How User-Centred Design for lab equipment can improve lab quality

Resist the urge to think technology first

Saying this might seem counterintuitive, coming from an embedded software company, but please hear me out.

You could look to technology trends and see that a combination of AI, machine vision and computer vision, plus robotics could lead to an automated solution that works. Note: could lead.

But jumping straight to solutions and pulling together requirements and features up front for a project means that teams risk building and coding the wrong thing. Something that ends up with features it doesn’t need while neglecting the ones it does.

(It’s also not a Lean-Agile way of working and risks creating a lot of waste.)

Technologies like AI, machine vision and computer vision can have their biggest impact in equipment for clinical and research laboratories when product owners and teams have thoroughly considered the end-user.

They’ve thought about the user experience (UX) and what it’s like to do certain tasks and they’ve considered the impact this has on things like productivity.

The drive for laboratory quality

Laboratory quality is important for both publicly owned and private laboratories. The main measure of this quality is often what is called Turnaround Time (TAT), with laboratory managers constantly looking to improve it. TAT is used as a signal for overall productivity and ability to process samples.

Factors like sample preparation can affect TAT by a large degree, as can data entry and other manual processes.

What is good TAT?

Accepted time scales for TAT vary depending on who you ask and what’s being tested. In one study, researchers showed that physicians expected a shorter TAT for samples checking on myocardial injury (median: 37.5 minutes for 90% completion) than laboratory staff (median: 60 minutes).

But the study also found that overall TAT still tended to be longer than both desired outcomes and had a median of 90 minutes.

These expectations versus reality for TAT is repeated across laboratories worldwide. And while expectations can be managed, there is room to improve on what is happening.

How quality (TAT) scales

Aside from improving productivity in labs, each minute saved in a setting dealing with tens of thousands of samples a month improves overall capacity, which can bring additional revenue and in clinical settings: improve patient care.

Improving testing times of a few minutes in clinical laboratories can mean the difference between life and death in areas like emergency medicine.

In public health, improved sample processing rates could mean the difference between containing a public health crisis and failing to act in time.

And in overwhelmed forensic laboratories (for example, in the US, UK and Canada), being able to improve TAT offers a chance to help with sample backlogs that frequently make media headlines.

Sample preparation, analysis, and TAT

According to 700 lab managers surveyed on behalf of Agilent Technologies in 2017, the biggest factor that limited productivity in their labs was “time consuming sample preparation”. Dealing with samples was a huge productivity problem cited by 80% of respondents.

Watching the many manually led tasks that take place in clinical and research labs around the world, it’s easy to see how TAT can be negatively impacted and decrease overall quality of service.

As discussed in the report looking at TAT in the University Hospital Campus Bio-Medico of Rome (link opens PDF), researchers noted that:

“[…] TAT can be improved by staff education, long-term planning, and even small investments in the laboratory, such as front-end automation that centrifuges, decaps, prepares aliquots, and sorts samples.” (My emphasis.)

While jumping straight to automation to improve TAT is tempting, looking to technology for a solution only works if we put users first.

Users first: User-Centred Design in laboratory equipment

Putting users first is what User-Centred Design focuses on. It enables teams to engineer software and hardware that helps with the challenges users have rather than assuming what they need.

There’s a lot going on in a laboratory setting that you might not be aware of or have assumed you know. Using User-Centred Design and the user research practices that comes with it helps you to challenge assumptions and find out what’s really going on.

The aim is to build “the right thing” so that you solve user’s problems while serving the market. It helps you make a product that users want to use because it reduces errors and helps them work more quickly and efficiently. That means the smart people who work in labs can spend more time doing the thing they’re trained for and making a real difference. They’ll become advocates for your product, enabling future sales, building revenue, and maximizing profits.

Any time is a good time to think about users, but for positive outcomes, the sooner you can do it, the better.

Discover user needs

Like we detailed in an earlier post on User-Centred Design and UX, identifying user needs is a key part of user research. Often identifying these needs starts with conversations between teams and stakeholders and then talking to and observing users.

By identifying user needs, we can ensure that the full context around design and software decisions is known. It’s not just what a user needs to do, it’s about understanding the why, when, and how of what they do.

User needs address the following:

• Context
• Motivations
• Goals
• Journeys
• Tasks
• Behaviours
• Emotions
• Mental models
• Capabilities
• Pain points

There are many different techniques and processes provided by UX to help with research and testing. These techniques help you to discover user needs or see them in context.

Here are a few examples of qualitative ones that can assist product and software teams in identifying where technology can help in a laboratory environment:

Interview your users

Interview techniques can vary and can involve the team and stakeholders in early stages, so that starting points for research can be found.

But interviews with users are the staple here. Here are four tips on questions for interviewing users:

• Questions shouldn’t be about the product or its design but should explore user needs, helping to identify what these are for the user.
• Good questions that allow users time and space to think and consider their own ideas.
• Don’t ask leading questions, telling users what their problem is or how they feel about it.
• Keep questions open-ended, rather than ones that will get you a “yes” or “no” answer.

Through interviewing laboratory workers, you can find points affecting their work, to then further explore specific aspects. Like activities to keep an eye out for when taking on observational forms of research, like the spots where TAT might start being affected.

(If you want to know more about good questions to ask users, it’s worth reading the book The Mom Test by Rob Fitzpatrick.)

Observe users

In user research, observation techniques offer many useful processes for finding out what is happening in a user’s environment and to them. In the case of laboratory workers, this is incredibly important because depending on what’s being analysed and how, the work done can vary greatly and have a big or small impact on TAT.

Types of observational methods include:

• Contextual inquiry. For this, the user is in their normal work environment, and observed carrying out tasks as they would do them currently. Again, the user is encouraged to talk about their action and detail what they’re doing. The emphasis here is seeing how “they normally perform tasks”.
• Naturalistic observation. Like the previous one, only there is no interaction between the user and researcher. Observation is meant to happen as inconspicuously as possible.
• Shadowing. Here the researcher follows the user through their daily activities. The researcher can see how the user goes about their tasks in a laboratory environment, not interrupting them. It’s good to follow up with an interview where the user is queried about what the researcher observed over the course of the day.

Through observations, researchers may be able to see opportunities to remove manual handling, improve meta information input and traceability, and see the types of analysis that are prone to error. All ways to improve TAT.

Perform usability testing

For usability testing you might have:

• A mock-up of an interface (even a paper mock-up)
• A prototype
• An existing product

With which to test. By using these you can trace interactions with a product back to user needs.

To do usability testing, you observe a user using, going through pre-set tasks. The user is encouraged to “think aloud”, and the researcher can ask questions about the user’s actions.

Usability testing should certainly be carried out during and after product development and can, once you have something users can interact with, form a regular section of software sprints.

And with prototypes or existing products, you have the means to see if the solutions you’re producing affect TAT.

User-Centred lab equipment and software

Taking a User-Centred Design perspective and using user experience (UX) processes for new and existing products, it’s possible to design and develop products that not only maintain and improve laboratory quality like TAT, but also help with:

• Safety
• Accuracy
• Productivity
• Traceability (key for meeting 21 CFR Part 11 when looking for FDA approval)

All leaving a clinical laboratory assistant free to do other activities that can improve quality in a laboratory and delivery of results to the people who need them most.