Using multiple perspectives to develop innovative healthcare technology

Rising waiting times, the rise of anti-biotic resistant ‘superbugs’ in hospitals, an ageing population, and unexpected crises like Covid-19, are showing the need for innovative approaches to the healthcare challenges of the present and the future. Dr Stuart English at Northumbria School of Design has used his research to work with industrial partner, PolyPhotonix Ltd, to lead the way in innovative healthcare technology solutions through the creation of a wearable sleep-mask as treatment for diabetic eye disease for patients at home, while enabling remote monitoring and care by medical professionals.

Diabetic retinopathy, a degenerative eye-condition affecting almost all Type 1 diabetics and 60% of type 2, is the leading cause of blindness among working age adults. Treatments for this condition include laser therapy and/or injections directly into the eyeball. This uncomfortable and highly invasive treatment requires the patient to attend regular clinic appointments, a burden to fit around work, family and other commitments, and also demands considerable time from hospital staff to arrange and conduct. But even then, the treatments themselves would not always be effective, and can themselves damage the eye.

Recognising that innovation in healthcare, and ultimately the patient experience, is traditionally hindered by looking at issues from a single perspective (such as technological novelty or the existing evidence base), English applied his ‘Multi Perspective Problem Framing’ (MPPF) design-led technique with PolyPhotonix Ltd – a North East England company specialising in organic light emitting devices (OLEDS) - to gain new insights on ways to successfully harness the opportunities of OLEDs in health technology.  MPPF helps companies see problems in new ways, releasing them from pre-conceptions or familiar methods and allowing them to see new and emerging challenges, and develop future-facing, creative solutions. Using MPPF to help model the relationship of critical factors, the research framed the opportunity for non-invasive and lower-cost treatments for diabetic retinopathy for which OLED technology could be effective. This research informed the design of an OLED sleep mask, known commercially as Noctura 400.

The mask is programmed to administer a certain dose of light of a particular wavelength each night to maintain or improve diabetic eye changes and a patient’s vision. The mask not only treats diabetic retinopathy but is able to feed data back to medical staff remotely, reducing the need for clinical appointments and regular tests. Patients receive treatment and provide regular updates about their progress that healthcare professionals can monitor, from the comfort of their homes and within the usual routines of their lives.

A study of the Noctura 400 from Ashford and St Peter’s NHS Hospital saw 94% of patients achieve a beneficial outcome, with 66% enjoying stabilisation of their eyesight (preventing further degeneration) and 32% experiencing measurable improvement in their eyesight. Noctura 400 is already being used by private patients in the UK, U.S.A, Belgium, France, Brazil, Oman, Portugal to preserve and/or improve their sight. In January 2022, PolyPhotonix also announced it had entered a $10m (£7.3m) deal with US-based Prevail InfoWorks as lead investigator of an FDA regulated clinical trial. Upon successful completion of the trial, working with such a major player in the industry will help Noctura 400 Sleep Mask break into the US market.

Diabetes is the second most common underlying condition among COVID-19 patients who have died, of which 35% had the illness. Government advice is that patients with high-risk conditions should not go to hospital, which means that patients with diabetes currently receiving hospital treatment for diabetic eye disease are at risk. It is likely that diabetic patients who cannot attend clinic for treatment (as many clinic appointments are being cancelled) are further risking their sight.

The treatment of diabetic retinopathy shines a light on one of the key challenges facing healthcare in the 21st century. Intensive healthcare infrastructure – a model of treatment designed around large, one-site, multi-purpose facilities like hospitals and clinical centres – is coming under stress when faced with new challenges it was not designed to meet. Outpatient treatments particularly are designed around short visits to hospital for tests, minor treatments, and sometimes results, and this is becoming unsustainable. The requirement to travel long distances and undergo treatments that are often invasive and uncomfortable is contributing to rising rates of missed appointments and increasing waiting times, even for some serious medical interventions.

English’s research shows how design-led research and innovation can tackle this, and other healthcare challenges of the future, offering solutions to emergent problems and contributing to effective responses to the unpredictable challenges which will emerge in a world changing more rapidly than ever.