3.1 Sources of user information
Both the interviews with the informants and the analysis of the project documents showed that the user insights utilised in the development of the thirty-eight selected HHCDs were established from the four sources: clients, team members’ intuition and experience, service and installation practices, and in-house user research. The clients of the devices were mainly the public sector, including local authorities and housing associations, and non-hospital healthcare facilities.
There was unanimity among those interviewed that intuition was strongly related to “the right experience and knowledge”. As presented in Table 2, intuition and experience influenced team members’ user insights that were utilised within the development of all of the HHCDs investigated; and was the sole source of user knowledge for 18.4% (n=7) of the devices. In addition to intuition and experience, user information for 28.9% (n=11) of the devices came solely from clients; 21.1% (n=8) came solely from service and installation practices; 2.6% (n=1) came from a combination of clients and in-house user research; and 5.3% (n=2) came from a combination of in-house front-end user research, and service and installation practices. For 2.6% (n=1) of the devices, user information came from all of the four sources. Overall, the clients contributed to 55.3% (n=21) of the devices with user information; service and installation practices to 50% (n=19) of the devices; and in-house front-end user research to only 10.5% (n=4) of the devices (see Table 3).
Fifty-eight per cent (n=22) of the selected devices were initiated, reflecting the direct requests and the conceptual product ideas from the clients. In the project briefing documents of 90.9% (n=20) of these projects, the clients described their own insights of the target users. In 70% (n=14), these insights were associated with field data collected by the clients. The user information from the clients was considered effective and credible by all of the interviewed product managers and project managers. These managers even took the initiative to request user information from the clients, in 18.8% (n=3) of the projects where project initiators were the managers themselves.
In terms of internal information sources, service and installation practices contributed to the development of 50% (n=19) of the devices with user information. This was the sole information in 5.2% (n=2) of the cases, besides team members’ intuition that was based on their experiences from the past work they were involved or other projects/devices that they were aware of. Service and installation practices were regarded by all of the five companies in this study as an economical and efficient in-house source of user information. For example, as per our conversation with M3’s project manager:
“The users were only engaged during the testing phase of these devices… All of the user tests were carried out by the installation engineers.”
The most common reason extracted from the interview results was that the service and installation engineers interacted with the end-users in everyday work, e.g., to solve technical problems, install new products and replace components. The other important reason was that there was not a formal Research and Design (R&D) department/team to undertake user research, with regard to M2-M5. However, both of the two interviewed service and installation engineers pointed out that studying users was above and beyond their duties, nor were they trained or received full support for doing this work.
As for M1, its R&D department neither led nor performed user studies, in the majority of the cases. Its workload was actually concentrated on reducing manufacturing costs, carried out under the operational director’s leadership. For example, the R&D manager said:
“Our team works mainly to meet the constant new requests from the operational director.”
This was inconsistent with the quality director’s description, which indicated that the R&D department should report to both the product managers and to the operational director, in everyday NPD practices. As per the innovation director:
“The workload of the R&D department should be shifted from supporting manufacturing and documenting to design-related activities”.
[Table 2 near here]
3.2 The impact of user insights on the NPD process
All of the five manufacturers in this study had forged their own principal/global NPD processes. For example, the medium-sized manufacturer employed a staged/waterfall process (Cooper, 1990) comprising of six major phases (i.e., discovery, scoping, building the business case, development, testing & validation, and launch), and over eighty secondary stages and activities. A principal NPD process is meant to be referred to by all projects of a company. It serves as the “bible” for guiding every day NPD practices, as described by an interviewed innovation director.
We found that only M1 and M4’s principal NPD processes incorporated pre-planned activities relevant to the production and application of user information. All of these activities were positioned in the later stages, when device designing had been completed, without exception. Users would only be engaged during the tests of the Alpha, Beta and/or pre-release versions of a new device. The purposes of the tests, as we summarised from analysing the project documents, included: ensuring a selected design meet business requirements and design specifications before mass production rolls out; providing essential user feedback as required by standards and policies in the sector; and facilitating new device launch by demonstrating its outstanding usability, performance and functionality. The evidence of the user research associated with strategy formulation or device designing, in any format, was present in the project documents of only 10.5% (n=4) of the investigated devices.
From comparing the answers given by different interviewees, we found that the designing of the NPD processes had led to inconsistency among team members’ perception of engaging the end-users and of adopting formal UCD methods. For example, one senior product manager from M1 pointed out that:
“… user information from the service and field engineers could hardly fit into the current NPD process.”;
And a service engineer from the same company:
“Frustration occurs as I am in the middle of user views and company strategies.”
This issue reduced some staff members’ willingness in collecting and in transferring user information. As per a senior installation engineer:
“Even when I have fed back to the company design ideas or suggestions from the users, I often do not know what has happened to them. It is like a black hole.”
3.3 Key factors determining the success of new HHCD development
Interviewing the managers/directors also revealed nine essential factors that influence the success of new HHCD development: 1) relationship with the public sector, 2) added value to a device, 3) business flexibility, 4) communication across departments, 5) stability in the supply chain, 6) resources (time and budget), 7) effectiveness of the NPD process, 8) market knowledge, and 9) business culture (see Figure 2). Among these items, a manufacturer’s relationship with the public sector was put forward by all of the interviewees as the most important success factor; and was regarded by 75% (9 out of 12) of the interviewees as the most influential factor. For example, M1’s product manager indicated:
“Our strong long-term cooperation with the purchasing organizations was the biggest advantage over the competitors.”
Furthermore, the added value to a device, business flexibility, and communication across departments were also considered by some of the interviewees as the most influential factor.
[Figure 2 near here]
3.4 Reasons for developing new HHCDs
The analysis of the project documents (i.e., the selected HHCDs) identified three main reasons from which new HHCDs were derived. These reasons included: client request for a new device (57.9%, n=22), the manufacturer’s own business strategy (31.6%, n=12), and changes to legislation and laws (10.5%, n=4). There was no trace of a device initiated reflecting the findings in terms of the end-user.
The above finding was consistent with the results from the interviews with the twelve project/product managers, which affirmed that the client request was the most common and critical reason of initiating the development of a new HHCD - this opinion was expressed and agreed by 91.7 % (n=11) of the respondents. According to them, the primary clients for 71.1% (n=27) of the devices were public organizations including local authorities and housing associations, and non-hospital healthcare facilities. These organizations purchased the devices and then provided the devices to the residents who needed them. For example, during the interview M4’s project manager said:
“XXX (the model name of a telecare home unit) had been installed in each bungalow (council house) of the community before the residents moved in.”