Last week, the Australian International Design Awards gave Nucleus® CR110 Remote Assistant Fitting (left) and the Nucleus® CR120 Intraoperative Remote Assistant (right) its Good Design™ mark. For my part, and in partnership with my colleague Rami Banna, I dedicated nine years of my own research and development to the clinical software on these two products. For the hearing industry, the product design enables significant changes in clinical care, opening cochlear implant management to a wider number of clinicians, surgeons and—for the first time—recipients themselves.
The week prior to the judging of the Design Awards, I published the design and outcomes of the clinical software with Rami and Saji Maruthurkkara in the International Journal of Audiology. These two events, coming in quick succession, have given me reason to describe the technology and reflect on my design career at Cochlear in this post.
When I began my career at Cochlear as a graduate engineer in 2002, Cochlear’s PC-only clinical software was essentially designed with expert clinicians and researchers in mind. The cochlear implant industry was relatively young, so whenever a researcher wanted to experiment with the implant’s inner settings, the request ended up as an option in software. It was no way to build an accessible application, and as the years went by, even the experts started to complain about the complexity of the software (the number of controls was in the hundreds). In those days, the acronym UX was yet to be understood, but the company knew that things had to change.
A year later I began work on the first software feature that actually replaced a function performed by expert clinicians. AutoNRT™ measures nerve responses from the auditory nerve at the press of a button. A machine-learned expert system automatically picks nerve signals from the noise, the first commercial intelligent system in the industry. With my colleagues Bas van Dijk and Matthijs Killian, I published AutoNRT’s design in the journal Artificial Intelligence in Medicine in 2007.
Following the success of AutoNRT, I decided to take on the challenge of automating as much as I could in the clinical software. When I completed my PhD in 2010, a recipient’s fitting could be reduced to a single volume control, all else being automated or hidden. That is precisely what you see in the image above of Remote Assistant Fitting. For the first time, both clinicians and recipients can switch on an implant using a mobile device, untethered to a clinic PC, hearing for the first time in the recipient’s own listening environment. Rami Banna saw the opportunity of porting AutoNRT to the mobile device and enabled the technology (the subject of a patent application), and the usability improvements are dramatic. More than that of course, Rami managed the two Remote Assistant projects.
In 2002, a surgeon could wait for half an hour or more for an expert clinician to wheel a PC into the operating room, connect cables and manually piece together auditory nerve responses. In contrast, the Intraoperative Remote Assistant can now sit in a surgeon’s pocket, providing auditory nerve responses at the press of a button, wirelessly, and in a couple of minutes.
But where does Remote Assistant Fitting leave expert clinicians? To complete the picture, Remote Assistant Fitting is now one of three fitting platforms, each progressively feature-rich. Nucleus Fitting Software is a new PC application that implements the same methodology as Remote Assistant Fitting, but also includes an additional set of fine tuning features. And with the widest scope of features is Cochlear’s original PC software, Custom Sound™, still available. This multiplatform trend is ever-present in digital technology today: applications are routinely made available for desktop, tablet and smartphone platforms, each with a progressively less complex interface, yet each operating on the same data. The design maximises access for experts and less-experienced users alike.
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I left Cochlear in 2010, newly married, to start Expressive Engineering. A few months later I was invited to be a judging panellist for the 2011 Design Awards, and the following year, I (a former research engineer) facilitated their ‘meet the judges’ event at the Apple Store on George Street, Sydney. Through those experiences, I’ve observed the design community becoming more interdisciplinary with the passing of time.
Healthcare must follow a similar trend of integration if it’s to be more effective, and indeed, Cochlear’s next generation of software aims to widen access to high standard audiological care. I wish them the best of luck for the finals of the Design Awards.
Interview with Pontus Wahlgren, Design Director at IDEO, at the Apple Store in Sydney for the Australian International Design Awards.
