A Q&A with Medical Design Consultant Yukiko Naoi

Spotlight articles shine a light on designers we admire, asking leaders in the field about their work and their design journey. In this interview we spoke with medical design consultant and acupuncturist Yukiko Naoi.

Yukiko’s journey bridges the worlds of design, medicine, and wellness. With a foundation in acupuncture and Chinese medicine combined with degrees in interior design and industrial design, Yukiko has spent over a decade designing innovative medical devices, diagnostics, and consumer products as long time partner and president of TKDG, Tanaka Kapec Design Group. Her hands-on experience with medical precision rekindled her passion for acupuncture, leading her to found her clinic, Rest NYC. From working with children battling cancer at Columbia University Medical Center to exploring the healing power of group dynamics in community clinics, Yukiko’s work reflects a holistic approach to health, design, and the interconnectedness of human experiences. She is also a long-time friend of Interwoven, and has collaborated with us on a number of medical design projects. We asked her about the challenges of medical design, getting feedback from stakeholders in the design process, and how her dual roles of acupuncturist and medical design consultant influence one another.

Q:

Why is medical design different from other types of industrial design? And what are some of the unique challenges you face when designing for the healthcare industry?

A:

I’m going to be really honest. To tell you what is truly unique about medical design, I would have to know everything else. I’d have to know aviation design and everything. Let’s think about designing an airplane or a helicopter—that must be just as complicated. I can’t definitively say that medical design is unique, so I’ll just talk about how I see it compared to some more general products.

Even when you say medical design it could mean different classes of products. It could mean consumer products or it could mean products only used by doctors, where there’s a different level of product development.

In general, there are more regulations and requirements. There are requirements for manufacturing and materials, and multiple rounds of approval for those materials. Toys are similar. Those are the obvious challenges that are somewhat unique to medical design;  regulatory requirements as well as the involvement of the insurance agencies. Whatever product that you’re designing has to work with that system of patients, healthcare providers, and insurance companies. The insurance companies can come in at the very early stages of the project. Let’s say you are designing something that focuses on the patient but the doctor is going to be the one pitching the emerging technology to the patient. This puts the doctor in a certain position of power, but at the same time they need the insurance company’s approval so that insurance will pay. Let’s say it’s a diagnostic device. They need to have some sort of system of checks and balances in place so the doctors have a certain level of power, but not so much power that the insurance companies wouldn’t approve it.  

Many medical companies have in-house consultants; doctors, nurses, techs, and even insurance consultants. All of a sudden, your scope could change. You might realize that you need another step in place to make sure that there’s an opportunity for doctors to share their input before the final outcome or to account for how they manage data or patient information. As designers, we are trying to make everyone happy.

Then there is an enormous amount of people in the healthcare industry who have nothing to do with the insurance company. They get the product in place or in the doctor’s hand or they clean the product or store the product, and that’s their everyday life. We always try to include those people to really make the whole process smooth. The ultimate goal is to have better outcomes; to provide the best health care that you possibly can while eliminating human error and maximizing efficiency and all that good stuff. The new trend is patients getting more power. Of course we include patients in our research as well.

Q:

Medical designs have multiple users from the patients to the doctors and the other medical professionals who use it to the hospitals or clinics that invest in the product. How do you ensure your designs satisfy the needs of all of these groups? 

A:  

There is a harsh element to this, which is about where the money comes from. The clients provided the money to solve this issue, and we need to satisfy them. Then there’s the receiving side, the target user for the product. They should have the same goal, but those sides don’t always have the same priorities. Not every project results in the best of the best for everyone.  So there’s the harsh side of budgets and time constraints, and there’s the super soft side—that this is a product that humans will touch and feel and live with. Our goal is to make a bridge between the two so that no one is overlooked. It’s not always easy.

Q:

How do you gather and incorporate feedback from end-users, such as patients and healthcare providers, during the design process?

A:

We often shadow medical professionals so we can really understand their roles and know what to bring to their attention. There’s a little void that we need to fill because the product has to work at every stage, and as designers we’re often the only ones who see every stage of a product. Good clients would give us the time and budget to really understand the beginning and the end of the life cycle of each product; where material comes in, where it’s going to be made, how it’s going to be packaged, how it’s going to be shipped, the carbon footprint, and all that stuff. It makes for better design but also each stage costs money, and a lot of clients are interested in saving a penny wherever possible. We’re talking about millions of whatever product you design. It’s ultimately more successful to consider all of these details in product development.

It’s important for us to observe as well as interview stakeholders. People aren’t necessarily aware of what they do, it’s second nature to them so they don’t think about it. They have standard tasks they repeat over and over, nurses are a great example but this happens in all kinds of medical roles. They do tasks, and if you ask them about it they say…whatever they think they’re doing, This is better. I want this. I’m doing this. But the reality may not be the same. It’s interesting to see their perception of what they’re doing, and that is valuable information, but they’re working with the existing system, so they may not be able to see what we can do for them. What they say could be very different from what they’re doing. It’s powerful to hear their words as well as to see their environment and how they work in it. 

Ideally we hear from stakeholders with all levels of income, to hear from a huge, well-funded hospital in Texas and also to hear from the one person clinic. They may be doing the same procedure but in a very different environment, and to understand both is important. Location is important also, or real estate. Some users have more room, some have very little. A Manhattan clinic is tiny. The same goes for patients. We want to see people with huge families and small families, we want to see a wide range of age differences and body types. One product should be able to go to all those places and work at an optimal level.

Q:

How do you address the need for balancing functionality, safety, and aesthetics in your designs?

A:

As a designer, I think aesthetics is a given. This is why we’re designers instead of being engineers or marketing experts. Of course everything is a collaboration because there are engineers, salespeople, manufacturers…I think we have to trust ourselves to know that aesthetics is just what we do. It’s in our blood, it’s in everything we do, without thinking. Then just try to design an honest, elegant solution. We are like aesthetic ambassadors. I’m glad that a lot of medical companies value that, and I think there is a demand for aesthetically appealing products from patients and doctors as well, they don’t want to live with not so nice things.

Q:

What considerations go into designing products that need to withstand rigorous use and sanitation protocols?

A:

There are two main options, and they are complete opposites. One is a reusable medical product, and one is a disposable product. Many medical devices are disposable because of the danger of cross-contamination. That comes with challenges around material use and environmental impact.

Certainly we can play a huge role in selecting better optimal materials and considering the environment issues. A lot of companies are under pressure to show environmental accountability. On the other side are the reusable products that go through a sterilization process. There are always trusted, well-established systems for sterilization; protocols and procedures that people are reluctant to change because of the risk involved. It depends on the area of medical design as well. Orthopedic surgery instruments are usually reusable but it depends on the cost, because hospitals are businesses, and if they see that a sterilization process costs more than disposable products, they may decide to get rid of the sterilization process just because it’s not efficient or not profitable enough.

The sterilization process itself is its own area of medical product design. I’ve done a little work in that area, just enough to understand how complex it is. The sterilization process is done by a human. There is a machine, but there is a human working the machine, and you have to keep it sterile. There is some automation, but that space between the human and the automated machine is a great opportunity for industrial design.

It’s always fun for us to look at the options and push the envelope a little bit, to consider new materials and processes, but in the medical field anything new has to go through an extensive and expensive approval process. It feels like it really comes down to money: whether or not there is a company or a government entity that’s willing to fund the project. I have to say, in this huge, wealthy country there are enough people to do that, and that’s how good things come to the market.

Q:

You’ve worked with Interwoven on a number of projects, including the Breg CrossRunner Soft Knee Brace. Could you talk about some of the challenges of that project and how the team addressed them?

A:

This was a proper industrial design project. The challenge at the beginning of the product exploration, once the discovery was in place and we understood our parameters, was to mix the hard and soft materials on the body. We have to consider three elements; the human body, the soft goods and the hard parts, and we’re trying to integrate them to create a new combination of all three. That part was really fun. And again there was the aesthetic ambassador part, because we wanted people to want to wear this product, and for them to find it easy and comfortable to wear. It was quite successful.

Q:

On top of being an Industrial Designer, you are also an acupuncturist and have an active acupuncture practice.  Has acupuncture informed your medical design work? How do they influence one another?

A:

At one point in my career, I got a little disheartened with the design industry because of all these things that we just talked about, the frustration with the money-making industry, proof that it’s a for profit industry, nobody’s doing it for free. It’s ideal if designers can make money and help people, that’s the ultimate goal, but sometimes it doesn’t happen. I was discouraged, thinking, What’s the point? Sometimes I felt that the industry was operating with priorities that were different from mine. I thought, Okay, I’m just going to do more hands-on things to help people. I wanted to fix things. That’s what designers do: problem-solving mindset.

So I went into this hands-on phase, working with people individually, which was when I started doing acupuncture. It was amazing because I had the perspective of working with a huge company and a huge budget, able to impact thousands of people, and this was the opposite, and I really got to appreciate both ends of the industry. I also did a post-graduate internship at the Columbia hospital in their pediatric oncology department, and got to see how the hospital worked from the inside. I learned a lot and everyday I interacted with patients. You learn a lot by touching people, and that was a huge influence. 

Q:

What medical design trends or emerging technologies excite you most right now? How do you see the medical design field evolving over the next ten years?

A:

The undeniable trends are AI, wearable technology, and companion apps. I have mixed feelings about the direction the trends are heading, part excitement and part fear. AI has the potential to revolutionize diagnostics, improve accuracy, and reduce human error. Wearables and apps are empowering patients to take more control of their health. This empowering of the patient is exciting! The medical design field is moving toward more patient-centered designs, with devices getting smaller, smarter, and more seamlessly integrated into daily life. 

Sustainability should be important, and I want to believe that society can push for more eco-conscious materials and manufacturing practices. The growing trend of wellness and preventative care, outside reacting to diseases and conditions, empowers people to stay healthier and more engaged in managing their well-being. This feels like a logical direction to focus on. We call it “healthcare” because we are caring for people’s health.

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