As ophthalmic technology continues to advance, we might assume that this technology will inevitably create complex surgical workflows. But shouldn’t we be working toward the opposite? Surgeons have always wanted solutions that are simple, intuitive and efficient. What is changing is our ability to deliver that simplicity.
Advances in technology and product design give us more opportunities to remove unnecessary steps, anticipate how people will interact with a device and make the technology itself do more of the work.
Looking beyond the device
When we talk about surgical workflow, we naturally tend to focus on the surgeon and what happens during the procedure. But that represents only one part of the workflow experience.
A product has a workflow long before it reaches the surgeon’s hands. It needs to be transported and stored; someone needs to locate it, unpack it and prepare it. During a procedure, it may be handled by nurses, scrub technicians and other members of the surgical team. Then afterwards, there are considerations around disposal and preparing the room for the next procedure. Each of these interactions presents an opportunity to make the workflow simpler.
That is particularly important in ophthalmology, where procedures such as cataract surgery can be performed very efficiently and operating rooms may handle a high volume of cases. Adding even small, unnecessary steps to an already streamlined procedure can add needless time and complexity.
The people interacting with a product can also change from case to case. Some surgeons work with dedicated ophthalmology teams, while others may work with staff who have much less ophthalmic experience; a workflow that depends on extensive training or requires users to remember additional steps can therefore create challenges.
This broader perspective also changes what we consider innovation. As Research and Development (R&D) professionals, it can be easy to focus on the device itself, but meaningful workflow improvements can happen well beyond the core technology.
Packaging is a good example: consider what happens when a surgical team prepares a sterile back table. Multiple packages may need to be opened in a short period of time. How easily can they be opened? How intuitively can the product be aseptically presented? Could the design increase the possibility that something is dropped or contaminated? How much material needs to be discarded afterward?
These may seem like small considerations, but in a high-volume surgical environment they can have a cumulative impact on preparation, turnover and the experience of the surgical team. Packaging also intersects with sustainability, as surgical teams witness firsthand the amount of material discarded throughout the day. I’ve even seen hospitals find creative ways to give some of that material a second life. One hospital, for example, saved large packaging trays and donated them to local schools for art projects. It’s a simple example, but it reinforces why we should think about the entire product experience, including what happens after the procedure.
At BVI, this broader view of the user experience is something we consider as part of product development. Innovation doesn’t always have to mean adding another feature, sometimes it means removing a step, simplifying preparation or reconsidering steps that have traditionally been accepted as part of the process.
Designing complexity out of the workflow
One principle we frequently discuss in R&D is the idea of “designing out” usability errors. Of course, users are trained medical professionals who understand how to operate medical technology correctly and safely. But whenever possible, we should also ask whether we can design a product to be so intuitive that the correct action feels natural and the technology integrates seamlessly into the clinical workflow.
During the development of one device, for example, we observed users interacting with prototypes without giving them extensive instructions beforehand. We wanted to understand what they would naturally do versus what they would do after being trained.
We discovered that some users would initially hold the device in the wrong orientation and might not recognize the issue until later in the workflow. One solution would have been to add another instruction: “Remember to turn the device before proceeding.” Instead, we changed the design so that an existing step naturally required the user to move the device into the correct orientation. We didn’t add another task; we made the correction part of the workflow itself.
The same thinking can apply to symbols, arrows, color, haptic feedback, auditory signals and many other design elements. The objective is not simply to tell users what to do, it is to create an experience that naturally guides them. When that works particularly well, the user may not even notice it.
But we cannot identify these opportunities from an engineering desk alone. User input must be part of the development process from the beginning. We learn a tremendous amount simply by observing surgeons and surgical teams using existing technologies. What do they naturally do? Where do they hesitate? Which steps take more time than expected? What are they trying to minimize or maximize (i.e. minimize time, maximize accuracy, etc.)?
As concepts become prototypes, users can help evaluate different approaches and refine the design. Later, usability and design validation help confirm that the final solution works as intended.
That population also needs to be representative. Experienced surgeons and key opinion leaders, including members of our Surgical Leadership Councils in the US and Europe, provide extremely valuable feedback. We also consider early-career surgeons, different geographies, gender, as well as the nurses, technicians and other staff who interact with the product.
More advanced technology via simpler experiences
When I think about the future of workflow innovation in ophthalmic surgery, I don’t believe there is one technology or one part of the OR that represents the single greatest opportunity. There are opportunities throughout the entire experience.
The challenge for R&D is to identify the unmet needs and determine where thoughtful design can help alleviate those areas. Some opportunities will involve innovative new technologies, others may come from rethinking packaging, preparation, storage or some other part of the workflow that has historically received less attention.
We should not misunderstand innovation as an “adding more” approach. More features, more functionality and more information do not necessarily create a better user experience. In my experience, sometimes the best solution is figuring out what the user should no longer have to do.
That means continuing to observe how surgeons and their teams actually work and bringing those users into development early enough that their feedback can meaningfully influence the design. It also means looking at the complete surgical ecosystem rather than optimizing one device or one moment in isolation.
We believe that as emerging technologies available to ophthalmic surgeons becomes more advanced, the experience of using them should become simpler. As we look ahead, perhaps the question we should be asking is not “What more can technology do?” but, “What can we make simpler for the people using this technology?"
