Do we know what we want?

This is the second post (first) in which I reflect on the conversations that took place during the Diabetes Mine Innovation Summit.


As part of my participation I was invited to be on a panel about design – “Breaking Out of the Clinical Silo into Lifestyle Thinking.” You don’t have to spend much time in the diabetes (online) community before you hear people’s preference on their products and devices – what they love, tolerate, or wish they could change.

From my perspective as a consumer, I know what I want and I wish that I could get someone to design it. I may not know all the right words to use in the technology talks or how to code anything, but I know when a device works in my life and when it doesn’t.

That is why I was so surprised to hear one of my fellow panelists say that he would never hold another focus group during his design innovation process. He believes consumers are unpredictable and don’t actually know what they want. [Side note: Are we consumers or patients? Both? Which is better?]

Photo courtesy Diabetes Mine. Clearly I have things to say.
Photo courtesy Diabetes Mine. Clearly I have things to say.

Maybe it is because I am approaching the topic AS a consumer, but I don’t think it is the fault of the consumer if the designer or the innovator misses a issue or doesn’t get the answers they want. I have been in several focus groups, and it seems more often that they are asking the wrong questions.

I remember as recently as this past summer sitting in a focus group with another person in the diabetes community. A company was showing us their latest and greatest device that was designed to take advantage of the latest and greatest technology. The other member of the DOC and I basically looked at each other, looked at the rep, and asked why in the world we would want a device that did what they were “selling.” Sometimes just because you can, doesn’t always mean you should.

When I got my first pump it came with a meter that wirelessly sent results to the pump. I had great insurance at the time but for some reason, they did not cover the brand of test strip needed. I read online at the time that this brand of strip was not all that reliable so it didn’t bother me that much. A few years (?) later I found out that the pump company was switching to a more popular brand of meter to wirelessly connect to the pump. I was excited because it was the brand of test strip I was already using and what looked to be an identical meter.

The first day, and maybe even the first time, that I used the meter I noticed that there was a significant difference. The new meter was missing a backlight. I can’t say for sure that the company never talked to a patient or that there was never a focus group during the product development, but I find it extremely hard to believe that anyone with diabetes would have neglected to mention how important it is to be able to see to test in the dark.

what do we want?One of the participants in the summit discussion described how most diabetes innovation takes a one-off approach. Companies change one thing at a time and rarely revisit that “problem” and later innovations tackle a different “issue” with the device. However, a solution to one problem causes a problem in another area. The lack of a backlight described above is one example.

Another example would be a pump company that moves forward to integrate their pump with a CGM but removes the functionality of their meter remote – the biggest marketing feature of their current model (hypothetically of course). I believe instead that innovation should look at the entire system instead of neglecting components as changes are made piece by piece. As one participant stated it, “is this still awesome or do we need to start over?”

It probably doesn’t require being a person with diabetes to design every aspect of a diabetes device – I don’t need to know how my pump reservoir works, just that it does – but doesn’t living with the disease every moment of the day for the rest of my life mean that my input counts for something?

I like it

P.S. There will not be a Best ‘Betes Blogs for the month of December. Instead, I will try to put together a wrap up of all the great posts that have been nominated throughout the year. We will start again with the best of the January posts.

P.P.S. Like the Christmas touches on the blog? Ho Ho Ho!


  • Yay.

    The presumption that a bunch of designers can try on diabetes stuff and get it seems fatuous. They may get a feel for a little of it but that seems to be a significant difference from living it. The lighting issues is a fantastic example. There is nothing like fumbling in the dark checking BG and not being able to line up the strip and the drop of blood. And if you can accomplish that then being able to read meter shouldn’t be a value add.

    As you suggest this is just one of a number of basic functions that we hold to be self evident. I was proud to see you standing up for usability as a starting point.

  • I’ve been thinking of this issue lots these days. I’m thinking of switching pumps and the one I wear currently is no longer on the market. The newer pumps out there all have some nice features but are all missing features that I put on my “high priority” list. I agree with you that interviewing users is essential but you’re so right too add that they need to be asking the right questions. (And don’t get me started on the meter light question! Why oh why doesn’t ever meter out there have a little spot light on the test strip?)

  • Pretty sure I know exactly what I want. (From a parent perspective, that is). The light thing is definitely a top priority. I remember feeling like the Freestyle Flash was a dream come true. What the frutose, people???? Is it really that complicated to understand that I need to be able to test, regardless of the lighting situation we may find ourselves in?

    And the remote….yeah. Not only am I not willing to give it up, but I want a sleeker, prettier version that does more!! I want that. Don’t suggest I don’t know that I want that. Because I know I want that. (Also, by “does more” I’m fully implying that a light feature would fall under that category…along with the ability to make setting adjustments and set temp basals. Yup. I know I want that too.)

    Sorry to get on a tangent…great post 🙂

  • Of course, another facet of the design phase of anything we use (at least in the USA) is getting FDA approval. Nice to see that patient concerns are at least being mentioned in FDA guidance with regard to Artificial Pancreas. Great insights. Thanks

  • As a marketing person (for no fields related to medical whatsoever) I like knowing that the products I’m promoting solve a problem or fill a desire for end-users.

    As people with diabetes, we’re the end-user so ultimately the product or service needs to work for us. We know what we want, so I think the companies should listen to the input of patients. For example, OmniPod was created by a father of a CWD to fit into their lifestyle. It doesn’t fit everyone’s needs, but actual end-user needs were considered.

    It bugs me that a designer said no more focus groups for him as well as that the wrong questions were asked. One of my clients has a “request a tool” option that lets people say what they need a tool to do for them and they work with that person to create one. I think more companies should do that.

  • I didn’t know there were meters with a strip light until I started reading d-blogs. I still don’t have one but…
    I love my Ping remote but there’s room for improvement(s).
    I think that sometimes you have to know what’s available or doable before you can say – yes, but, can it do this?
    So – of course focus groups are needed!

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