical Technology Innovation by Josh Makower, a medtech entrepreneur. “The average cost of taking a product through 510(k) clearance is $31 million, and the average cost of getting a product through PMA….is $94 million (excluding reimbursement and sales/marketing activities),” Makower reports. “For U.S. companies, these mounting costs are unsustainable in a venture-backed industry where [fewer] than one out of four medtech start-ups succeeds, 50% of all reported exits are less than $100 million, and the total pool of available investment capital is shrinking.”

These source articles reveal two seemingly contradictory trends over the last decade. On the one hand production costs have risen significantly; on the other, venture-investing medtech returns have outperformed tech investments at a time when it seemed that all the VC action was with Internet-related plays. Both are true. Digging deeper reveals how various investors, entrepreneurs, and other stakeholders have reacted to these changes. This exploration in turn uncovers what the next three to five years of medtech investing may look like.

Structural Changes

A survey of historic financial data will not necessarily show today’s medtech entrepreneurs where their funding will come from in the near future and what the next set of investors is likely to care about. At least four structural changes in the market account for this state of affairs:

• Shifts in investment amounts, timing, and risk appetites of venture money sources.
• Increasing regulatory and reimbursement pressures.
• Globalization of medtech funding and newly emerging markets.
• Increasing emphasis on the overall cost of outcomes in a world of escalating healthcare costs.

The good news is that medtech investment insiders all seem bullish on the industry. Robert Curtis, CEO of Respira Therapeutics and a seasoned medtech chief executive with 10 start-ups, notes: “There have been some great successes in the device industry; it’s probably one of the most resilient of the regulated industries in the U.S.” Makower hopes “that brighter days are ahead. Medtech is a good place to invest in the future, but those involved must be exceptionally selective.” Reports on the latest medtech funding numbers support this optimism, showing an increase of approximately 33% in the first quarter of 2012 compared with the same period last year.

Of course, investors of any kind have always been selective, but anyone who has tried to raise money over the last few years has felt the chill wind of this exceptional selectivity. It affects who funds entrepreneurs and when they’re funded, and it creates bigger hurdles for a product to overcome.

Where Will VC Money Come From?

The current environment has scared a lot of investors off, changing where the early seed money is more likely to come from. Casey McGlynn leads the life sciences practice of the law firm Wilson Sonsini Goodrich & Rosati (Palo Alto, CA), which over the last two years helped privately raise about $1 billion for medical device companies. “Our industry has spent a lot of time analyzing and complaining about the performance of FDA, and rightfully so,” he notes. “Congress has heard us, and the institutional funds that invest in VCs also heard us, and I think we scared them about the difficulties our industry is facing.”

Compounding this regulatory tightness was, of course, the global financial meltdown. Curtis says that medtech started to feel the effects a little before 2008. “The financial market started to get constipated; money wasn’t flowing well. When that spigot got cut off, the funds looked at what they were doing and instead of investing in early stage start-ups they invested in later rounds of more mature start-ups because they could foresee getting to an exit earlier. On top of that came a shutdown in the IPO market, so for the most part, device companies couldn’t raise money from the public over the past few years. The sole exit has been to be purchased by a big medical device company.”

These pressures have lead VC firms to become more specialized. “Today’s VC firms don’t make the mistake of dabbling in areas in which they are unfamiliar,” says Steve Halasey, vice president of the Institute for Health Technology Studies (Washington, D.C.), which supports independent research and educational activities focused on medtech. “Firms have become increasingly specialized, even to the point that medtech VCs who have a strong interest in a sector such as cardiology might not deal in another area such as IVDs. For the investors who know what they’re doing, there’s no question that the returns in the medical device area have been very good.”

Regarding investor returns, Jonathan Wyler, a principal in SV Life Sciences (Boston) who specializes in medical devices, says, “On average in medtech it’s seven years until an exit, but many of the successful companies of recent years have taken over a decade to reach acquisition. This is a very long time horizon, and hence investors have to support the organization for a longer period, which means considerably more capital. To manage a venture fund to a three-times return, and because returns on successful medtech investments are generally not as high as in tech, it becomes critical to manage loss ratios by identifying the losers more quickly, manage to get your money back on as many as you can, and to avoid expensive investments with binary outcomes.”

This approach makes it harder for VCs to invest early in companies where outcomes are inherently less certain and holding periods are longer. “VCs are not running to invest in very early stage companies,” Wyler says. “Most are buying in later and looking for attractive economics, and much less frequently making an exception for only the most [distinctive] earlier stage opportunities with the very best teams.”

On top of these pressures VCs are feeling a chill from the institutional investors when they go out to raise their own new funds. “The risk-return in medtech relative to the substantial capital needed to get to an exit is different from the tech world,” Wyler says. “Institutional fund managers who are investing in many different asset classes are generally not into the detail of a particular product category or science, but [they] do recognize the headline level themes—depressed markets, challenges with FDA, healthcare reform, acquisitiveness of consolidators, and so on—and often generalize such issues to the entire medtech space. This complex environment has given large institutional funds pause in terms of investing in healthcare. However, these regulatory and other hurdles do create value-generating barriers, and with the right experience and expertise, such risks can be managed to create long-term value in a manner that is not typically present in the tech world.”

Historical returns from VC healthcare funds “are more consistent over time” than the high-profile IT and software successes, according to Rich Ferrari, cofounder of De Novo Ventures (Menlo Park, CA). Formerly CEO of two successful VC-backed, publicly traded medtech companies, Ferrari adds: “There are bubbles in technology, consumer, and electronics. When you look at healthcare, over the last decade or so, it really doesn’t have bubbles. It has a consistent gradual increase. Some returns in IT and technology look good, but they are small in numbers compared with the thousands of companies that are funded. So actually, healthcare does have a better [internal rate of return]. But the environment today for raising money as a healthcare fund is difficult. The institutional investors in VC funds look at these headline big IT returns and their 10-year return in healthcare, and they are not pleased with it.”

Angels ‘Alive And Well’

These twin pressures on the investment dollars available for VCs, both into and out of their funds, have meant other sources of funding have increased, especially for early-stage ventures. “Angels are alive and well,” says McGlynn. “At the earlier stages of a company they’re more active in putting more money in than ever before. In many ways the Series A venture financing is now being done by angel investors. To lure a five-star VC firm and build that first syndicate you really need to have a great animal beta, a great prototype, and in some cases even credible human data. We are doing a lot of early-stage work with angels and what you might think of as micro-venture capitalist funds. They’re slightly more institutionalized than just an individual investor.” Examples of very early investors, McGlynn says, are Aphelion Capital, X/Seed Capital, and MedFocus Fund. Angel groups include Life Science Angels, Angels Forum, and Bank of Angels, he says.

Another group of angel-like investors, family funds, is gaining momentum, particularly in Europe, Curtis says, “where the family funds model is more advanced; and in the Far East, places like Singapore, which has some fairly sophisticated investors.” McGlynn has also seen Asian sources of funding rise: “We see companies looking for capital in Singapore and other Asian countries where they can set up R&D at a low price, get grants from the government, and raise money from what you’d think of as offshore angel investors.”

Corporate Venture Investing

“There’s a resurgence in corporate venture capital,” says Curtis. “In the 1980s a lot of companies like Medtronic, Pfizer, and Boston Scientific invested in deals directly from their balance sheet. They then retrenched, but recently I have noticed that more corporations in pharmaceuticals as well as medtech have formed venture funds, or have partnered with experienced funds to invest in start-ups. These companies are beginning to invest broadly. As an example, Pfizer has invested in a couple of medical device deals that could replace pharmaceuticals in some areas. One is NovoCure, which uses a device for glioblastoma therapy. Novartis has looked at medical device deals. So far, not many of these funds are willing to invest in early stage deals, but at least the corporate interest has increased.”

The list of device companies with recently established corporate venture funds includes Covidien (August 2008), Abbott (June 2009), Baxter (July 2011), and Philips Healthcare (August 2010). These companies join the parade of existing players like Novartis, Medtronic, St. Jude, and Kaiser, all of which have longstanding venture investing arms. “The corporations in general have really stepped up to be major funders of new medtech companies, all the way down to the seed level,” notes McGlynn. “The business development people at these large medtech companies are very sophisticated people; they do their homework, they’ve got huge domain knowledge in their specialist area. They’re a bit more targeted than the venture capitalist. I think they’re under a tremendous amount of pressure to help find and fund the best new projects, and the exit might be a little bit earlier to the corporate investor than the venture capitalist. We just started a company with really exciting technology, and Covidien was the first investor.”

Other Funding Sources

“European venture funds are interested in investing in medtech companies that have a CE mark and want to commercialize in Europe,” McGlynn says. “So these late mezzanine rounds where we used to have a lot of interest from domestic VCs now have a lot of interest from international VCs.” He also notes that grants are a big source of capital today. “There’s a lot of money through DOD, SBIR, and NIH grants, as well as from foundations with an interest in the area a new venture is addressing.”

Curtis has seen a change in attitude about grants. “I think government grants are going to be increasingly important,” he says. “For the past 10 years, the venture community looked down their noses at device companies that received grants. Grants are attractive from a founder’s standpoint as they are non-dilutive, but it sets a government-financed research culture that the VCs find not very entrepreneurial. The state of Texas, for instance, has made two very large funds available for grants to Texas-based start-ups. Some states realize the benefits of doing this and will be able to stimulate their entrepreneurial economy.”

Regulatory Climate And Reform Hopes

Makower hopes for a new stable FDA environment because of these three changes:

• MDUFA guidance will be modified to incorporate key stakeholders feedback.1
• This legislation then passes, improving the efficiency and predictability of FDA.
• When it does pass, FDA quickly and vigorously pursues the changes needed for it to take effect.

Ferrari is optimistic about the near future. “I think we see that FDA is very serious about trying to make appropriate changes to streamline the system,” he says. “There’s a lot of effort going on between AdvaMed and other lobbying and industry groups working with FDA. I think we’re going to see improvements. It may still take us two to three years, but there is a tremendous amount of pressure from Congress to change the system. I think politically it’s going to happen.”

Advice To Entrepreneurs

Makower sums up advice for those device companies currently looking for early venture cash: “You need to be aggressive [and] resilient, and if you believe in what you are doing, don’t give up. If you have a choice of projects, choose one where the regulatory path is clear.”

Keeping your venture lean has become the new mantra to allow sparse investment dollars to go further. “Don’t quit your day job until you’ve made some progress with your new product,” Curtis advises entrepreneurs. “Make sure that every dollar goes to moving the product forward in the early days to get to a major milestone, like first-in-man. Then you’ll be better able to go out and raise more money at a decent valuation. Entrepreneurs should look at being entrepreneurial within the context of what they are already doing, and find other people who are interested in doing virtual incubation, making progress working evenings and weekends. There are some very smart and dedicated people in this industry. I think they’ll find new ways to do things faster, cheaper, and better.”

Ferrari also counsels a lean approach. “If you are going out to raise a seed or early round, the best validation to raise money is if you’ve already got some angel money or put some of your own money in,” he says. “If you haven’t done that, [then] when you pitch you’ve got to have a well-thought-out game plan. It might be best to approach the problem in small bites. For example, instead of asking for $10 million now, just raise $2 million, set up some very tight milestones, and run an efficient operation. Mitigate the risk of the program and then go on to raise the next piece. Inch your way along until the risk gets wrung out of the program. That’s a very efficient way to run a company, and the way we used to run them a decade ago.”

Wyler believes today’s leanness means something different than before. “I think it’s much harder to be the cliché engineer in the garage,” he says. “It’s a lot tougher today to go on your own as a first-time entrepreneur. Team up with proven people with a proven process. Connect with the incubators, connect with the successful entrepreneurs who have relationships with investors, and recognize that fundraising is likely to take longer and require more creativity and persistence than in the past.”

Demographic trends still make the medical device business an attractive investment opportunity. “At the end of the day,” says Ferrari, “I still believe that healthcare is an important component to have in an asset allocation model because you can’t get away from the fact that the population of the world is growing older faster than at any other point in time. And we need healthcare. We want the best devices and drugs, and to go to the best medical centers. This is not going to change."

“Be tenacious,” McGlynn advises medtech investors, because the industry is still healthy. “We continue to close a lot of early-stage rounds. This is a great age. There are some incredible ideas out there. I’ve seen that entrepreneurs need to be leaner. They’ve understood they have to move their products farther before they’re going to be eligible for venture financing. So I’m very bullish about the industry. For those who are tenacious and have a great idea, there’s going to be money.”

References

1. Medical Device User Fee Amendments of 2007 expire September 30, 2012. Congressional committees had planned to move legislation by April 2012 and have the new measures passed by both the Senate and House by early summer.

The Healthcare IT Series: Medical User Interfaces – it ought to be about engagement

Mon, 12 Mar 2012 17:40:00 GMT

After Bridge’s recent highly-attended webinar “Easier-to-use UI,” Bridge Design President, Bill Evans will be presenting a similar topic about the diverse usability and customer appeal challenges of medical UIs at the Silicon Valley Forum Healthcare IT Series on March 13, 2012. Participants will come away with a new perspective on what it takes to design medical UIs and actionable ideas to tackle their own UI challenges.

This is likely to be a lively interactive presentation as Bill is presenting alongside Dr. Justin Graham, M.D., M.S., the Chief Medical Information Officer at NorthBay Healthcare which is a two hospital healthcare provider in Solano county. Justin will bring a healthcare provider perspective to the discussion on what is likely to be an interesting debate about various needs on medical UIs to improve the quality and potentially lower the cost of care as well as engaging healthcare professional and patients more in the process.

Location: DLA Piper
2000 University Avenue East Palo Alto, California 94303-2214

Agenda:
6:30 - 7:00 p.m. Registration / Networking / Refreshments
7:00 - 7:15 p.m. Announcements and Introductions
7:15 - 8:30 p.m. Presentation and Discussion
8:30 - 8:45 p.m. Wrap-up / Networking

Cost:
$20 at the door for non-SVForum members
No charge for SVForum members

www.svforum.org/healthcareIT

If you are a UI device developer or a healthcare professional with some pet peeves about the devices you use, please contact HealthcareITsig@svforum.org to address your issues during the Q & A.

Easier-to-Use UIs: How to win approval from users-and the FDA

Tue, 17 Jan 2012 22:56:00 GMT

Bridge and Design Science jointly present a Qmed webinar on February 22, 2012 11 am PST/2 pm EST. Diana Greenberg, Bridge's Director of User Experience and Design Science Principal & Founder, Dr Stephen Wilcox will draw on their considerable experience in designing easy to use, engaging and safe user interfaces for medical products to lead a discussion about what it takes to develop such interfaces.

Your customers have told you that your next-generation medical device must be easier to use and you’ve heard about the new FDA human factors testing that might be required. You know you’ve got to have some kind of information display, and now you're ready to move towards creating that highly-desired, simple, engaging, and FDA approved medical user interface. This webinar covers the fundamentals of how to go about creating such an interface and how to smooth the path through FDA HF testing. Two companies, Bridge Design and Design Science, each with great expertise in their respective fields (UI design and human factors), will explain and illustrate how to:

Understand what your specific users and stakeholders mean by "ease-of-use"
Appreciate the fundamentals of good usability
Know the criteria to help you choose the right style of interface (e.g., touchscreen or soft key-based, or using other input devices)
Understand how to integrate a UI into the other components of your medical device or system
Create that customer-appealing interface
Develop an optimal prototype-test-iterate process with your users that will validate its usability and smooth the path to regulatory approval
Deliver the UI to the software development-team in a simple and clear way that is as easy to implement as possible

Attendees of this webinar will get immediately actionable ideas on all the above topics as well as access to downloadable articles and whitepapers that provide data and further explanations of good practices and processes.

Bridge Design’s Director of User Experience, Diana Greenberg, and Design Science Principal and Founder, Steve Wilcox, will provide the core content of this webinar.

Some related items:

-These articles are from MDDI in May & July 2007 and outline Bridge's approach to designing medical UIs.

"Design Research Part 1: Creating Better User Interfaces"

"Design Research Part 2: Refining User Interfaces"

-A workshop session on touchscreens from Design & Manufacturing Conference 2011 chaired by President of Bridge Design, Bill Evans.

Some examples of our UI work:

Cozmo Insulin Pump: Sets the standard for ease-of-use in this category.
Solis
AcelRx NanoTab PCA . This recently announced delivery system integrates RF tags and a small colored screen into a small delivery device that enables secure and safe drug delivery.

Bridge Design to lead all day workshop about Touchscreen Interfaces

Wed, 24 Aug 2011 23:48:00 GMT

If you are just beginning to think about using a touchscreen or if you already started down the path and want expert guidance, then visit us at this year’s Design & Manufacturing Midwest 2011 Conference on September 22 in Chicago. My colleague Diana Greenberg who heads Bridge’s User Experience practice and I will be leading this session. In it you'll get to understand the most crucial aspects of what you'll need to know to make the right decisions about the technology, design and development issues of bringing this great user experience to your customers.

Also speaking is Steve Wilcox, Founder and Principal of Design Science, a Bridge partner who has worked with us on several occasions assisting with the Human Factors aspects of UIs. He is speaking about Fitting Touch Screens to Your Users.

Bridge is also pleased that several other leading experts are working with us to make this a very informative session – see the conference agenda here for more details and the other speakers.

The session runs on Thursday, September 22nd from 9 a.m. to 4 p.m., with a 2-hour break for lunch and networking. Join your colleagues and register today to gain new insights and practical information you can immediately apply to your job responsibilities!

Register by August 26th to get the early bird discount. Click here for more registration details.

A recent touch screen interface for ICU blood glucose monitoring developed by Bridge with IntelliDx.

If you are interested to learn more about Bridge's approach in creating highly usable UIs prior to this workshop, see this article Bridge wrote that outlines our approach. We've refined our process quite a bit since writing this article in 2007, but it does explain the basics and has some great information on smoothing the path of how your UI will undergo scrutiny with the FDA.

Innovation in MedTech Companies

Wed, 11 May 2011 22:22:00 GMT

Read the new article by Bill Evans in this month's MD&DI magazine called "Lost in Translation? Innovation in MedTech Companies, from Ideas to Execution."

Read about it here.

20 percent of San Francisco banks on it!

Wed, 11 May 2011 19:59:00 GMT

Bridge Design decided to ring in 2011 by volunteering at the San Francisco Food Bank. Along with two other groups, we weighed, repacked, labeled and boxed bulks of pasta into 1 lb. bags for a total of 4000 lbs.

The scale of operations in SF Food Bank is overwhelming. Tons of donated canned goods and produce are provided to approximately 200,000 people through over 400 non profit partners. This translates into approximately 1 million pounds of food passing through the food bank every single week – hence the need for so many volunteers.

Stay tuned for more Bridge Design volunteer events in 2011!

The Convergence of Medical Devices & Consumer Products

Tue, 29 Mar 2011 17:50:00 GMT

Bill Evans Principal of Bridge Design San Francisco speaking at a GlobalSpec eVent "Medical Equipment Design" on March 3rd 2010.

After a short introduction by the moderator, Bill discusses the opportunities and design approaches for
medical device manufacturers to create convergent products. For Bill, the way the term convergence is
used in this context is not the same as it might be used to describe a smart-phone that converges a
music player and PDA into itself. For him it’s about the convergence of consumer product design
thinking with medical device design thinking, creating products that delight users and exceed
expectations.

Especially in highly competitive areas of medicine the biggest opportunity for device manufacturers is
to create more consumer product-like experiences for their users rather than just trying to leverage
consumer product technology. Certainly inexpensive color LCD screens and powerful processors help
in this convergence but it is not the only way. Medical devices without any electronics in them can
benefit from this thinking. Bill gives specific examples of products and describes where he gets his
inspiration for convergence and the design processes that are likely to be successful in achieving
such customer-satisfying devices..

1960 Decanter Design video

Tue, 29 Mar 2011 18:52:00 GMT

As one of the younger designers at Bridge, and a person who remembers very little prior to the mid
1980’s, I have come to take certain things for granted. As a member of contemporary society, the
internet, e-mail, and advanced computing have become so ingrained in the fabric of everyday life
that I often forget to take a step back to appreciate and even stand in awe of the modern
conveniences that make life, and more specifically, work, so efficient and, in some cases, much
more painless than they would be otherwise.

Once in a while I stumble across a reminder of how daily life would be without many of the
technological advances that have become so ubiquitous in my work day. The short film
“Design story: The Decanter” created as a promotional video for the design firm Landor & Assoc. in
1960 is one such reminder. As I watched this film I was amazed at the amount of effort and the
laborious steps that went into the design of a simple whiskey decanter. Even as a student, with
limited resources and finances, I was afforded many more luxuries than the professional designers
of that era. As each scene played out I could list in my head numerous modern tools at my
fingertips that the designers at Landor had no difficulty doing without. Looking at the totally
analog, manual design process in this video, I can appreciate the great skill and craftsmanship that
was a standard part of industrial design 50 years ago.

I do recognize that some legs of the design process have changed very little since the time of this
film, but with the introduction of such technological advances as e-mail, 3-D CAD, and rapid
prototyping these processes have become less cumbersome and much more streamlined. My hat is
definitely off to the designers of the 1950s and 1960s.

Enjoy the video.

-Chris, Senior Industrial Designer

Welcome to Bridge’s new website

Thu, 13 May 2010 21:22:00 GMT

Finally our new web site is up and running – thanks to considerable efforts by our ID Director Matt Presta and our Marketing Assistant Caitlin Clarke. We should also thank our web developer and host Level9. The new site will allow us to update and add new projects much more easily as it has the latest in content management systems to make this easier. Thanks for visiting and come back as we will be adding new content regularly.

Bill Evans President Bridge Design

The Next 30 Years

Tue, 29 Mar 2011 17:49:00 GMT

Bridge’s views on the future of medical design were featured in an article for this month’s edition of MD&DI Magazine. In the article, President Bill Evans discusses the rise of patient-centric design, using the Stork example we recently featured, and includes a few other important trends we’ve observed.

Above: photo from superDimesion website

Evans writes about the use of gaming industry technology to create new ways of guiding surgeons and interventionists to their quarry, with companies like SuperDimension leading the way. He also discusses our prediction that as electronic medical records (EMRs) become more widespread, there will be a greater possibility of smarter devices that will act independently according to the patient’s medical history, in addition to what the sensors are reading.

Click here to read the full article.

This article reflects Bridge’s more general approach to design thinking – we are always on the lookout for general trends in technology that will have a potential impact on medical product design. Evans recently returned from a trip to the UK and noted a couple of trends in Europe that are slightly ahead of the U.S. that could eventually find their way into medical products.

First, an example with interesting potential in chronic disease management is a new cell phone-enabled technology on sale in the UK by O2 (a large carrier) called the Joggler. It’s a family-oriented “central” organizer (think a touch screen family calendar you keep on the fridge door). It is inexpensive and serves as a way of coordinating family activities by texting reminders to all family members and generally being a place to keep common family information. It has a large touch screen, is video capable and is rumored to allow third-party apps to run on it.

Above: The Joggler

Imagine the power of this kind of network-connected appliance that is also connected to you personal cell phone or personal healthcare device in the future. Applications could be created that become a central place for current information about your health to be stored, text reminders could be sent to your cell phone, your doctor could get monthly reports or be notified about exceptional events triggered by readings from your personal monitors. When more of these personal health monitors (such as BG meters, pill containers, inhalers, etc.) start talking to each other, this could be a boon to managing chronic conditions such as diabetes, asthma or COPD, obesity etc. where a combination of monitoring compliance or reporting diagnostics could be more powerfully and transparently coordinated. No need to worry about inputting it to your computer or even bothering to have an internet connection with difficult-to-set-up WiFi connectivity. The always-on cell link could look after that.

Another interesting trend noted on the same UK trip was a way of making print advertisements more interactive that could have interesting medical applications. Some innovative marketers have added 2D bar codes to their print ads that are readable with a regular cell phone camera. The idea, seen on a Volvo car ad in the Guardian Newspaper, is that users snap an image of the small 2D bar code. Because of a previously-installed generic app, the phone knows where to send the bar code and the cell-phone user then gets a link to a video sent to them by return, in this case a video showing a Volvo ad.

What Bill found interesting about this idea is that if this technology takes off, it could become an interesting way of expanding the way in which people with various conditions monitor and manage their health. For instance, Advair inhaler users are supposed to note the exact day they open their inhaler package and stop using it after 30 days, due to its shelf life once opened. Who actually does this?

Instead, if the packaging had this bar code printed on it the user could just snap a photo and 30 days later, they’d get a text saying it was time to open a new one. Imagine if all foods began carrying this bar code and it was linked via web site to help you manage calorie intake for dieting or carbohydrate intake for people with diabetes. How many users bother to read those obscure, icon-laden instructions for use (IFUs)? What if the packaging for that complex device had this 2D barcode: the healthcare professionals could photograph it on their iPhone camera and then immediately see a short IFU video in their local language that shows them in better-animated terms how to correctly use it?

Bill put together a short list of directions for how to do this yourself:

First, download the free “scanbuy” app to your phone (we tested it on an iPhone but it’s also available to many other phones) from scanlife. You must have this app on your phone for it to work.

Next, aim your camera phone at one of the barcodes below on the computer screen. The first bar code will lead your phone web browser to the Bridge Design blog; the second one will lead to a video demonstration of how to use a product we designed, Cleo (you’ll need to click through on the video to run it). The bar code will work from print, computer, and television. Take a picture.

Above: Cleo video 2-D bar code

Bridge 2-D bar code

Did it take you to our website blog, or to the video? The possibilities are enormous — get on with applying it!

Stork Prenatal Portable Ultrasound

Tue, 29 Mar 2011 17:43:00 GMT

From our vantage point of spending a great deal of time in the field and always working on the next great medical product that’s 2 to 5 years away from release, we have an interesting relationship to medical product design trends. On the one hand we help establish the trends with the products we do. On other hand we observe changing cultural trends and incorporate those into our design thinking.

One of the larger trends we are seeing is that some of the thinking behind what makes a great consumer product is finding its way into forming medical products, especially those that are very patient-centric in their use. Nowhere is this more obvious than in application specific products where we have an opportunity to design for a much more specific group of users, the product can be designed for a much better patient experience without the need to be all-things to all users like many of the general medical products out there. To give an example of this trend and be able to show it now the Bridge ID team designed our interpretation of what an ultrasound device could be like in the near future. Our press release below.

San Francisco – April 6, 2009 – Bridge Design, Inc. - Portability is the fastest growing segment in the ultrasound market. Imagine fast-forwarding a few years when technology becomes less expensive and more powerful and compact. What would a birthing-specific ultrasound, designed specifically for the mother–to-be, look like?San Francisco-based Bridge Design has come up with an innovative, mother-centric device that focuses on making the ultrasound experience pleasant and hassle-free. The Stork provides a number of features not yet on the market, including a second display so the mother won’t have to strain her neck to look at the screen. It also allows the mother to email electronic images directly to family and friends from the device instead of receiving paper printouts. Unlike the average ultrasound machine, the Stork is unintimidating, even playful, with a flip screen and basket-like portability which contains “cup holders” for probe and gel. The Stork’s color, materials, and finishes forgo the clinical white and gray palette for a much more soothing birthing experience.Bridge’s Director of Industrial Design, Matt Presta, who also happens to be a parent, explains:“Any mother who has had an ultrasound is familiar with the cart of equipment, probes, gels, screens, printouts, and everything else that comes with it. And although the experience is necessary for clinical reasons, many parents just want to see their baby. For years, Bridge has observed trends clearly pointing towards designing for the patient’s experience. Since we’re still a few years away from seeing the tipping point of the patient-centric trend in health care, we wanted to provide a glimpse into the future based on what we’re seeing happening in the industry.”It’s worth noting that although this device has not yet been manufactured it reflects a trend that Bridge sees growing, with more application-specific medical products likely to appear at healthcare facilities in the not-too-distant future. “As a given technology matures, its cost and size typically shrinks. This opens up exciting possibilities to those forward-thinking medical equipment manufacturers who understand that if you change your design thinking to be more user and patient-centric, then new market opportunities can be created. Addressing baseline functionality and reliability at low cost is not enough to stay ahead of the game in mature markets,” says Presta.

A description of services can be found at http://www.bridgedesign.com. SOURCE Bridge Design, Inc. Contact Matt Presta of Bridge Design, Inc. +1-415-487-7100, ext 300, mpresta@bridgedesign.com

Dave Clark Aviation Headset Conceptual Project: Photorealistic Renderings

Tue, 29 Mar 2011 17:54:00 GMT

Taking a breather between projects, we got a chance to do an in-house conceptual project: A design refresh to the legendary Dave Clark aviation headset. Like what BMW did with the Mini Cooper, this was an exercise in envisioning one way that Dave Clark could extend and reinvigorate its brand as it moves into the new millennium. Since the original was a rich mix in materials (metal, painted plastic, rubber, etc.), the new version retained and amplified these qualities. Unfortunately we’ve never had a chance to work with Dave Clark, but who knows…maybe some day. Photorealistic renderings done in Hypershot for Bridge Design.

©2009 Bridge Design Not for republication.

©2009 Bridge Design Not for republication.

©2009 Bridge Design Not for republication.

All New Ronaldo

Tue, 29 Mar 2011 17:41:00 GMT

Bridge is excited to announce the latest addition to our Industrial Design team, Ronaldo Carreon. Ronaldo has spent the past five years working at Worrell Studios in the Twin Cities designing new and exciting products for the medical, biotech, and commercial industries.

Along with bringing top notch design skills to the team, he also brings expertise in photorealistic rendering. Ronaldo is a Pisces, enjoys fusion jazz and his favorite color is red.

New Video for CADD-Solis Infusion Pump

Tue, 29 Mar 2011 17:41:00 GMT

We created this one-minute video about our work on the CADD-Solis Infusion Pump. Take a look:

Bridge collaborated with Smiths Medical to create the next generation of Smiths' flagship ambulatory pain management pump. The CADD-Solis pump is designed to deliver pain management drugs safely and effectively. Click here to visit Smiths' website.

The project was the result of researching the needs of each set of stakeholders who contribute to pain medication delivery, from hospital risk managers, to pharmacists, to the doctors and nurses who program the pumps. Bridge's role focused on the design research, user interface concepts, GUI graphics and industrial design of the pump itself.

CADD-Solis: Improved Features

Three main new user features were created for CADD-Solis:

The pump's user interface is designed to reduce medication errors as well as greatly simplify and shorten the time it takes to set up a new patient and modify pump settings. The UI is simple, intuitive, and task-oriented. The on-screen graphics are designed to help make it informative at a glance and provide tools for clinical assessment.
The improved remote dose cord is ergonomically designed to sit much more comfortably in the hand of a potentially sleepy patient. It also offers greater ease-of-use for those patients who cannot comfortably use their hands.
The medication cassette can now be changed using only one hand, instead of two hands as was previously required.

How CADD-Solis Works

The CADD-Solis system provides a framework that is customized by the hospital. Using PC-based CADD-Solis Medication Safety Software, the hospital creates a customized library of therapy protocols. A therapy might be named by route of delivery, further defined by a qualifier such as patient age and condition, and finally associated with the drugs selected for the protocol. The therapy protocol library is downloaded to all the CADD-Solis pumps in the hospital. The pump user now has a simple and effective way to administer medication.

To set up a patient for drug delivery, the user steps through a sequence of three questions. Only a limited set of safe choices are available at each step during programming, based on the therapy protocol selected. Once a protocol is selected, the user can adjust delivery parameters only within predetermined safe limits. Click here to visit Smiths Medical's website.

Working on Your Creative Muscle: SoCRA Presentation

Wed, 24 Feb 2010 23:45:00 GMT

Here is a speech Bridge Principal Bill Evans presented at SoCRA on September 26th, 2008 in Vancouver. It details how to get back in touch with your right-brained creative side, and some specific activities that will help your creative juices flow.

SoCRA Creativity Presentation

How to improve your creativity and become more innovative in your organization.

Hello, my name is Bill Evans and I make my living as a designer of medical devices. But today I am going to talk to you about creativity. Before I begin in earnest I’d like to ask, how many of you would like to improve your own creativity? I think that there isn’t a walk of life that wouldn’t be improved by a more creative approach.

Witness these two radically different aspects of life – both of which might be characterized as areas one would not expect to find much creativity – but that demonstrate you can apply creativity anywhere to great effect. One example is for the good of mankind and the other didn’t turn out so good. On the left we have person who demonstrated in spades that the allegedly dullest profession on earth is indeed capable of great creativity – it is of course Jeff Skilling of Enron and his corrupt but creative accounting practices. And on the right is a man, Nelson Mandela, who took an aspect of war and conflict resolution, usually known for its blunt application of power and found a much more creative approach with his Truth and Reconciliation Commission, which has now become a model around the world for helping solve seemingly intractable conflicts between warring interest groups.

Now I know from my own interactions with medical device approvals that your professional society’s members are charged with running a tight research process to satisfy the rigors of the FDA and the scientific method. And you might say “what place does creativity have in the process? – it’s not a very important part of my job.” I would still argue that there are plenty of opportunities to apply creativity, whether it is in structuring innovative trials that shorten the approval cycle, or in observing the trial in progress and making creative connections with what you observe to allow the product development team to either fix design problems that are hindering the products success in the field, or to creatively see ways that you can tell them what to consider as improvements for the next generation products.

I know from my own experience that it is the eyes and ears of the field researchers who actually put in the hours observing device users at work who often can have the most insight into what could be better in the future. I wish more engineers spent more time in the field – products would be so much more usable.

Many of you just indicated that you’d like to be more creative. The truth is that most of you used to be much more creative than you are now. Creativity tests (yes they do exist) show that at age 5 most children score highly in creativity, yet by the time they get to 8^th grade their creativity scores have dropped considerably. They’ve had it knocked out of them so they can get through all this rational linear education process. That creative ability is still inside every one of us, and I don’t mean that we’ll all quit our day jobs and end up playing our instruments in Carnegie Hall, hanging our art in MOMA or signing our best seller in Barnes and Noble.

What I am going to describe today is a number of simple activities you can do that will help you unlock the creativity inside of you. You never know: maybe there will be a few second careers as a result of it (that new mystery novel about the machinations of the FDA is going to be a best seller for sure.) But what I know for certain is that as you unlock this side of yourself, you’ll become that little bit more effective in your work and enjoy things in your personal life you thought you left behind many years ago. As Sponge Bob Square Pants said, “It’s about ‘Imagination’.”

The skills that unlock creativity are often about seeing things anew, listening to what people say with a different kind of attention, quieting your own internal voice that keeps trying to direct you in old ways and observing the non-verbal aspects of communication. I hope you can see that all of these things have relevance to what we all do every day, and today I intend to describe a number of things you can practically do to help develop these qualities in yourself.

For this talk to be effective I am going to ask each of you to make a commitment. Ask yourself what kind of educational experience you want. Is it a high, medium or low risk experience? And I say “risk” as being creative or innovating anything always carries potential risk of failure as well as the reward of success. Paradoxically part of succeeding at creativity involves occasionally failing on your way to success (and I’ve failed at a ton of things I’ve tried). This might make you uncomfortable, especially as you are probably used to succeeding in what you do now. This is yet another barrier to unlocking this ability inside of you, get used to the discomfort as creativity is a messy business, becoming good at it means sticking your neck out and risking the embarrassment of failure – but it’s worth it. Is it high, medium or low risk experience? And don’t worry, I’m not going to ask you to embarrass yourselves in front of your colleagues here today!

Now I’m going to suggest a number of things you can do to unlock your creativity muscle. Those of you that wanted a high risk experience just agreed to do at least two of the things on this list, the medium risk people agreed to do one and the low risk people need to re-examine their risk tolerance if they are ever going to unlock the potential I know they’ve got inside of themselves.

My first suggestion is:

Learn to Draw

Some of you may well already draw “realistically”. Kids love to draw and as they go through developmental stages their drawing changes. There is a point at about 10-12 years old where kids either make the transition to draw things realistically or they tend to get stuck drawing in a representative fashion.

If you got stuck at the representative level (and most of us did) then probably what has happened is that the “rational” side of your brain is overpowering the part of your brain that could see the way something actually looks and instead keeps drawing the house or the face in a fairly unsophisticated way.

Many of you will have heard this type of explanation before as the right-brain left-brain argument. The research goes that the left brain processes and controls the rational, analytical and objective parts of us, while the right brain processes the intuitive, random and subjective parts.

Back in the late 70s an art educator named Betty Edwards decided to do something with this research and wrote her best seller on learning to draw: “Drawing On the Right Side of Your Brain.” I’m glad she did because I used it to teach myself to draw before going to art school and now that I find myself in a room full of people who are probably very left-brained I can present a rational left-brained argument as to why you can all learn to draw (or perhaps at nearly 5 o’clock on a Friday, I mean I am in a room full of people whose brains have left – you decide.)

Betty Edwards’ argument is very simple and she is able to demonstrate her hypothesis to you with a couple of simple exercises that I thoroughly recommend you try.

What she says is that if you have not yet made the transition to drawing realistically you need to learn how to quiet the left-brain part of yourself and switch on the right side. And she has an outrageously simple trick to demonstrate to you that you can draw.

Here is one of the illustrations she uses. It’s a sketch of Stravinsky by Picasso. She says “Copy it” but only allows you to look at the cartoon upside down. It’s hard to make heads or tails our of this sketch upside down so in my experience (and I’ve tried this with many people) when people are asked to copy it upside down they focus on copying the lines by actually looking at them very carefully and reasonably faithfully reproducing them – they may get the proportions a little wrong and stretch the image here and there but on the whole after about 10 minutes of trying to copy it they are very surprised when they turn their line drawing up the right way and see they’ve done a pretty good job – “Good grief – I can draw after all!”

From this example Edwards goes on to refine your way of looking at things with a string of equally simple exercises. She’ll have you drawing faces with just the shadows, or trying to draw your hand with your eyes shut just by feeling what it looks like.

I grew up like many of you in this room from a pretty left-brained educational process and this book really worked for me. I found that the more I looked at what was actually there the more I saw and the more able I was to represent it. I could spend hours in a life drawing class focusing on a small detail. Time would pass by without my being aware of it – it was a different state of mind.

Sure I learned to draw but I also took away a very important new way of looking at the world that helps me every day.

Learn to draw - and you learn to see things more as they are.

Do A Creative Writing Class

I am sure many of you have to write quite a lot for your work. And perhaps some FDA submissions might qualify as works of fiction…. But for those of you that skipped that creative writing class 101 (and we have no such thing in my native England) I would suggest that trying your hand at some creative writing is another great way of unlocking some more of your innate creativity.

For this I recommend doing a group class as not only will a good teacher tailor the feedback to each student’s ability but also it allows you to deal with another important part of the creative process – that is dealing with the risk of putting your creative product out there and not having it well received by your fellow classmates. All of us have a fear of failure, of being embarrassed that whatever you did was not good enough, of finding out something you thought was a funny idea maybe isn’t funny to anyone else. Personally I have this little demon sitting on my shoulder whenever I am doing anything you might call creative and he gives me a running criticism of what I’m doing wrong – I have to keep smacking him down to shut him up. This fear can sometimes stop us from trying to stretch out and exercise that creativity muscle. And of course as you try and stretch out in new creative ways as an adult you are often asking yourself to start at such a basic level you feel like a one-year-old taking its first stumbling steps. It’s potentially embarrassing – get over it; you’re probably better at creative writing than you think and the paradox of exposing yourself to potential failure is that you’ll probably meet success sooner than you think (sure you’ll fall over sometimes too).

For those of you that haven’t tried creative writing I know what you’re thinking. “Woe is me” – what an earth am I going to write about creatively. Well just like the Betty Edwards trick of upside down drawing, a good creative writing class will start with simple tricks to un-freeze that 8 year old story teller inside of you. (Did you ever notice what good story tellers and dwellers in fantasy land kids are – yet when we get to adulthood most of us seem to have lost the ability to want to make stuff up.)

Here’s some tricks I’ve observed:

A sneaky teacher will do something like this – throw up a big list of words and ask you to pick 10 words you like. You think this is a random list and without too much consideration for what might happen to the words you pick 10 probably unrelated words you like. You might think “the teacher will ask us why we choose these” or some other such stuff. Of course the teacher is being sneaky to get you over the woe-is-me hurdle – she then ask you to write a prose poem that uses all the 10 words; you’ve got 10 minutes now write!

You didn’t choose the 10 words to go together, yet alone to frame a poem around. The result is that you are caught off guard, and forced to be creative with your seemingly unconnected words. It’s a short exercise that often produces some amusing or clever little vignettes from the class – sure some of them don’t work but everyone gets a chance in a short space of time to write something original AND creative. I’ve heard of variations on this like the teacher dumping out a big box of seemingly unrelated bric-a-brac and asking everyone in the group to take two things from the pile that look interesting – “Now write 200 words connecting these two objects in a story” – you get the idea. Get over the hurdle of what to write about and instead just write –you’ll be surprised at your creative ability.

My personal favorite is the assignment to choose a “found” kind of writing form like a menu, an instruction book, a guarantee, a classified advertisement and write something creatively interpreting and re-purposing that form. One of the students who was a city guide in San Francisco used postcards and wrote short snap shots of exaggerated tourist-speak that she had to put up with each day in her job…. This writer is now a good way through writing a children’s book inspired in part by her success in this class.

The important thing to note about creative writing is that it’s impossible to do it without having to think about the subject in new ways, with a fresh pair of eyes so to speak, by thinking around the subject not necessarily thinking about it head on. And then once you’ve thought about it you’ve then got to communicate this new creative thought to your readers clearly and engagingly.

So it’s a two-fer:

Do A Creative Writing Class – and you’ll improve the way you observe and understand things as well as the way you try and communicate these things to other people.

You may never get published in that literary journal, but you’ll have worked that creativity muscle a little more and that next 50 page report will be that little bit better of a read and based on a broader way of understanding the issues.

Do an Improv Workshop

I got the idea for this section from my experience at an improv workshop with Steve Portigal.

I know what you are thinking; you work in a field where the last thing in the world you want to be doing is making stuff up as you go along. But that’s only one way of looking at what doing a little bit of improv can bring to your everyday life. In reality it has a lot to offer us about listening and observing as well as exercising that creativity muscle some more.

Contrary to the name of the popular chain of comedy clubs, improv is not stand-up comedy. Stand-up is typically highly scripted and rehearsed. And despite its anything-goes reputation, improv is a form of performance that is in fact highly restrained but with several open parameters. It is unscripted and the specific restraints and themes of the performance are typically assigned right before the performance is started. It does not necessarily try to be funny, but “funny” tends to happen. In teaching how to do it they say, “Your first idea is often your best idea” and when you’re starting to dry up try “yes, and….”

Like creativity, improv is spontaneous at its core, but like all these exercises designed to improve your creativity it can of course be taught, exercised and improved. To see what improv can do for you is something that you have to experience by doing. It is of course best demonstrated with simple examples (more of these tricks to fool you into being creative). This is where we come to the section of my talk you’ve all been dreading when I ask for audience participation. It is after all nearly 5 o’clock on a Friday so it’s time to let our hair down a little bit.

Now this exercise is not about acting or prancing about on stage, instead it’s a simple short word game and I promise there is no sting in the tail. I need 6 volunteers to come on stage and form a simple line.

Your job is to tell a story and the audience is going to give you your subject. The rules are simple – each of you can only add one word to the story at a time and then the next person in line adds the next word and then back to the start of the line. Remember – “Your first idea is often your best” and the old trick of “yes, and….” You can decide to finish the sentence or start a new one. The point is that this group of 6 people are collectively telling the story, it belongs to all of you not just one of you. You might say, “I-Just-cycled-around-Stanley-Park.”

Here is the topic (and this is SoCRA’d):

Name a type of thing in a hospital operating room –

A person’s name –

A city in Canada -

OK the story must include these words somewhere (OR thing, person, city), it can be one sentence or many, but you’ve each got to add one word only at a time. If you feel the group is getting stuck just end that sentence or thought and start a new one.

OK go (OR thing, person, city).

Now you’ve seen this demonstration what did people observe – those that participated as well as those watching?

My observations: you’ve got to let go to make it work, the more you focus on your own impending word opportunity the more frozen you can become. You’ve got the stand back a little and listen to the whole rather than on the part immediately before you. The group owns the story not you.

Now I only had time for one very short exercise and there are many more that could be done to make all sorts of points about words and observations.

The main lesson for me when I did some of these exercises is that it really demonstrates how complex listening (and observing) are. How

we can really get in our own way of hearing or seeing what is really going on. So much of what I do when I go out into the field to interact with healthcare professionals is about trying the figure out what they actual do, what they expect my potential new design to do and how to deal with the very difficult subject of trying to understand what “could be” instead of “what has been.” You in the room are often working on new stuff and you know full well the difficulties of, on the one hand, users having to change their habits and on the other of the development team seeing that those great ideas they had back in the lab are not as great as they first thought.

A key to unlocking a better understanding of these issues is to become a better listener and observer of what your users are trying to communicate to you.

An important skill is that you have to learn to be comfortable with silence, creating gaps to let the person you are questioning fill them in without them getting subliminal prompts from you to chase the conversation along in your direction.

Do an Improv Workshop – and you’ll become a better listener (and observer but we didn’t get to that exercise today…)

I am sure many of you in this room play or have played a musical instrument, so this part will be more familiar to you. Probably fewer have played improvised music and it’s the improvising part and its role in creativity that I am most interested in talking about today.

Those that don’t play an instrument are thinking, how on earth can I improvise on an instrument if I haven’t a clue how to play it in the first place. “This is going to take me years to achieve”.

Wrong – just like all the other creativity exercises suggested here today there are some simple tricks that in minutes will have you unlocking the improviser within.

Music does not have to have complex tonal and rhythmic arrangements to be music. It can be very simple. The trick is to pick instruments that have minimal technical skills required to play them. The easiest place to start of course is with rhythm and use simple percussion instruments, but actually there are many simply instruments to use and there is a whole body of educational approaches encompassed in the Orff music teaching methods.

Many of us, especially from the boomer generation like me, faced a music education that got bogged down quickly in technique and theory instead of letting us have a ton of fun messing around making music. The result was that we gave it up young. Hang on a minute didn’t that also happen with all those wonderful creative things we used to do as kids and have now given up – there’s a theme here….

The beauty of improvising music as a group is that within minutes of starting to play it will become apparent to you how powerful non-verbal communication can be in creating something. You can’t talk to your fellow performers but you’ll often end up going in new directions together, you’ll build to an intensity and then lay back slowly all without uttering a single word (and often without the need for any overt gestures either). It’s all about anticipation, expectation, surprise etc all these qualities (often contradictory) will inject something into the improvisation to make it unique and interesting. Of course jazz relies on this form – but it’s by no means the only music to do this.

In fact if you liked the stuff earlier on left-brain right-brain then this is another activity that is a very pronounced right brain skill. When I play music with others I am incapable of talking, although of course it’s easy to sing along! The act of improvising with others truly takes you mind to a different place – but of course like many of the topics we’ve discussed today, you’ve got to let go to get something back.

A drum circle is the easiest way to try it. At this point I have of course gone beyond the pale – I am from California, I’ve worked on you to do all this touchy feely stuff like drawing, creative writing and embarrassed you with improv and now you want me to drum? Pleaaase…. You’ll be breaking out the absinthe next (which by the way is legal in Canada but I don’t recommend it.)

I warned you that creativity was a messy business.

For those reluctant to join into an intimate musical event they have invented the perfect safety-in-numbers version. The Giant Drum Circle.

With sometimes as many as a hundred participants you can have a fairly-low-risk-of –embarrassment experience. Shown here is a drum circle typical of what you might find at Carnivals around the various Latino communities. A good leader (and you need a great leader to bring out the best in any team) will organize the percussionists and slowly introduce the various rhythmic patterns that you’ll be using. You really don’t need to know anything about drumming or music. The leaders will use call-and response techniques straight out of the roots of music in many ancient tribal events. (see on this video). From the mother singing to the swaddled baby to the farmers working in the fields calling out rhymes, the call-and-response is the easiest way to learn.

A typical drum circle will build a base rhythm over perhaps 5 or 10 minutes and then give people room to improvise on top of this. It gives you a chance to get comfortable with the “pulse” so you can stretch out and play some rhythmic counter points on top of the basics. You may not be comfortable at first, but as the words of the proverb and country song go, “You got to dance like nobody's watching.” Especially in smaller groups you will be amazed how much the music breathes, changing gradually with a distinct form that was never written down and never verbalized to change – yet the group is somehow able to react to each other’s contributions and create something greater than the sum of the parts. Your best music will be when you let go and let the group’s music take you with it.

Brainstorming is a form of creativity that is very close to improvising or “jamming”. A successful session has very similar characteristics. It may be verbalized or not. It is possible to “riff” on someone else’s ideas (to steal from musical jargon). A person might suggest a humorous and not very practical idea that injects some laughs, and with the right group of people who are good at not being critical, one of the group members might immediately create a more serious response that “riffs” on the humorous idea but is new in a way that might be more practical. Who owns the ideas? Didn’t the band create the tune? That’s the whole point of good brainstorming, it truly is the group’s idea. Ask the patent lawyers what they think of that one!

It is actually possible to teach people to be better at brainstorming - and I do that from time to time and have written of my experiences here…

Play improvised music with other people – and learn the power of non-verbal communication in creativity and life.

The final lines of this come from a song called "Come From The Heart" recorded by Kathy Mattea, written by Susanna Clark & Richard Leigh.

You got to sing like you don't need the money
Love like you'll never get hurt
You got to dance like nobody's watchin’
It's gotta come from the heart if you want it to work.

There is theme here:

Creativity and innovation are risky but potentially rewarding activities that are very paradoxical:

You risk rejection –to get accepted

You’ve got to let go – to catch something

There isn’t a day goes by where I don’t find that some of the skills I’ve picked up at being creative don’t help inform and improve what I do – whether in my personal or business life.

I was teaching a new researcher the skills of interviewing healthcare professionals just this week and remembered what my improv workshop had taught me about listening.

I watched a bronchoscopist at work with a tricky new interventional procedure when the whole room was riveted to the endoscope video screen I was looking at his hands – observing carefully the nuance of the motion and noting where he was getting frustrated and what his fingers were doing when all around were pointing to the video screen.

In writing a field report about how we could design a new painkiller pump that reduced medical error I pondered hard a paragraph trying to explain how the interaction between human nature and technology could be made more forgiving to the human side of the equation and figured out how to communicate this complex analysis with few words and great clarity, so an upper manager with little field experience could see why it might be worth spending half a million dollars to create software to improve this situation.

As I sat interviewing a person with a chronic disease explain how they lived with their condition I paid closer attention to their body language to better understand what parts of living with their disease made them the most anxious.

All skills I have homed through practicing some creative arts, I hope you find them as useful as I do.

Don’t forget the promise you made at the beginning. Is it to be one or two of these suggestions you try? Please email me with your experiences or feedback – I’d love to know how you get on. Thank you for listening to me today.