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Group Information

24-441 Spring 2012, Group 3

Kellen Chow (Team Leader with the new hair cut)

Jacob Divone (EMT with the puking guts)

KinHang Leung (Brainstorming Facilitator with the weird balloon animals)

Cecily Sunday (Charts Specialist with the sweet grandma)

Report 2 - Opportunity: Market Research and Design Concepts

Executive Summary

Market Research and Observations

Use Study Observations

The pictures on the right were taken during a training session for the Carnegie Mellon University EMS team. This training session covered the proper use of a stethoscope during a blood pressure analysis as well as the procedure for checking lung sounds. The trainees were asked to answer the interview questions below.

A First Responder practices taking a patient's blood pressure using a blood pressure cuff and a stethoscope.

Closeup view of stethoscope and blood pressure cuff.

A first responder practices listening to lung sounds through a patient's shirt

A pink Littmann brand stethoscope.

User Interview Questions

In order to determine stakeholder needs we conducted user interviews using the following set of questions:

Choosing the Product

How did you select which stethoscope to buy?
How did you research your options?
What factors played the biggest role in your choice?

Using the product

How were you taught to use this equipment (in a class, on the job, etc.)?
Do you warm up, clean the face of, or do anything else to the stethoscope prior to using it on a patient?
Does your stethoscope perform equally well in all conditions (temperatures, background noises, etc.)?
How often do you buy a new stethoscope? Why do you buy a new one?
What type of maintenance operations do you perform on your stethoscope?
How do you carry the stethoscope and why (around neck, in pocket, etc.)?

Suggestions for Improvement

What don't you like about this product?
How would you suggest improving this product?

Highlights from User Interviews

Our interviewees included the following stakeholders:

Trauma Surgeon
Clinician
Retired Nurse
Nurse with 3 years of experience
1st year Medical Student
Medical Intern
Carnegie Mellon University EMS Team Members

Stethoscope selection

Hospitals supply cheaper ones or at a discount
Need easy replacements and low cost (especially for medical student)
Ear comfort very important
Littman very durable and has replaceable parts
High sound quality important
Asking around lets you know which brands are useful
Determine:
- Type of patient working on (human vs. animal)
- Size of patient (child vs. adult)
- Listening to specific organ (heart, lung, etc.)
Aesthetics
Likelihood of loss or theft

Stethoscope Use

Used cheap ones until figured out what assigned environment and specialty
Carry in pocket, around neck if no pocket
Wipe down earbuds with alcohol wipes
Rarely clean tubes and diaphragms
Rub diaphragm with palm to make warmer
Wash bell with ETOH swab after every day
Patients in isolation have special stethoscopes that do not leave their room

Difficulties and Problems

Difficult to hear in loud ambient noise (e.g. loud emergency room)
Hairy surface causes unwanted noise
Harder to examine larger people
Problem with diaphragm cracking and drying up
Extra weight on neck causes discomfort
Carrying in pocket causes stethoscope to hit obstacles while walking
Stethoscope heads are rarely cleaned
Heavy and cumbersome, especially on double tube designs
Can get caught in hair and gets in the way when on the phone
Ambient noise very big problem, esp. in ER or even with A/C
Earbud angle is very awkward and uncomfortable
Electronically amplified stethoscopes are bulky and awkward to store and use

Suggestions for Improvement

Warmer for diaphragm
More comfortable earbuds
Overall reduced mass
Clip on lab coat for stethoscope
Snap-on earbuds instead of screw-on
Amplify diaphragm or top of tubes
Abnormality indicators
Antibacterial surface on bell
Noise-cancelling headphones or earbuds

Top Stakeholder Product Needs

Earbud Comfort
Reduced Total Mass
Sterilization of Stethoscope Diaphragm
Better Portability
Abnormality Indicators

Our Top 3 Design Concepts

Design 1: Coat Integration with Heater and Sanitizer

In order to address the stakeholders' need for a light-weight, self-heated, self-sanitizing and easily portable stethoschope, this design aims to integrate a stethoscope onto an average doctor's coat. By attaching the stethoscope onto the coat, the weight of the stethoscope is distributed over the user's shoulder through the coat, improving its portability and eliminating stress on the user's neck. The diaphragm holder will also act as a heater (keeping the diaphragm surface around the average body temperature) and a sanitizer (cleaning the diaphragm surface after each use).

Potential Design Opportunities:

Integration should not affect the manufacturing of the coat; the design should focus on making mechanisms on the stethoscope that would easily attach to an average doctor's coat
Integrating the tubes inside/under the collar - What kind of attachment mechanism...Pins? Velcro? Adhesive? Clips?
Mounting the heating/sanitizing holder on the chest area of the coat - What kind of attachment mechanism...Safety Pins? Clip? Velcro?
Alternate material selection for a light-weight design
Designing the appropriate and low-cost heating element - Drawing heat from user's body? Battery-powered?
Designing the sanitizing element - Alcohol patches in the holder must be easily replaceable

Design 2: Headset Redesign

During user interviews, numerous complaints arose in association with the stethoscope's headpiece. In order to hear properly, the holes in the ear pieces should be directly aligned with the user’s ear canals. However, this task is made difficult by the stiff body of the full headset and the often un-customized size of the ear buds. In environments with extraneous background noise, medical professional must often hold the headset in place with one hand with using the other to place the chest piece. Other issues associated with the headset include general discomfort, problems with the ear buds unscrewing and getting lost, and cracked or dried-out ear pieces due to frequent cleaning with alcohol wipes.

Design 2 aims to address the numerous user complaints that center around the headpiece while maintaining the sound quality, durability, and portability of the original product. In place of the ear buds, this design uses headphone cups that will go around the user's ears as opposed to inside of them. This not only helps to block out excessive background noise, but provides a comfortable and effect solution for directing sound without customized pieces.

Potential Design Opportunities:

The metal band connecting the headphone cups should be adjustable to fit all users

Design 3: Peltier heated stethoscope head

Through our market research, we learned that patients consistently complain that the stethoscope is too cold when it touches their bare chest or arm. If order to reconcile this, a heating device (peltier cells) could be added to the head of the stethoscope. Given the right current, the air could heat up, causing the head of the stethoscope to heat up to a warm temperature. To ensure it doesn't get too hot, and potentially burn either the patient or the health care provider, the ring holding the drum in place will be replaced with a rubber material.

Design 4: Abnormality Indicator

Design 5: Retractable Tubing

[[Image:]]

Competitor Products Research

Online Reviews

Several online sites were consulted to research the effectiveness of competitor products. The sites included independent sites such as Stethoscope Reviews, online magazines such as ForUsDocs.com and online retailers such as Amazon.com. From these reviews we were able to gain some insight into stakeholder needs (links to the specific reviews are in the Reference section below).

Pugh Chart


Criteria	Weight	Datum	Design 1: Coat Integration	Design 2: Headset Redesign	Design 3: Peltier Heating Method	Design 4: Abnormality Indicator	Design 5: Retractable Tubing
ease of use	3	0	0	1	0	1	3
comfort	3	0	1	2	2	-1	0
noise transduction	3	0	0	0	0	0	-3
noise cancelation	3	0	0	2	0	0	0
safety	3	0	1	0	-1	0	3
cost	2	0	-1	-2	-1	-2	-2
manufacturability	2	0	0	-1	-1	-2	0
portability	2	0	2	0	0	-1	2
durability	2	0	0	-1	0	-1	-2
sanitation	1	0	2	1	0	0	0
aesthetics	1	0	1	1	0	0	0

Weighted Positive		0	13	17	6	3	8
Weighted Negative		0	2	8	7	15	7
Total Neutral		11	5	3	7	5	5

Weighted Total		0	11	9	-1	-12	1

another table??


Criteria	Weight	Datum	Design 1: Coat Integration
ease of use	3	0	-1
comfort	3	0	1
noise transduction	3	0	0
noise cancelation	3	0	0
safety	3	0	1
cost	2	0	-1
manufacturability	2	0	0
portability	2	0	2
durability	2	0	0
sanitation	1	0	2
aesthetics	1	0	1

Weighted Positive		0	13
Weighted Negative		0	2
Total Neutral		11	5

Weighted Total		0	11

Gantt Chart

In order to keep track of our progress and better organize ourselves in the upcoming months, we have planned out our project with a Gantt Chart. This is a very useful way keep ourselves on task and be aware of the order of things to get done. We created our Gantt Chart using a free online project management tool named "Smartsheet" (see Reference).

Summary and Recommendations

Appendix (100 ideas)

I organized these...but i have the original list if we prefer those. do you think there is a way to carry over the numbers?...

Air-tube Alternatives

Water filled tubes
Alcohol filled tubes
Oil filled tubes
Replace air-filled tubes by electronic wires (headphones cables)
Retractable stethoscope tubing

Headset Alternatives

Snap-on earbuds instead of screwed-on
Noise-cancelling headphones
Noise-cancelling earbuds
Extendable tubes for better reach
Rubber earpieces
Silicone earpieces
Sleep plug earpieces
Ear cover earpieces
Bose styled head set
gel filled ear pieces
adjustable triple leaf spring
suction cup ear muffs
adjustable head band connecting ear pieces

Chestpiece Alternatives

Snap-on Diaphragm
Aperture style diaphragm
Disposable diaphragm surface/film
A diaphragm heater using Peltier cells
Replace diaphragm material with self-sanitizing brass
Sonar sensor integrated on the diaphragm
Adjustable drum
Changing tribology of the drum to lower noise produced from sheer forces

Stethoscope Integration Products

Blood pressure cuff interface
Diaphragm heater and holder integrated on coat (battery)
Alcohol Pouch integrated on coat
Coat pouch/clip around the chest area
A coat pouch/holder that heats and cleans the diaphragm
Integrating tubes in the coat sleeve and the diaphragm in the cuff
Hugging stethoscope coat (integrated in the coat so user hugs the patient during use)
Integrating a heart rate monitor on chestpiece
Integrating a murmuring sound indicator on chestpiece
A hand-held separate heart rate monitor (connects to chestpiece by wire)
A hand-held separate heart rate monitor (Bluetooth)
Bluetooth connection to user's mobile device (like an app)
Integration of a respiratory rate indicator
Integrate visual display of sound
Integrated with pulse oximeter
integrating recordable lung sounds
integrated timer stethoscope

Other Ideas

Hooked up to visual display on eyeglasses
Integration of the stethoscope on dummies that create sounds for medical training
Heated fluid in stethoscope for comfort
speaker output stethoscope
speaker integration stethoscope
broadcasting noise for training purposes
golf ball cleaning system
air blasting cleaning system
magnetic stethoscope holder
amplification through mechanical resonance
Bio-inspired sound amplification using inner ear drum
Signal processor at junction
Heated stethoscope holster to keep stethoscope at comfortable temp
Break away security system
Stethoscope flashlight
Remove metal to ensure stethoscope doesn't get cold

Reference

Acoustic Stethoscope Review, ForUsDocs.com - [1]

Amazon.com review of a Littmann Cardiology III Stethoscope (accessed Feb. 26, 2012) - [2]

Review of a Littmann Master Cardiology Stethoscope - [3]

Smartsheet Online Gantt Chart Tool - [4]

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 ===Design 5: Retractable Tubing===
+[[Image:Stethoscope_retractable_cord.png|300px]]
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Stethoscope opportunity