Hypertension poses a serious risk

The primary factor is hypertension, or high blood pressure¹. In Japan, approximately 43 million² people are hypertensive, of which 1 in 3 face severe risks in their everyday lives. Estimates suggest that 1 in 3 adults worldwide (approx. 1 billion people³) have hypertension, so controlling this condition is now a challenge at the global level.

Pioneering home blood pressure measurement

At the time, people believed that blood pressure could be measured only at hospitals. Since then, OMRON has remained at the forefront of monitoring blood pressure at home, conveying its importance to a global audience.

Stepping up to the challenge

The problem, however, has not been eliminated. Cerebro-cardiovascular disease still decreases quality of life and remains a cause of death.

In response, we have taken up the challenge to explore ways to catch risky fluctuations of blood pressure by increasing the frequency of blood pressure monitoring, enabling us to predict the risks of cerebro-cardiovascular disease and prevent the onset of disease.

It enabled people to monitor their blood pressure wherever and whenever they want. It also helps us to understand the daytime blood pressure fluctuation and to get better control of blood pressure. This is a great step toward solving the global challenge.

Establishing habits of regular monitoring

With the help of doctors, we have accumulated clinical evidence supporting the efficacy of home blood pressure monitors and established the habits of monitoring blood pressure twice a day.

Looking into the future

To advance this culture forward, in the next phase we plan to initiate preventative treatments of hypertension.

1 Demographic statistics from the Ministry of Health, Labor and Welfare in 2010.

2 Epidemiology of Hypertension in Japan – Where Are We Now? (2010) – Katsuyuki Miura, MD, PhD; Masato Nagai, PhD; Takayoshi Ohkubo, MD, PhD

3 WHO report, 2013

Backstory of the development of HeartGuide: project management and user survey

Brigham: HeartGuide is one of the first projects where we had engineers and design working together from the very beginning. It took 3 or 4 years. It was 2015.

We tested this early on by making rough prototypes and doing actual user testing on the people in the US.

Only about half could reliably place the sensor over the artery. When we began developing the HeartGuide technology, we thought it would be necessary to measure the BP by aligning the sensor with the artery. That’s why the user testing was good for us. Obviously we were wrong.

Ogihara: At first, we thought we would be able to reduce the size of the device easily when people found their artery and fit the sensor on it. However, the survey in the US showed our hypothesis was wrong. So we shifted our focus and in collaboration with the R&D team, we sought to make it much easier to use.

For this, we needed to explore not only comfort and wearability, but also maintain the high level of measurement accuracy. This is one of the hallmarks of our business, and we repeatedly developed prototypes with usability and accuracy in mind. Collaboration between engineers and designers operated smoothly and helped the rapid progress of the project. While Brigham carried out multiple user surveys in the US and shared the results with us, R&D responded. As I said, this is the first project where designers and R&D team worked together from scratch. It was a great opportunity to work hard and encourage each other to clear the hurdles.

Brigham: We changed the size of the sensor in response to the user research.

This is maybe the first example. But we went through many many iterations.

We had to make a variety of changes to the cuff design itself, and how that impacted the placement of how people put it on.

The other part of that is what people are willing to wear. That’s where more of the image of the blood pressure monitor is. Early on, we weren’t thinking of a watch. But, through user research, visiting people’s homes and talking to them, we learned that they really didn’t want to call attention to any sort of device on the wrist.

We also picked a watch because it gave engineering a limit on size. Size is really important. At that time, smart watches were about this size. So we could give engineering a really concise goal for how big to make it.

What were the biggest insights you gained during user surveys?

Brigham: Probably, my biggest learning from the research is, depending on your target, they are definitely people who are much more proactive and interested in knowing themselves. That’s ultimately who we targeted as our target market. We call them “take control.” This is a name of the persona we have given them.

What kind of challenges did you face during the development of the very first watch-type blood pressure monitor?

Hamaguchi: This is a completely new device. Everyone who got involved in this project had their own individual vision. For example, someone wished to incorporate a function to receive messages, or add a function of a pedometer. Another wanted to add a function to measure the quality of sleep, and another wanted a history of blood pressure readings.

However, we needed to focus on a balance between display and CPU function during the design process because monitoring blood pressure itself requires an advanced level of control.

Hamaguchi and team members had repeated discussions to strike a happy medium.

During the discussions, we often used a flow chart which shows functions and screen transitions. The main purpose of this project is to increase the frequency of BP monitoring, and the concept of HeartGuide was “anytime, anywhere”. So we put these taglines on a wall and refined the chart in order to align the awareness of everyone who got involved in this project. This allowed us to repeatedly consider why this shape is necessary and why this function is essential.

What point did you consider the most while contemplating the main target users?

Hamaguchi: While studying the results of user surveys, we found out there are typical methods or operational orders for older users.

At the same time, we developed app functions to help the user understand trends and analyse their readings.

We were able to clarify the positioning of HeartGuide, a device to increase the frequency of blood pressure measurement. At the same time, we started to think about the user experience from the initial opening of the box, to establishing the initial settings of the app, all the way through to how the measurement data is used.

As the one in charge of visual communication, which part did you focus on the most?

Goto: What I focused on the most was the UX-first approach. As HeartGuide is the very first device of this type in the world, we needed to think carefully how to reach users and how to get their approval, or what type of experience we are able to offer to those who liked the product. We then focused our marketing efforts using effective communication.

First determine the concept, core values and main target of the device, then narrow down the communication methods both visually and verbally.

In order to help users understand our brand, we formatted colours, fonts and key visuals specifically for ease of use.

In addition, HeartGuide is one of the flagship blood pressure monitors to represent our Going for Zero vision. We shared the concepts, core values and target markets with our global members to establish the one brand.

The key visuals being clearly differentiated from the conventional images of blood pressure monitors.

What is the next step for achieving the Going for Zero vision, to have no cardiovascular events?

Hamaguchi: First, we are now trying to expand our business domains from blood pressure management to the prevention of cerebro-cardiovascular diseases. We have started the development of a technology to detect atrial fibrillation (one of the symptoms of an irregular pulse).

As part of a global initiative, we have started the VitalSight project in the US, a remote patient monitoring service with the aim of achieving zero events, the purpose of the Going for Zero mission.

Daily monitoring provides vital data for effective medical treatment based on doctor’s instructions. This is how we started the development of remote patient monitoring service. For effective hypertensive treatment, it is critical to continue the blood pressure management. For example, in Japan, patients are supposed to visit the doctor every three months and take medication every day.  It often forms a barrier for patients to carry on their hypertensive treatments, and for doctors, it is also challenging to understand patients’ physical conditions during a check-up only every 3 months without examining the data taken at home.

We will keep on developing and providing user-friendly devices and services for achieving Going for Zero by promoting home blood pressure monitoring.

Brigham: OMRON has expanded its businesses from device manufacturer to service provider, from monitoring blood pressure to managing cardiovascular diseases.

So, what we have to do now is take all these measurements that they’re collecting and help interpret them. So that’s ultimately what remote patient monitoring (RPM) is. It is helping them make sense of the data that they’re collecting. There are different dimensions of RPM. It can be done from a doctor-centred standpoint, but there’s also a consumer side. So this is really just a starting point. It makes it easier to measure and easier to collect more data. But what we’re working on now is helping them take that data and make meaning from it. And take action based on that data.

Goto: We have expanded our business from blood pressure monitoring to new domains including electrocardiogram (ECC) readings.

In order to be competitive, I believe we need to establish our brand identity, to focus on simple messages and communicate effectively with users. To do this, we need to find our core competence and help users to make choices by delivering clear messages.

Ogihara: As we’ve said, in the past we only needed to focus on the users of our devices. Today when we think about the way to achieve the Going for Zero vision, the range of our stakeholders has expanded. Adding the communication with doctors, interaction with nurses and pharmacists could be one of the important UXs to users, and the touchpoints as well. We need to be highly conscious of the laws and medical systems of each country where we launch our products and services.