Redefining Treatment Experiences - A Conversation with Alisan Atvur

Alisan Atvur is a seasoned veteran in the field of user experience and design thinking. With a rich background that spans various sectors including healthcare, digital ecosystems, and disease management, Alisan has made significant contributions to enhancing user experiences and operational efficiencies. His tenure at leading organizations such as Novo Nordisk has not only enriched his professional expertise but also underscored his commitment to leveraging design for social good. Alisan's work is characterized by a deep understanding of the markets he operates in and a passionate commitment to improving lives through design. He employs a practitioner's lens in every engagement, focusing on the practical application of his skills to drive positive outcomes. Beyond his professional endeavors, Alisan is an avid speaker and contributor to the design community, sharing his insights and experiences to inspire innovation and best practices in design thinking. His dedication to chronic disease management and the broader cause for mankind is reflected in his approach to design—always with an eye toward impactful, sustainable solutions. He embraces the power of design as a tool for change, making him a respected figure in the design and healthcare industries.

* The statements and perspectives of Alisan are his own: they are not an official representation of current or prior employers.

We caught up with Alisan via Zoom in his home in Denmark.

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Loft: Growing up in the US and now living in Europe has given you a unique perspective on the differences in work culture, as well as the distinct approaches to the development of Medical Devices and Pharmaceuticals. I'd be interested in your observations on the varying methodologies and mindsets, particularly how each region embraces innovation and design for these sectors.

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‍Alisan: While I've also explored the British and German healthcare systems through research, my firsthand experience has been with Denmark's approach. The work-life balance and the societal attitude towards work and health significantly differ between the U.S. and Denmark. In the U.S., the norm at many companies, including those in healthcare consulting, was to have a fixed number of sick and vacation days. Exceeding your sick days often meant dipping into vacation time, which fostered a mindset of quickly overcoming illnesses like the flu to return to work, especially during intensive work periods.

Contrastingly, in Denmark, the perspective on illness at the workplace is more understanding, acknowledging sickness as a natural occurrence without penalizing individuals for taking the necessary time to recover. This approach not only reflects a different work culture but also a broader societal value on personal health and well-being.

These reflections underscore the value of diverse perspectives in fostering meaningful discussions on health, especially when considering the variances across cultures, healthcare delivery models, and corporate health policies.

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The value of diverse perspectives in fostering meaningful discussions on health, especially when considering the variances across cultures, healthcare delivery models, and corporate health policies.

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Loft: Novo Nordisk stands out not only as Europe's highest-valued company but also as a significant contributor to Denmark's GDP, marking it as an exceptionally successful entity by any standard. It boasts a unique culture and a focused area of disease management. Despite being a pharmaceutical company—where operations are traditionally driven more by scientific advancement than by human-centered design—I'm curious to hear your thoughts.

In the realm of research and development, the conventional strategy involves rapidly advancing scientific innovation, securing patents to protect this innovation, and then leveraging these patents to generate revenue over time, all while continuing to expand the patent portfolio. This approach primarily focuses on the molecule, ensuring its availability and effectiveness.

However, when speaking with patients, it becomes clear that disease management encompasses complexities far beyond the medication itself, though the medication plays a crucial, potentially life-altering role. From your perspective, how do human-centered design principles contribute to enhancing the patient journey? Furthermore, how do these principles support product roadmaps for companies like Novo Nordisk?

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Alisan: Personally, when exploring a problem or opportunity space, I find it crucial to understand it through the eyes of those experiencing it, rather than imposing my viewpoint. This perspective remains consistent whether I'm working in MedTech or Pharmaceuticals, emphasizing the importance of aligning with the end users' views and needs, often striving for our solutions to seamlessly integrate into their lives without taking up their mental focus or physical energy.

Regarding chronic disease treatment, the ideal scenario is one where the disease is either defeated or managed so smoothly that it is unnoticeable in daily life. This approach involves understanding the condition from the end users’ viewpoints, irrespective of the clinical framing, and focusing on how they aim to live their lives. This could mean considering treatments as part of a service experience, which unfolds over multiple touchpoints and periods, aiming for a seamless integration into the patient's routine.

At Novo Nordisk, many of us operate with this philosophy, intentionally designing research programs to view treatments as comprehensive experiences requiring varied touchpoints, whether they involve devices, packaging, or usage patterns. This approach starts with understanding current experiences, identifying pain points, and exploring areas for improvement, thereby guiding the direction of research programs toward solutions that ease integration into daily life.

This strategy may not be traditionally how new pharmaceutical treatments are developed in some companies, but it has proven valuable in clarifying what our key stakeholders—be it doctors, patients, or caregivers—need to feel supported. Recognizing the different experiences across various life stages, from children to middle-aged adults to seniors, influences our research and product development approaches.

Lastly, it's crucial to distinguish between the perceived value we think we're providing and the actual value recognized and appreciated by the recipient. This awareness is fundamental to any relationship, including the one between patients and their treatments, involving a complex network of healthcare providers, insurers, and other stakeholders. A holistic approach, aimed at aligning the interests of all parties involved, could significantly enhance healthcare delivery and patient care. This notion suggests an industry-wide benefit from clearer communication and alignment of various stakeholders' interests, facilitating more effective and human-centric healthcare solutions.

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At Novo Nordisk, many of us operate with this philosophy, intentionally designing research programs to view treatments as comprehensive experiences requiring varied touchpoints, whether they involve devices, packaging, or usage patterns.

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Loft: The concept of multi-tiered connections and the diverse range of stakeholders, each with their unique incentives and needs, is crucial. A doctor's requirements differ significantly from those of a patient, just as a caregiver's needs are distinct from an insurer's. The reimbursement strategy, while essential, acts as a somewhat blunt instrument designed to ensure companies can produce the necessary products for patients. However, by its nature, it's a complex exercise, encompassing various stakeholders' needs to collectively advance disease management strategies.

This complexity was highlighted in a conversation I had a few months ago, where it became apparent that the medical devices and pharmaceutical market isn't solely driven by the immediate needs of patients. Instead, it's shaped by a composite of all stakeholders' requirements, gradually pushing forward the approach to managing diseases. This realization underscores the importance of considering the entire ecosystem when devising healthcare strategies, acknowledging that progress in disease management often results from navigating and aligning these diverse needs.

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Alisan: Exploring various models of care delivery has led me to appreciate that this process isn't the sole responsibility of a single individual, despite the doctor often playing a pivotal role in coordinating different services and tools. Behind this orchestration lies a complex network of systems, which both the healthcare provider and the recipient must navigate. These systems, sometimes interconnected and sometimes not, add layers of complexity to the patient-healthcare provider relationship, making perfect synchrony a challenging ideal to achieve.

Acknowledging this complexity is straightforward, but the more significant challenge lies in identifying and aligning the diverse interests across these systems to foster collaboration. Rather than accepting systemic friction or industry silos as the norm, the goal should be to demonstrate through concrete examples that collaborative efforts are not only possible but can be highly effective. These initiatives show that bringing the right mix of people together can lead to innovative solutions.

Such collaboration requires a blend of leadership, strategic thinking, and hands-on effort. It cannot succeed through top-down or bottom-up approaches alone but rather a synergistic combination of both. While this activity transcends simple design or facilitation, it shares similarities with grassroots activism, supported by sufficient top-down backing. This blend of efforts aims to navigate and streamline the complex systems behind care delivery, highlighting the potential for a more integrated and cooperative healthcare ecosystem.

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Loft: Certainly, the realm of care delivery is intricate, extending beyond the capacities of any single individual. While a doctor may orchestrate the various services and tools required, they depend on a complex network of systems behind them, and similarly, patients engage with their own interconnected systems. This dynamic makes the ideal of seamless cooperation between two individuals challenging due to the multiple systems and demands influencing their interactions.

Recognizing this complexity is just the starting point. The real challenge lies in identifying ways to align interests across these systems to foster collaboration. This does not necessarily mean overcoming systemic opposition or industry silos but rather demonstrating through concrete examples that harmonious operation is achievable. There's significant potential in non-competitive research institutes and think tanks, which facilitate collaboration across different entities within the digital health sector and beyond. Such efforts require a blend of leadership, strategic thinking, and hands-on collaboration, transcending simple top-down or bottom-up approaches. This multifaceted activity, akin to grassroots activism but supported from the top, represents a novel approach to healthcare innovation.

Regarding software as a medical device (SaMD), this sector is indeed one of the fastest-growing, driven by recent FDA policy changes and a surge in new companies and solutions. This area, which you've previously mentioned, is critical to our efforts in creating ecosystems that bolster our core mission. SaMD not only expands the possibilities for disease management but also integrates with big data and generative AI to transform our understanding and approach to healthcare. These technologies offer unprecedented opportunities to enhance patient outcomes, streamline care delivery, and personalize treatment plans. As we navigate this evolving landscape, the potential for these tools to improve, and at times challenge, our current practices in disease management is immense. I'm keen to explore further how SaMD, alongside the insights derived from health data and the capabilities of generative AI, can be leveraged to advance our mission and reshape the future of healthcare.

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Alisan: I see this topic unfolding in three parts: the potential positives, cautionary tales, and the basis of experiments with this technology. The promise of using AI, such as in medical imaging to detect specific types of cancer more efficiently, showcases the remarkable benefits of technological advancements. However, concerns can understandably arise such as with the potential for unchecked bias within such sophisticated systems, highlighting the need for a balanced approach.

The path forward, I believe, will be shaped by a series of carefully managed experiments. These will help us understand how to harness this technology safely, pushing the boundaries of what we can achieve in medical research and patient care. The potential for AI and big data in healthcare is immense, offering unprecedented insights and efficiencies. However, the principle of 'do no harm' must guide us, emphasizing the importance of privacy, data security, and the ethical use of technology.

Beyond the technical safeguards, we must also ensure that patients and users feel safe and protected, drawing parallels to concerns around social media and data privacy. The challenge extends to creating a digital "bedside manner" for AI technologies, ensuring they are perceived not just as tools, but as part of a caring and trustworthy healthcare system.

As we navigate the implications of AI and big data in healthcare, it's crucial to remember that every technological tool has its limitations. Rather than replacing professionals, these advancements will augment their capabilities, requiring ongoing learning and adaptation within the field. Looking ahead, our goal should be to learn from past experiences with emerging technologies, aiming to improve our approach and outcomes with each new advancement. This optimistic perspective encourages us to embrace change while prioritizing the well-being and trust of those we serve. This underscores the importance of experimentation in understanding and utilizing technology responsibly. 

No tool is inherently perfect or without the potential for misuse. Just as Photoshop has been used both to create wondrous works and to manipulate images for malicious purposes, the same dichotomy applies to newer technologies. The value of a tool lies in its responsible use, a standard that evolves through the collective examination of each experiment. We must continuously question: Did we cross any ethical boundaries? Is this application ethically sound? Such scrutiny is essential, though it inherently requires time and a series of carefully managed, safe experiments. These experiments should be designed to explore potential benefits thoughtfully, always with an eye toward responsible innovation.

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Loft: The MedTech sector, particularly in areas beyond direct patient management, highlights an important consideration: the role of technology as a support system for overworked and often distracted medical professionals. Throughout my conversations with healthcare professionals over the years, a common theme is their need for tools that act as a co-pilot, reducing cognitive load and simplifying decision-making processes. When a tool effectively lightens this burden, it becomes immensely valuable. However, if it leads to second-guessing or adds complexity, it likely misses the mark.

This distinction offers a critical lesson for UX designers in the development and implementation of medical technologies. It's crucial to design these tools with the nuanced understanding that they should enhance, not complicate, the decision-making process for healthcare professionals. The path to implementing these technologies is pivotal, ensuring they are used as intended and truly serve to support rather than hinder medical practice. This serves as a cautionary reminder of the responsibility UX designers hold in shaping the interaction between medical professionals and technology.

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Alisan: You've pinpointed a crucial aspect of design—trust and reliability. Trust, as I see it, builds over time through consistent reliability. It's about establishing a relationship where even mistakes are anticipated and accounted for. This perspective raises an important question for us as designers: how do our design choices affect the trust between the user and the object, the person and the system, or among stakeholders? Regardless of a design's sophistication, if trust is lacking or inadvertently compromised, achieving desired outcomes—whether in tool adherence, customer satisfaction, or any chosen metric—becomes challenging.

Unfortunately, trust isn't something we can easily quantify with precision, but its presence or absence is quickly felt. The signs of eroding trust are unmistakable, manifesting in negative feedback, low adoption rates, or general skepticism toward the product or system. This underscores the conversation about trust as being equally important, if not more so, than the value delivered by the design. In every interaction, whether with AI, social media, an Internet of Things device, or a new healthcare system, the critical question remains: can users trust the product or system they're engaging with? This becomes a fundamental consideration in design, impacting everything from user adoption to long-term success.

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Regardless of a design's sophistication, if trust is lacking or inadvertently compromised, achieving desired outcomes—whether in tool adherence, customer satisfaction, or any chosen metric—becomes challenging.

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Loft:  As someone deeply involved in the field of research and design, how would you observe the impact of emerging technologies like big data and AI? Designers must now understand not only how data operates but also how it is presented and explained, and the regulations that govern it. How important is it for individuals entering the field, particularly those passionate about UX/UI, research, and health-centric strategies, to actively seek knowledge and skills that meet the evolving demands of leveraging technology for superior user experiences? How can embracing continuous learning and staying abreast of the latest trends, methodologies, and tools contribute to their success in creating impactful, user-centered designs within the health sector?‍

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Alisan: This discussion echoes a debate I encountered about 15 years ago in San Francisco, questioning whether all designers must become coders. Opinions vary widely, with many designers excelling in development skills while others thrive without them. My perspective on enhancing a designer's success rate involves acknowledging that maintaining complete expertise in every technology or domain is unrealistic. However, the ability to swiftly learn about new systems, technologies, and their interplay is invaluable.

Historically, business consultants have exemplified this skill by immersing themselves in unfamiliar industries and quickly grasping the essential workings and value delivery systems. Regardless of the opinions on the outcomes of their work, the skill of rapid acclimation is acknowledged and mirrors cognitive and academic agility beneficial to designers. This agility is crucial for staying abreast of developments across various fields, from AI to new human factors policies affecting data governance.

Designers need not be experts in every area but should be adept at understanding the essentials and making connections between different domains. This might involve delving into areas outside one's comfort zone, like enterprise development processes or learning about specific software environments, not out of preference but necessity for delivering the best solutions.

Embracing this adaptability doesn't diminish the importance of core design skills such as visual communication, storytelling, empathy, and craftsmanship. Instead, it complements these skills by preparing designers to absorb new information rapidly and integrate it into their work, enhancing their decision-making and creative output. While it's impossible to be a master of all domains, being strategically knowledgeable about areas relevant to current challenges enriches a designer's work and broadens their professional toolkit.

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Loft: This insight is indeed fascinating and offers valuable advice. The concept that learning is a continuous journey is crucial. Recognizing that embracing continuous learning is foundational to your growth not only keeps you evolving but also positions you as a leader in your field. The moment you accept that being in a constant state of learning is your primary mindset, you're stepping into a leadership role, guiding others by example, and driving forward with innovation and adaptability.

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Alisan: Throughout my career, I've had to relearn the basics of visual layout software more times than I can count. My journey began with Quark, transitioned through PageMaker, and then onto InDesign, from version 6 to its latest iterations. Each switch required learning features and re-learning altered workflows, illustrating that even if my focus remained solely on visual design for print publications, my adaptation to new tools would be inevitable. The idea of clinging to a single tool, such as Quark, is simply not feasible if I want to stay relevant and capable in my field. This necessity for adaptability is akin to exercising professional skills—while not all abilities need to be maximized, maintaining a well-rounded skill set ensures readiness for new challenges. Regularly updating and flexing these "professional muscles" allows for quick acclimation to new tools or methodologies. This approach has been my strategy for staying prepared and adaptable in the dynamic landscape of design work.‍

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Loft: Thank you for sharing so many valuable insights and viewpoints. It's been enlightening to discuss so many important topics. We greatly appreciate your openness and candid thoughts!

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‍Alisan: I'm truly grateful for this conversation.