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Design Studio II
Spring Project
2015
Contents
Tutors	4
Partners	5
Team	6
I phase, Research	 9
Discovering the brain	 10
Discovering potential technologies	 12
Discovering potential focus areas	 13
Analysis of initial research / Defining a focus area	 14
II phase, Defining	 15
Identifying a field of application	 16
Journey map	 17
Identifying users and design requirements 21
Contents
Design Brief	 22
III phase, Development	 23
Brainstorming	24
Early concepts	 25
Prototyping & testing	 26
Evaluation and focus	 28
IV pahse, Delivery	 29
MoniTech	31
Visual identity	 34
Analysis & conclusion	 35
Opportunity (vision for the future)	 36
Tutors
Sven Sõrmus
Designer
Supervisor, Estonian
Academy of Arts
Janno Nõu
Designer
Supervisor, Estonian
Academy of Arts
Martin Pärn
Designer
Dead of D&E, Estonian
Academy of Arts
Partners
ELIKO
Rauno Gordon
Senior research
scientist
Eiko Priidel
Engineering Manager,
PhD student
Annuka Mikola
Clinical Engineer
Technology Competence Centre in
Electronics-, Info- and Communication
Technologies
The mission of ELIKO is to improve the compet-
itiveness of Estonian ICT industry through the
collaboration of top research institutions and
businesses in the fields of electronics-, info- and
communication technologies.
PERH
Põhja-Eesti Regionaalhaigla / The North
Estonia Medical Centre
The North Estonia Medical Centre is one of the
top health care providers in the country. A pa-
tient-centred institution committed to profes-
sionalism, innovation and teamwork, the Medical
Centre has more than 3,700 people – doctors,
nurses, caregivers and specialists – working for
the good of patients.
Team
Guillermo Guerra
Industrial Engineer
Spain
Maret Martsepp
Mechanical Engineer
Estonia
Pranay Kenkre
Mechanical Engineer
India
Taavet Pärenson
Designer
Estonia
Taavi Taros
Mechanical Engineer
Estonia
The goal of the project
Eliko deals with research and devel-
opment of technologies in the medi-
cal field. They have been involved in
the development of a Portable Brain
scanner for nearly two years.
The task and goal for our team was
to identify an appropriate area of use,
understand the environment, the
people involved and create a con-
cept of form and operating procedure
for such a device.
I phase
Research
The goal of conducting the inital re-
search phase is to identifie potential
areas of use.
Discovering the brain
Through desk research, going
through PERHs research materials
and interviewing hospital personnel
we aimed to understand the anatomy
of the human head and learn why we
would even want to look inside it.
In the development process we were
facing a product for emergency situa-
tions so the research around the brain
anatomy was oriented at the problems
that appear after a head injury.
The brain is protected from external
damage by the skull and several irri-
gated layers between the skull and the
“pink mass”, these layers are the first to
show damage when there is a strong hit
to the head.
The general complications in this area
occur when there is bleeding (hemato-
ma) between these layers, raising the in-
tracranial pressure (Figure 2).
The types of these hematomas are differ-
ent depending on the layer it is forming
in (Figure 1). In any case it is important
to note here that when the hematoma
grows, it starts to squash the brain lead-
ing to many different health problems
and even leading to death. The sever-
ity of the injury depends on the the area
where the excess blood is present.
In an emergency situation where the
skull is not injured but traumatic head
injury is suspected it is especially im-
portant to know where and what has
happened to the brain to see if and what
kind of treatment is needed. Treatments
can vary from surgery to simply monitor-
ing the patient.
The research unveiled that there are
different reasons to look inside the
brain but the most valuable reason
from our perspective was the need
to accurately assess changes in the
brain and decide on an appropriate
treatment.
Figure 1
Figure 2
Discovering potential technologies
Through desk research, studying
ELIKOs research materials and inter-
viewing hospital personnel we aimed
to understand what are the current
non invasive technologies used to
see inside the head and wich of those
could be conidered for portable use.
Nowadays when there is a need for a
non invasive way to detect injuries in the
patients brain for any reason there are
mainly two stationary options, MRI and
CT scans.
CT (computer tomography) is a tech-
nology that uses computer-processed
X-rays in order to produce images (slic-
es) of different parts of an object allow-
ing the user to see inside without cutting,
this technology is fully developed and is
a perfect tool in order to diagnosticate
many different problems in the head.
MRI (magnetic resonance image) is an-
other technology used in radiology to
study the state of the body by images.
MRI scanners use radio waves and mag-
netic fields to form images of the body.
Both technologies show the same defi-
ciency which is that both are stationary,
big machines. Because how thtese tech-
nologies work, they cant not be used for
portable solutions. Also both machines
are rather expensive and need contin-
uous maintenance. But this is under-
standable as it takes alot of power to
generate images of that quality.
Some portable technologies also exist
that can be used to examine the brain.
NIR (Near infrared Technology) can be
used for early detection of brain injury.
A device is used to compare the left and
right side of different areas of the brain
to find irregularities that might indicate
brain injury.
The research team at ELIKO are devel-
oping technologies that show promise in
this field.
MIT (Magnetic induction tomography)
uses multible small coils around the
hea compile an image of the brain. an
electromagnetic field gives us informa-
tion depending on the differences in the
frequency of the wave back from the
head. The changes in the wave patterns
are made by the bouncing of the wave
on the molecular links inside the head.
UWB radar (Ultra-wideband radar) uses
an antenna to sends short pulse of elec-
tromagnetic waves inside the brain and
compiles and image based on the fre-
quency signals that bounce back. This
can be used as a single antenna moved
around the head.
Researching technologies unveiled
that depending on the injury and the
results needed different technologies
can to be used for examining the
brain. Most importantly current wide-
ly used technologies are not suitable
for use in portable devices. Thankful-
ly ELIKO is developing technologies
suitable for such use.
Discovering potential focus areas
Through studying research materi-
als, desk research scenario building
we aimed to find potential application
opportunities and find who would po-
tentially benfit from a portable brain
scanning system.
As we are dealing with brain trauma we
focused on areas of life where such inju-
ries are a part of everyday life.
From civilian life we identified sports
events as potential application areas.
Repeated head injuries like concussions
are a part of everyday life in sports like
american football and extreme sports to
name a few. There a documented cas-
es where such injuries go unnoticed in
sports events and lead to future com-
plication in athletes. A portable device
could help with early detection on inju-
ries.
Military use proved to be a potentally
huge opportunity for such devices as
access to hightech medical machinery in
war zones is limited and traumatic head
injuries occur often. A portable device in
such situations could help in streamlin-
ing the process of getting the appropri-
ate treatment for the patient in time.
One of the most interesting potential
opportunities are first response teams/
paramedics who are first on the scene
and could be in a position to be the first
to identify brain injury.
Hospitals of cource are another obvious
potential application area as not all hos-
pitals have access to sophisticated brain
imaging technologies. It can also be the
case that different procedures could be
streamlined by having access to porta-
ble imaging devices.
In any case the hospital is a big area of
interest as there we have the profession-
als who can provide treatment and de-
tailed diagnosis fot the patient. This is
an important feature that other potential
application areas (especially civilian cas-
es) are missing.
From the research we concluded that
whatever happens outside the hos-
pital the patient still ends up in the
hospital in the hands of professionals
as the non professionals do not have
the knowhow, authority or machinery
to make decisions concerning diag-
nosis and treatment.
Analysis of initial research / Defining a focus area
In our research into brain anatomy,
brain scanning technologies and po-
tential focus areas we found that it’s
not about who wants to find what in-
side the head but about what can be
done with that information or more
importanly about who can do some-
thing with that information.
This lead to us shifting our focus onto
hospitals and the the patients who
experience a traumatic brain injury
(TBI) and are sent to the hospital for
diagnosis and treatment.
II phase
Defining
The goal of defining phase is to de-
fine the field of application, users and
design requirements.
Identifying a field of application
By creating a patient journey map
and conducting interviews with PERH
personnel and pitching hypothetical
cases to nurses we aim to find the
approprate field of application fot a
portable brain scanning device.
As we are ultimately interested in improv-
ing the patients quality of life we chose
to create a patient journey map (Figure
3) to unterstand and find opportunities
where portable brain scanning device
can help streamline patient recovery.
This method helped us create three hy-
pothetical cases for testing. These were
pitched and presented to medical per-
sonnel to indentify users and require-
ments and the need for a portable brain
scanner in those situation.
The following the analysis of these three
cases.
Bike crash,
Paul sustains
a head injury
Paul in
unconsious
Pauls friend
calls for help
Pauls friend
Pauls friend
shows the crash
site to the
paramedics
Paul getting his
clinical status
checked
Paul getting his
clinical status
checked
PATIENT PAUL
PARAMEDICS
PHYSICIAN
RADIOLOGIST
NURSES
Paramedics
arrive to the
crash site
Paramdics
assess
patients
clinical status
Paramedics
stabilize the
patient
Paul is being
stabilized
Paramedics
take the
patient to the
hospital
Paramedics
keep patient
stable
Paul is put in to
the ambulance
car and taken to
the hospital
Paul recives
an IV drip and
some
medication
Paul is taken of
the strecher
and lifted on to
a hospital bed
Handing over
the patient
Nurses recive
the patient
Physician
assesses
patients clinical
status
Physician
orders a CT
scan
Doctor
ordering
another CT
scan
Paramedics
infroming the
hospital about
condition of the
arriving patient
Nurses start
peparing for
the patient
Radiologist
prepares the CT
scanner
Radiologist
recives a scan
request
Radiologist
prepares the CT
scanner
Radiologist
recives a scan
request
Nurses
transport the
patient to the
CT scnanner
Nurses
transport the
patient to the
CT scnanner
Nurses
transport the
patient to the
CU
Nurses
prepare the
patient for
scanning
Nurses
prepare the
patient for
scanning
Nurses prepare
the patient for
transport
Nurses
prepare the
patient for
transport
Paul is lifted
into the CT
scanner
Paul is lifted
into the CT
scanner
Paul gets
scanned
Paul gets
scanned
Radiologist
operates the
scanner
Radiologist
operates the
scanner
Paul is taken
to the
emergancy
room (ER)
Paul is taken
to a care unit
(CU)
Radiologists
delivers
assessment,
diagnosis
Nurses
transport the
patient
Nurses
monitor the
patient
Nurses
monitor the
patient
Nurses
monitor the
patient
Paul is taken to
a CT scanner
Physician
reciving
information
about the
arriving patient
Physician
decides on
treatment
Physician
recives the
scan results
Nurses prepare
the patient for
transport
Nurses
prepare the
patient for
transport
Nurses prepare
the patient for
transport
Paul is lifted
out of the CT
scanner
Paul is lifted
out of the CT
scanner
Paul is taken
back to care
unit
Radiologists
delivers
assessment,
diagnosis
Transporting
the patient
Palus is taken
to the CT
scanner
Doctor decides
on further
treatment
Doctor
reciving scan
results
Paul recives
treatment at
the ER
Treating
patient
Treating
patient
Paul is at
the CU
Paul is at
the CU
Paul is at
the CU
N
u
r
ses
transport t
h
e
p
atient to the
C
T scnanner
N
u
r
ses
prepare t
h
e
p
atient for
scannin
g
N
urses prepare
the patient
f
or
t
ranspor
t
3rd case
2nd case
1st case
Figure 3
Journey map
Bike crash,
Paul sustains
a head injury
Paul in
unconsious
Pauls friend
calls for help
Pauls friend
gives first aid
Pauls friend
shows the crash
site to the
paramedics
Paul getting his
clinical status
checked
Paul getting his
clinical status
checked
PATIENT PAUL
PARAMEDICS
PHYSICIAN
RADIOLOGIST
NURSES
Paramedics
arrive to the
crash site
Paramdics
assess
patients
clinical status
Paramedics
stabilize the
patient
Paul is being
stabilized
Paramedics
take the
patient to the
hospital
Paramedics
keep patient
stable
Paul is put in to
the ambulance
car and taken to
the hospital
Paul recives
an IV drip and
some
medication
Paul is taken of
the strecher
and lifted on to
a hospital bed
Handing over
the patient
Nurses recive
the patient
Physician
assesses
patients clinical
status
Physician
orders a CT
scan
Doctor
ordering
another CT
scan
Paramedics
infroming the
hospital about
condition of the
arriving patient
Nurses start
peparing for
the patient
Radiologist
prepares the CT
scanner
Radiologist
recives a scan
request
Radiologist
prepares the CT
scanner
Radiologist
recives a scan
request
Nurses
transport the
patient to the
CT scnanner
Nurses
transport the
patient to the
CT scnanner
Nurses
transport the
patient to the
CU
Nurses
prepare the
patient for
scanning
Nurses
prepare the
patient for
scanning
Nurses prepare
the patient for
transport
Nurses
prepare the
patient for
transport
Paul is lifted
into the CT
scanner
Paul is lifted
into the CT
scanner
Paul gets
scanned
Paul gets
scanned
Radiologist
operates the
scanner
Radiologist
operates the
scanner
Paul is taken
to the
emergancy
room (ER)
Paul is taken
to a care unit
(CU)
Radiologists
delivers
assessment,
diagnosis
Nurses
transport the
patient
Nurses
monitor the
patient
Nurses
monitor the
patient
Nurses
monitor the
patient
Paul is taken to
a CT scanner
Physician
reciving
information
about the
arriving patient
Physician
decides on
treatment
Physician
recives the
scan results
Nurses prepare
the patient for
transport
Nurses
prepare the
patient for
transport
Nurses prepare
the patient for
transport
Paul is lifted
out of the CT
scanner
Paul is lifted
out of the CT
scanner
Paul is taken
back to care
unit
Radiologists
delivers
assessment,
diagnosis
Transporting
the patient
Palus is taken
to the CT
scanner
Doctor decides
on further
treatment
Doctor
reciving scan
results
Paul recives
treatment at
the ER
Treating
patient
Treating
patient
Paul is at
the CU
Paul is at
the CU
Paul is at
the CU
3rd case
2nd case
1st case
A portable device part of paramadics
equipment for “in the field” scanning.
This was seen as one of the most poten-
tial application fields. A paramdics are
the first medical professionals to come
in contact with the patient they have the
potentil to initiate the early detection of
possible brain injury and the severity of
it.
When presenting this application case
to the head of emergancy medicine in
PERH it became apparent that there are
a lot of complications.
As any unexpected movement can in-
terfier with the scanning procedure the
conditions in a moving ambulace car are
far from perfect.
As Estonia is lucky to have so many hos-
pitals the potential time window from the
accident site to the hospital is to short to
give any meaningful benefits.
In addition paramedics are not qualified
to decide on a diagnosis and treatment
based on the scanner readings. They
would not take the responibility.
1. hypothetical case
A portable device in the hospital for
early detection of brain injury.
As some hospitals limited brain scan-
ning capabilities a portable, low cost
detection device was presented as a fit
for these hospitals also to work as back-
up system in case CT/MRI machines are
overloaded with patients.
Talking with PERHs medical personnel it
became evident that right now there is
no other technology besides CT/MRI the
doctors trust to base their diagnosis on.
Making decision on diagnosis and treat-
ment is a lot of resposibility and it’s not a
risk the doctors are willing to take.
As the brain is a delicate organ there is
no room for misinformation. A machine
that makes 1 mistake for every 1000
scans in not accurate enough to base
life or deth decison on.
No portable technologie can provide
accurate enough readings for detecting
brain injury as of now.
2. hypothetical case
A portable device in the hospital for
monitoring dynamic changes the
brain.
As patients who go through traumatic
brain injury might need monitoring to
keep an eye on any complications that
can develop from such injuries patient
monitoring was indetified as a potential
application field.
Inetrviewing the medical personnel at
PERH we identified this to be a likely
field of application. We recived valuable
insight from them.
In the existing situation, the victim of a
traumatic brain injuty is taken to Radiol-
ogy department for CT / MRI scan. Upon
scanning, the patient is transferred to
the Intensive Care Unit (ICU). In the ICU,
the patient is kept under close inspec-
tion. The patient is taken back to the ra-
diology department when physical signs
of dynamic change in the brain appear.
This can sometimes already be too late.
In addition the repeated transport of the
patient can become fatal for a victim of
3. hypothetical case
brain trauma as they are in a delicate
condition. Even even though moving the
patient is dangerous a scan is needed to
assess the patients conditions, to give a
diagnosis and decide on treatment.
The doctors had a saying about this
complicated situation:
Death comes in Radiology
This piece of insight is the corner stone
of our development process.
Identifying users and design requirements
By conducting phenomenological
observations in PERHs ICU and con-
ductiong interviews with medical per-
sonnel we aimed to idetify the users
and possible requrements for a por-
table brain scanning system in ICU.
We identified the users as following:
Primary user - Nurse. Nurses will be the
users who are hands on with this device.
Secondary user - Physician. Physicians
are not directly using the system but in-
teract with the readings from the device
Tertiary user - Hospital board. They are
influence the other users as they decide
if this device is up to the task and worth
purchasing for the secondary and pri-
mary users to use.
As we identified nurses as our primary
users we focused on observing them.
By being able to observe the nurses
working in the ICU we were able to un-
dersand their workflow. By interviewing
and observing them in action we got
valuable infights on how nurses interact
with medical equipment and what kind
of requirements that creates.
Even though the patient is not in this
case a user they affect the requirements
the most.
Design Brief
There is a need or a non invasive
brain scanning device that detects
the need for a CT scan by monitoring
dynamic changes in the brain.
Design guidelines:
• Primary users are Nurses.
• Simplifie use for the Nurses.
• Easy mounting and detaching of the 	
device.
• The device may not interfere with the 	
patients recovery.
• Easily maintainable
• Able to accommodate future
technologies.
III phase
Development
The goal of development phase is to
create concepts of form and oper-
ating procedure for a portable brain
scanning system in the ICU.
Brainstorming
Multiple Brainstorming sessions were
conducted (Figure..)
Throught these sessions we narrowed
the possibilities for our focus to few con-
crete ideas: flowers, pillows and head-
phones.
Flower:
A device which will wrap around the
head of the patient and will monitor his/
her brain activity without constraining
his/her movement.
Pillow:
A smart surface that will be able to get
information from the patient who lay
down on it, making a comfort situation
during the scanner.
Head-phones:
A concept to implement Eliko’s long de-
veloped technology possibilities, based
on a moving single antenna around the
surface of the head with the help of
two electrical motors and a conductive
chain.
Figure
Early concepts
In the beginning of the project many
ideas were rized upon. Some of them
are following:
Helmet with 10 to 20 antennas inside.
Antennas are sending signals to the
main device, pulse generator is the one
collecting the information. Not all of
them are working together, switching
them is complicated and also having
wires around.
Kinect device usage.
MEG - small combs, so you don’t need
to shave the hair, easy to contact with
the head (head massage circular comb).
Smart pillow - patient is lying on the bed,
the pillow/towel comes around the head
and start to scan the head, so we don’t
need to move the head later and it could
be a little softer surface.
Smart towel - will be wrapped around
patient head in a certain order.
Smart mattress - like a pillow concept,
except it is a part of the mattress.
Bed attachment device, such as a spe-
cial lamp.
Robot spiders, are moving in that area,
that needs to be scanned.
Smart arm - the smart hand is combing
the head meanwhile scanning the brain.
Fabric hat with antenna.
flower pillow- the blossoms are moving
automatically around the head for mon-
itoring.
Fabric headband, which is fastened on
the forehead part.
Shaver/ hand held cylinder - nurse will
need to move the “shaver” alike device
itself, where on top of it there is an an-
tenna working and scanning.
Smart fluid hat, where there are coils
built inside
Prototyping & testing
After realizing that we can not fix the
technology we are going to use yet,
we decided to start to work with dif-
ferent concepts to find out the best
solution.
Three ideas were chosen for developing
to a mature stage.
Radar Headphones
Smart Pillow
Modular Helmet
Evaluation and focus
Thanks to good co-operation with Eliko
we managed to take into consideration
all the technical issues while building
those concepts. After receiving the
confirmation from Eliko that all those
concepts are doable in real-life we went
to PERH to join a morning meeting of
the nurses to introduce them the ideas
and ask feedback. The feedback we got
from them is following:
Radar headphones - NO GO!
• The head support is not good- patient
can get bed sores
• Neck lengths are different, not suitable
for everyone
• Patient will sometimes lay on the side
(then you can not use it)
• Pressure on the neck
• You can not move the patient
Smart pillow - NEEDS A LOT OF
IMPROVEMENT
• Needs to be cleanable (BIG PROBLEM)
• Liquids will run also inside of the coils
holes (foam can be filled with liquid such
as blood)
• Coils and pillow should be changeable
• Will fit for most head sizes
• Perhaps the best option to move the
patient
• The pillow will take the shape of the
head, it will keep the head stable
• The angle of the pillow must be pointed
up (so the head is at the upper part- it
will keep away the lung infection)
• There should be signs which coils
should be connected with which places
they might change the pillow cover many
times a day so it will be uncomfortable
to unconnect and connect the coils in
between
Modular helmet - WE GOT THIS!
• we need to change the material (can
not be porous, because neet to be
cleanable)
• Cleanability
• Breathability
• wires should come out from top of the
head
• We need to take care there is not too
much pressure on the head.Perhaps
add some gel pads next to the head to
make it softer
• The blood flow is not as good on the
head trauma patient as a normal person
it is adapting different head sizes
• If some bolt or some injury pieces
coming out from the head, one piece of
the module could be removed (have to
think about how to connect the wires in
this case)
IV phase
Delivery
The goal of deliveryphase is to illus-
trate the concept of form and oper-
ating procedure for a portable brain
scanning system in the ICU.
MoniTech
Headgear
MoniTech
Introduction to our product
With Monitech Headgear the require-
ments of users have been met with with
constraints of technology.
Technology
Monitech Headgear is designed to fit
MIT technology. Magnetic Induction To-
mography: The theoretical base of this
technology is close to the base on MRT.
Electromagnetic field gives us informa-
tion depending on the difference in the
frequency on the wave back from the
inspection, the changes on the wave
are made by the bounce of the wave on
the molecular links inside the head. The
main difference is that instead of create
a close electromagnetic field inside a
jail, we use microwaves that go from one
coil attached to the head to another one
crossing it. Using a lot of coils we get
to cover the whole surface of the head,
creating a different jail and achieving all
the possibilities through the head to get
all the information that is need.
Design
The use of MIT technology enables to
design the device in most suitable way
for users. Placing it to patient’s head is
intuitional and requires very little knowl-
edge. It is easy to clean to meet the
strict hygiene requirements of ICU envi-
ronment.
Visual identity
Since the project is focused on cre-
ating a product which helps the med-
ical people to monitor a human brain
and discover the changes in the brain
dynamics we decided to keep the
design of the product as simple and
clear as possible.
Picking a project name was not an easy
task. We decided that the name should
give a straight hint what the device is
doing, even when the person is hearing
the name for the first time. Our project
name MoniTech comes from the words
Monitoring Technology combination
which is pretty much the simplest way
to say what is it doing.
The goal is to show the product clear,
visible and understandable. We are us-
ing grey and blue colour, since they car-
ry the right feeling.
Analysis & conclusion
Our concept was trying to design a new
brain scanner which would be cheaper,
“portable” and open using the technol-
ogy that eliko was developing, the three
different concepts that we get during the
creative process fulfill these needs, but
not all of them were suitable to use on
real patients due to the physical con-
straints around the products so we final-
ly choose the “Modular Helmet” which
was the concept nurses were more in-
terested in.
This concept has many improvements
compared to the actuals techniques of
brain monitoring, As it is a small device
the patient will not get stressed if s/he
has claustrophobic fear,it will improve
the treatment of the patient, there will
not be a need to displace the patient so
there will no be complication attached to
these movement to the radiology area,
it will be possible to make a continuous
monitor of the brain while the patient is
in the ICU so the doctors will be able of
taking decisions on the critical points in
the development of the patient’s state
the price of this device compare to the
price of a CT or a MRI would be much
lower so it will be possible to monitor the
the brain activities in rural areas which
were not able to afford one of these ma-
chines on their local hospitals or health
centers.
Opportunity (vision for the future)
With the develop of Eliko’s technology
the future for medicine scanner would
get revolutionized if they succeed on
their purpose.
Their work on Magnetic Induction To-
mography could get to release a func-
tional portable scanner that could have
applications not only on the ICU also in
emergency situations or even satisfying
the needs of the public (monitoring the
brain activity from the residence of the
small users who can afford to buy it as
example).
And even more interesting the potential
of their works on Eddy currents which
could finish on the developing of an ef-
ficiency device to monitor bones, mus-
cles or internal organs on any scenario
(emergencies, residences, hospital pro-
tocols etc) that also would not be too
expensive.
Monitech headgrear

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Monitech headgrear

  • 1. Design Studio II Spring Project 2015
  • 2. Contents Tutors 4 Partners 5 Team 6 I phase, Research 9 Discovering the brain 10 Discovering potential technologies 12 Discovering potential focus areas 13 Analysis of initial research / Defining a focus area 14 II phase, Defining 15 Identifying a field of application 16 Journey map 17 Identifying users and design requirements 21
  • 3. Contents Design Brief 22 III phase, Development 23 Brainstorming 24 Early concepts 25 Prototyping & testing 26 Evaluation and focus 28 IV pahse, Delivery 29 MoniTech 31 Visual identity 34 Analysis & conclusion 35 Opportunity (vision for the future) 36
  • 4. Tutors Sven Sõrmus Designer Supervisor, Estonian Academy of Arts Janno Nõu Designer Supervisor, Estonian Academy of Arts Martin Pärn Designer Dead of D&E, Estonian Academy of Arts
  • 5. Partners ELIKO Rauno Gordon Senior research scientist Eiko Priidel Engineering Manager, PhD student Annuka Mikola Clinical Engineer Technology Competence Centre in Electronics-, Info- and Communication Technologies The mission of ELIKO is to improve the compet- itiveness of Estonian ICT industry through the collaboration of top research institutions and businesses in the fields of electronics-, info- and communication technologies. PERH Põhja-Eesti Regionaalhaigla / The North Estonia Medical Centre The North Estonia Medical Centre is one of the top health care providers in the country. A pa- tient-centred institution committed to profes- sionalism, innovation and teamwork, the Medical Centre has more than 3,700 people – doctors, nurses, caregivers and specialists – working for the good of patients.
  • 6. Team Guillermo Guerra Industrial Engineer Spain Maret Martsepp Mechanical Engineer Estonia Pranay Kenkre Mechanical Engineer India Taavet Pärenson Designer Estonia Taavi Taros Mechanical Engineer Estonia
  • 7. The goal of the project Eliko deals with research and devel- opment of technologies in the medi- cal field. They have been involved in the development of a Portable Brain scanner for nearly two years. The task and goal for our team was to identify an appropriate area of use, understand the environment, the people involved and create a con- cept of form and operating procedure for such a device.
  • 8.
  • 9. I phase Research The goal of conducting the inital re- search phase is to identifie potential areas of use.
  • 10. Discovering the brain Through desk research, going through PERHs research materials and interviewing hospital personnel we aimed to understand the anatomy of the human head and learn why we would even want to look inside it. In the development process we were facing a product for emergency situa- tions so the research around the brain anatomy was oriented at the problems that appear after a head injury. The brain is protected from external damage by the skull and several irri- gated layers between the skull and the “pink mass”, these layers are the first to show damage when there is a strong hit to the head. The general complications in this area occur when there is bleeding (hemato- ma) between these layers, raising the in- tracranial pressure (Figure 2). The types of these hematomas are differ- ent depending on the layer it is forming in (Figure 1). In any case it is important to note here that when the hematoma grows, it starts to squash the brain lead- ing to many different health problems and even leading to death. The sever- ity of the injury depends on the the area where the excess blood is present. In an emergency situation where the skull is not injured but traumatic head injury is suspected it is especially im- portant to know where and what has happened to the brain to see if and what kind of treatment is needed. Treatments can vary from surgery to simply monitor- ing the patient. The research unveiled that there are different reasons to look inside the brain but the most valuable reason from our perspective was the need to accurately assess changes in the brain and decide on an appropriate treatment. Figure 1
  • 12. Discovering potential technologies Through desk research, studying ELIKOs research materials and inter- viewing hospital personnel we aimed to understand what are the current non invasive technologies used to see inside the head and wich of those could be conidered for portable use. Nowadays when there is a need for a non invasive way to detect injuries in the patients brain for any reason there are mainly two stationary options, MRI and CT scans. CT (computer tomography) is a tech- nology that uses computer-processed X-rays in order to produce images (slic- es) of different parts of an object allow- ing the user to see inside without cutting, this technology is fully developed and is a perfect tool in order to diagnosticate many different problems in the head. MRI (magnetic resonance image) is an- other technology used in radiology to study the state of the body by images. MRI scanners use radio waves and mag- netic fields to form images of the body. Both technologies show the same defi- ciency which is that both are stationary, big machines. Because how thtese tech- nologies work, they cant not be used for portable solutions. Also both machines are rather expensive and need contin- uous maintenance. But this is under- standable as it takes alot of power to generate images of that quality. Some portable technologies also exist that can be used to examine the brain. NIR (Near infrared Technology) can be used for early detection of brain injury. A device is used to compare the left and right side of different areas of the brain to find irregularities that might indicate brain injury. The research team at ELIKO are devel- oping technologies that show promise in this field. MIT (Magnetic induction tomography) uses multible small coils around the hea compile an image of the brain. an electromagnetic field gives us informa- tion depending on the differences in the frequency of the wave back from the head. The changes in the wave patterns are made by the bouncing of the wave on the molecular links inside the head. UWB radar (Ultra-wideband radar) uses an antenna to sends short pulse of elec- tromagnetic waves inside the brain and compiles and image based on the fre- quency signals that bounce back. This can be used as a single antenna moved around the head. Researching technologies unveiled that depending on the injury and the results needed different technologies can to be used for examining the brain. Most importantly current wide- ly used technologies are not suitable for use in portable devices. Thankful- ly ELIKO is developing technologies suitable for such use.
  • 13. Discovering potential focus areas Through studying research materi- als, desk research scenario building we aimed to find potential application opportunities and find who would po- tentially benfit from a portable brain scanning system. As we are dealing with brain trauma we focused on areas of life where such inju- ries are a part of everyday life. From civilian life we identified sports events as potential application areas. Repeated head injuries like concussions are a part of everyday life in sports like american football and extreme sports to name a few. There a documented cas- es where such injuries go unnoticed in sports events and lead to future com- plication in athletes. A portable device could help with early detection on inju- ries. Military use proved to be a potentally huge opportunity for such devices as access to hightech medical machinery in war zones is limited and traumatic head injuries occur often. A portable device in such situations could help in streamlin- ing the process of getting the appropri- ate treatment for the patient in time. One of the most interesting potential opportunities are first response teams/ paramedics who are first on the scene and could be in a position to be the first to identify brain injury. Hospitals of cource are another obvious potential application area as not all hos- pitals have access to sophisticated brain imaging technologies. It can also be the case that different procedures could be streamlined by having access to porta- ble imaging devices. In any case the hospital is a big area of interest as there we have the profession- als who can provide treatment and de- tailed diagnosis fot the patient. This is an important feature that other potential application areas (especially civilian cas- es) are missing. From the research we concluded that whatever happens outside the hos- pital the patient still ends up in the hospital in the hands of professionals as the non professionals do not have the knowhow, authority or machinery to make decisions concerning diag- nosis and treatment.
  • 14. Analysis of initial research / Defining a focus area In our research into brain anatomy, brain scanning technologies and po- tential focus areas we found that it’s not about who wants to find what in- side the head but about what can be done with that information or more importanly about who can do some- thing with that information. This lead to us shifting our focus onto hospitals and the the patients who experience a traumatic brain injury (TBI) and are sent to the hospital for diagnosis and treatment.
  • 15. II phase Defining The goal of defining phase is to de- fine the field of application, users and design requirements.
  • 16. Identifying a field of application By creating a patient journey map and conducting interviews with PERH personnel and pitching hypothetical cases to nurses we aim to find the approprate field of application fot a portable brain scanning device. As we are ultimately interested in improv- ing the patients quality of life we chose to create a patient journey map (Figure 3) to unterstand and find opportunities where portable brain scanning device can help streamline patient recovery. This method helped us create three hy- pothetical cases for testing. These were pitched and presented to medical per- sonnel to indentify users and require- ments and the need for a portable brain scanner in those situation. The following the analysis of these three cases. Bike crash, Paul sustains a head injury Paul in unconsious Pauls friend calls for help Pauls friend Pauls friend shows the crash site to the paramedics Paul getting his clinical status checked Paul getting his clinical status checked PATIENT PAUL PARAMEDICS PHYSICIAN RADIOLOGIST NURSES Paramedics arrive to the crash site Paramdics assess patients clinical status Paramedics stabilize the patient Paul is being stabilized Paramedics take the patient to the hospital Paramedics keep patient stable Paul is put in to the ambulance car and taken to the hospital Paul recives an IV drip and some medication Paul is taken of the strecher and lifted on to a hospital bed Handing over the patient Nurses recive the patient Physician assesses patients clinical status Physician orders a CT scan Doctor ordering another CT scan Paramedics infroming the hospital about condition of the arriving patient Nurses start peparing for the patient Radiologist prepares the CT scanner Radiologist recives a scan request Radiologist prepares the CT scanner Radiologist recives a scan request Nurses transport the patient to the CT scnanner Nurses transport the patient to the CT scnanner Nurses transport the patient to the CU Nurses prepare the patient for scanning Nurses prepare the patient for scanning Nurses prepare the patient for transport Nurses prepare the patient for transport Paul is lifted into the CT scanner Paul is lifted into the CT scanner Paul gets scanned Paul gets scanned Radiologist operates the scanner Radiologist operates the scanner Paul is taken to the emergancy room (ER) Paul is taken to a care unit (CU) Radiologists delivers assessment, diagnosis Nurses transport the patient Nurses monitor the patient Nurses monitor the patient Nurses monitor the patient Paul is taken to a CT scanner Physician reciving information about the arriving patient Physician decides on treatment Physician recives the scan results Nurses prepare the patient for transport Nurses prepare the patient for transport Nurses prepare the patient for transport Paul is lifted out of the CT scanner Paul is lifted out of the CT scanner Paul is taken back to care unit Radiologists delivers assessment, diagnosis Transporting the patient Palus is taken to the CT scanner Doctor decides on further treatment Doctor reciving scan results Paul recives treatment at the ER Treating patient Treating patient Paul is at the CU Paul is at the CU Paul is at the CU N u r ses transport t h e p atient to the C T scnanner N u r ses prepare t h e p atient for scannin g N urses prepare the patient f or t ranspor t 3rd case 2nd case 1st case Figure 3
  • 17. Journey map Bike crash, Paul sustains a head injury Paul in unconsious Pauls friend calls for help Pauls friend gives first aid Pauls friend shows the crash site to the paramedics Paul getting his clinical status checked Paul getting his clinical status checked PATIENT PAUL PARAMEDICS PHYSICIAN RADIOLOGIST NURSES Paramedics arrive to the crash site Paramdics assess patients clinical status Paramedics stabilize the patient Paul is being stabilized Paramedics take the patient to the hospital Paramedics keep patient stable Paul is put in to the ambulance car and taken to the hospital Paul recives an IV drip and some medication Paul is taken of the strecher and lifted on to a hospital bed Handing over the patient Nurses recive the patient Physician assesses patients clinical status Physician orders a CT scan Doctor ordering another CT scan Paramedics infroming the hospital about condition of the arriving patient Nurses start peparing for the patient Radiologist prepares the CT scanner Radiologist recives a scan request Radiologist prepares the CT scanner Radiologist recives a scan request Nurses transport the patient to the CT scnanner Nurses transport the patient to the CT scnanner Nurses transport the patient to the CU Nurses prepare the patient for scanning Nurses prepare the patient for scanning Nurses prepare the patient for transport Nurses prepare the patient for transport Paul is lifted into the CT scanner Paul is lifted into the CT scanner Paul gets scanned Paul gets scanned Radiologist operates the scanner Radiologist operates the scanner Paul is taken to the emergancy room (ER) Paul is taken to a care unit (CU) Radiologists delivers assessment, diagnosis Nurses transport the patient Nurses monitor the patient Nurses monitor the patient Nurses monitor the patient Paul is taken to a CT scanner Physician reciving information about the arriving patient Physician decides on treatment Physician recives the scan results Nurses prepare the patient for transport Nurses prepare the patient for transport Nurses prepare the patient for transport Paul is lifted out of the CT scanner Paul is lifted out of the CT scanner Paul is taken back to care unit Radiologists delivers assessment, diagnosis Transporting the patient Palus is taken to the CT scanner Doctor decides on further treatment Doctor reciving scan results Paul recives treatment at the ER Treating patient Treating patient Paul is at the CU Paul is at the CU Paul is at the CU 3rd case 2nd case 1st case
  • 18. A portable device part of paramadics equipment for “in the field” scanning. This was seen as one of the most poten- tial application fields. A paramdics are the first medical professionals to come in contact with the patient they have the potentil to initiate the early detection of possible brain injury and the severity of it. When presenting this application case to the head of emergancy medicine in PERH it became apparent that there are a lot of complications. As any unexpected movement can in- terfier with the scanning procedure the conditions in a moving ambulace car are far from perfect. As Estonia is lucky to have so many hos- pitals the potential time window from the accident site to the hospital is to short to give any meaningful benefits. In addition paramedics are not qualified to decide on a diagnosis and treatment based on the scanner readings. They would not take the responibility. 1. hypothetical case
  • 19. A portable device in the hospital for early detection of brain injury. As some hospitals limited brain scan- ning capabilities a portable, low cost detection device was presented as a fit for these hospitals also to work as back- up system in case CT/MRI machines are overloaded with patients. Talking with PERHs medical personnel it became evident that right now there is no other technology besides CT/MRI the doctors trust to base their diagnosis on. Making decision on diagnosis and treat- ment is a lot of resposibility and it’s not a risk the doctors are willing to take. As the brain is a delicate organ there is no room for misinformation. A machine that makes 1 mistake for every 1000 scans in not accurate enough to base life or deth decison on. No portable technologie can provide accurate enough readings for detecting brain injury as of now. 2. hypothetical case
  • 20. A portable device in the hospital for monitoring dynamic changes the brain. As patients who go through traumatic brain injury might need monitoring to keep an eye on any complications that can develop from such injuries patient monitoring was indetified as a potential application field. Inetrviewing the medical personnel at PERH we identified this to be a likely field of application. We recived valuable insight from them. In the existing situation, the victim of a traumatic brain injuty is taken to Radiol- ogy department for CT / MRI scan. Upon scanning, the patient is transferred to the Intensive Care Unit (ICU). In the ICU, the patient is kept under close inspec- tion. The patient is taken back to the ra- diology department when physical signs of dynamic change in the brain appear. This can sometimes already be too late. In addition the repeated transport of the patient can become fatal for a victim of 3. hypothetical case brain trauma as they are in a delicate condition. Even even though moving the patient is dangerous a scan is needed to assess the patients conditions, to give a diagnosis and decide on treatment. The doctors had a saying about this complicated situation: Death comes in Radiology This piece of insight is the corner stone of our development process.
  • 21. Identifying users and design requirements By conducting phenomenological observations in PERHs ICU and con- ductiong interviews with medical per- sonnel we aimed to idetify the users and possible requrements for a por- table brain scanning system in ICU. We identified the users as following: Primary user - Nurse. Nurses will be the users who are hands on with this device. Secondary user - Physician. Physicians are not directly using the system but in- teract with the readings from the device Tertiary user - Hospital board. They are influence the other users as they decide if this device is up to the task and worth purchasing for the secondary and pri- mary users to use. As we identified nurses as our primary users we focused on observing them. By being able to observe the nurses working in the ICU we were able to un- dersand their workflow. By interviewing and observing them in action we got valuable infights on how nurses interact with medical equipment and what kind of requirements that creates. Even though the patient is not in this case a user they affect the requirements the most.
  • 22. Design Brief There is a need or a non invasive brain scanning device that detects the need for a CT scan by monitoring dynamic changes in the brain. Design guidelines: • Primary users are Nurses. • Simplifie use for the Nurses. • Easy mounting and detaching of the device. • The device may not interfere with the patients recovery. • Easily maintainable • Able to accommodate future technologies.
  • 23. III phase Development The goal of development phase is to create concepts of form and oper- ating procedure for a portable brain scanning system in the ICU.
  • 24. Brainstorming Multiple Brainstorming sessions were conducted (Figure..) Throught these sessions we narrowed the possibilities for our focus to few con- crete ideas: flowers, pillows and head- phones. Flower: A device which will wrap around the head of the patient and will monitor his/ her brain activity without constraining his/her movement. Pillow: A smart surface that will be able to get information from the patient who lay down on it, making a comfort situation during the scanner. Head-phones: A concept to implement Eliko’s long de- veloped technology possibilities, based on a moving single antenna around the surface of the head with the help of two electrical motors and a conductive chain. Figure
  • 25. Early concepts In the beginning of the project many ideas were rized upon. Some of them are following: Helmet with 10 to 20 antennas inside. Antennas are sending signals to the main device, pulse generator is the one collecting the information. Not all of them are working together, switching them is complicated and also having wires around. Kinect device usage. MEG - small combs, so you don’t need to shave the hair, easy to contact with the head (head massage circular comb). Smart pillow - patient is lying on the bed, the pillow/towel comes around the head and start to scan the head, so we don’t need to move the head later and it could be a little softer surface. Smart towel - will be wrapped around patient head in a certain order. Smart mattress - like a pillow concept, except it is a part of the mattress. Bed attachment device, such as a spe- cial lamp. Robot spiders, are moving in that area, that needs to be scanned. Smart arm - the smart hand is combing the head meanwhile scanning the brain. Fabric hat with antenna. flower pillow- the blossoms are moving automatically around the head for mon- itoring. Fabric headband, which is fastened on the forehead part. Shaver/ hand held cylinder - nurse will need to move the “shaver” alike device itself, where on top of it there is an an- tenna working and scanning. Smart fluid hat, where there are coils built inside
  • 26. Prototyping & testing After realizing that we can not fix the technology we are going to use yet, we decided to start to work with dif- ferent concepts to find out the best solution. Three ideas were chosen for developing to a mature stage. Radar Headphones Smart Pillow Modular Helmet
  • 27.
  • 28. Evaluation and focus Thanks to good co-operation with Eliko we managed to take into consideration all the technical issues while building those concepts. After receiving the confirmation from Eliko that all those concepts are doable in real-life we went to PERH to join a morning meeting of the nurses to introduce them the ideas and ask feedback. The feedback we got from them is following: Radar headphones - NO GO! • The head support is not good- patient can get bed sores • Neck lengths are different, not suitable for everyone • Patient will sometimes lay on the side (then you can not use it) • Pressure on the neck • You can not move the patient Smart pillow - NEEDS A LOT OF IMPROVEMENT • Needs to be cleanable (BIG PROBLEM) • Liquids will run also inside of the coils holes (foam can be filled with liquid such as blood) • Coils and pillow should be changeable • Will fit for most head sizes • Perhaps the best option to move the patient • The pillow will take the shape of the head, it will keep the head stable • The angle of the pillow must be pointed up (so the head is at the upper part- it will keep away the lung infection) • There should be signs which coils should be connected with which places they might change the pillow cover many times a day so it will be uncomfortable to unconnect and connect the coils in between Modular helmet - WE GOT THIS! • we need to change the material (can not be porous, because neet to be cleanable) • Cleanability • Breathability • wires should come out from top of the head • We need to take care there is not too much pressure on the head.Perhaps add some gel pads next to the head to make it softer • The blood flow is not as good on the head trauma patient as a normal person it is adapting different head sizes • If some bolt or some injury pieces coming out from the head, one piece of the module could be removed (have to think about how to connect the wires in this case)
  • 29. IV phase Delivery The goal of deliveryphase is to illus- trate the concept of form and oper- ating procedure for a portable brain scanning system in the ICU.
  • 31. MoniTech Introduction to our product With Monitech Headgear the require- ments of users have been met with with constraints of technology. Technology Monitech Headgear is designed to fit MIT technology. Magnetic Induction To- mography: The theoretical base of this technology is close to the base on MRT. Electromagnetic field gives us informa- tion depending on the difference in the frequency on the wave back from the inspection, the changes on the wave are made by the bounce of the wave on the molecular links inside the head. The main difference is that instead of create a close electromagnetic field inside a jail, we use microwaves that go from one coil attached to the head to another one crossing it. Using a lot of coils we get to cover the whole surface of the head, creating a different jail and achieving all the possibilities through the head to get all the information that is need. Design The use of MIT technology enables to design the device in most suitable way for users. Placing it to patient’s head is intuitional and requires very little knowl- edge. It is easy to clean to meet the strict hygiene requirements of ICU envi- ronment.
  • 32.
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  • 34. Visual identity Since the project is focused on cre- ating a product which helps the med- ical people to monitor a human brain and discover the changes in the brain dynamics we decided to keep the design of the product as simple and clear as possible. Picking a project name was not an easy task. We decided that the name should give a straight hint what the device is doing, even when the person is hearing the name for the first time. Our project name MoniTech comes from the words Monitoring Technology combination which is pretty much the simplest way to say what is it doing. The goal is to show the product clear, visible and understandable. We are us- ing grey and blue colour, since they car- ry the right feeling.
  • 35. Analysis & conclusion Our concept was trying to design a new brain scanner which would be cheaper, “portable” and open using the technol- ogy that eliko was developing, the three different concepts that we get during the creative process fulfill these needs, but not all of them were suitable to use on real patients due to the physical con- straints around the products so we final- ly choose the “Modular Helmet” which was the concept nurses were more in- terested in. This concept has many improvements compared to the actuals techniques of brain monitoring, As it is a small device the patient will not get stressed if s/he has claustrophobic fear,it will improve the treatment of the patient, there will not be a need to displace the patient so there will no be complication attached to these movement to the radiology area, it will be possible to make a continuous monitor of the brain while the patient is in the ICU so the doctors will be able of taking decisions on the critical points in the development of the patient’s state the price of this device compare to the price of a CT or a MRI would be much lower so it will be possible to monitor the the brain activities in rural areas which were not able to afford one of these ma- chines on their local hospitals or health centers.
  • 36. Opportunity (vision for the future) With the develop of Eliko’s technology the future for medicine scanner would get revolutionized if they succeed on their purpose. Their work on Magnetic Induction To- mography could get to release a func- tional portable scanner that could have applications not only on the ICU also in emergency situations or even satisfying the needs of the public (monitoring the brain activity from the residence of the small users who can afford to buy it as example). And even more interesting the potential of their works on Eddy currents which could finish on the developing of an ef- ficiency device to monitor bones, mus- cles or internal organs on any scenario (emergencies, residences, hospital pro- tocols etc) that also would not be too expensive.