Iteration & the Story of Three Brilliances
“Iteration is the name of the game in human-centered design, and though your solution is now nearly ready to get out into the world, you need to keep iterating.” —IDEO.org’s Design Kit
Yes, keep iterating! Even—and especially—after your product is out in the world.
When we talk about Brilliance at D-Rev, we don’t mean one device, but actually three. The original Brilliance that we launched with our partner Phoenix Medical Systems in late 2012 is what we now call Brilliance Classic.
The user feedback we collected on our phototherapy prototypes during the design phase was very useful. However, after launching the first iteration of Brilliance and seeing it in use all over the world, we were able to learn even more deeply about what people loved about Brilliance – and where there was still room for improvement. Getting our first iteration out there was important for our impact-driven model, too: there were some hospitals we’d hoped would use our product, and we were able to examine why they didn’t or couldn’t. Iteration isn’t driven only but users, but also markets.
D-Rev’s line of Brilliance phototherapy devices. For a detailed comparison, please see Compare Models
One of our early learnings after releasing Brilliance Classic was that there is a perception among some doctors that “double-sided phototherapy is better.” Phototherapy effectiveness, however, is a function of light intensity, surface area of treatment, and the quality of blue light. For example, a strong single-surface device, like Brilliance, can be significantly more effective than double or even triple-surface devices with weak intensity. The doctors’ bias makes sense, though—most of the phototherapy devices being used in low-income hospitals are not very effective. That is, they take too long to bring a baby’s bilirubin level down. So a diligent doctor would dedicate several of these relatively ineffective devices to treat a single baby. As a result, government tenders in places like India often required double-sided phototherapy to ensure effective treatment.
Triple-sided treatment at an Indian government hospital: two phototherapy devices on top, and a third under the baby. If you look closely you can see the child is resting on clear bubble wrap—the hospital’s attempt at improving her comfort.
Even though (single-sided) Brilliance is highly effective at treating even the sickest babies, Phoenix and D-Rev launched Brilliance Underside to use with Brilliance Classic in 2013 to capture these government tenders that specified double-surface treatment. The goal was to ensure that target public hospitals, where we knew need was high, had access to effective treatment.
With feedback from doctors in our target hospitals, we also iterated the technical and embodiment design of Brilliance Classic. The result was Brilliance Pro, which we launched in early 2015 for the same retail price as Brilliance Classic: $400 in India, $500 plus shipping in all other countries (comparable devices range from $1,500 to $3,500). A key new feature of Brilliance Pro is “Smart Tilt”: if the light head is tilted—as it often is when used with a radiant heat warmer for the baby —the intensity of the outer LEDs adjusts to maintain uniform intensity while minimizing light spill. We also gave Brilliance Pro a sleeker design and usability improvements, such as counterbalancing the head so it could be tilted with one hand.
These user-driven iterations paid off: Brilliance has continued to see sales and installation growth, particularly at higher-need facilities, which leads to impact. At NEOCON, India’s largest neonatal conference, Brilliance Pro took “Best in Show” in December 2014 across all product and price categories, beating out well-known multinational companies and other innovative health products. Wired Magazine described Brilliance Pro as “the MacBook Air of developing world jaundice treatment”.
Will we keep iterating the product? It depends on impact. Our goal is that newborns globally with severe jaundice receive effective treatment by a Brilliance—or another effective device. Based on sales and installations since launch, more of our iterating now is around distribution and scaling. For example, how do we reach high-need hospitals faster via a market-based model? So please stay tuned—we’re iterating.