In short
- The question
- Dentists and surgeons needed to prepare a procedure digitally: plan implants on a CT scan, take the plan to the drill and prepare jaw surgery.
- Approach
- I turned clinical workflows into functional analyses and designs, owned the product backlog and checked designs with dentists and surgeons.
- Delivered
- Functional designs for NobelClinician, for combining CT and optical scans and for the plan on an iPad drill unit, and the foundations of new jaw surgery software.
The context
Nobel Biocare makes dental implants, and software to plan their placement. From 2012 to 2014 I worked on that software.
At its heart was NobelClinician, desktop software for dentists and surgeons. You load the CT scan of a patient’s jaws and plan the implants at your own pace: which type, where, how deep and at what angle. That plan produces a surgical guide (NobelGuide): a template that fits in the patient’s mouth, with sleeves in exactly the planned direction. That way the surgeon drills more precisely than freehand. It is called guided surgery, and at the time it was quite new.
User experience design was not yet a common term then. What I did was called functional analysis and functional design. Together with the business and with research and development, mostly mathematicians and engineers, I came up with and designed new features for NobelClinician, and later for other software too.
A board full of paper
We worked in Scrum, in a team of about fifty. But still in real life: with sticky notes, and tickets I printed, cut out myself and pinned in the right column on the board. Developers, testers, research and development, the business, my fellow analysts and the animators were all within walking distance. That made the work very human.
I made my designs in high fidelity in Axure. I drew flows in Photoshop and printed them to discuss together. I owned the product backlog, and after every sprint I gave the demo to the business: everything that had been built, laid out clearly in a presentation.
I am not a doctor. So to translate a procedure well into software, we read reference works on how such an operation goes. And we asked the people who perform it: together with a colleague I interviewed dentists and surgeons, and we showed them designs and ran acceptance tests with them.
Bone and gums in one view
A CT scan shows the bone. In NobelClinician you could move through it in every direction: axial, coronal and sagittal, in a panoramic view along the dental arch, in cross-sections, and as a 3D model. But the gums, the soft tissue, barely show on a CT scan. They do show on a plaster model of the mouth, and that can be scanned optically.
Research and development had worked out a method to lay the two on top of each other. It was not fully automatic: the clinician had to start it, be able to adjust it, and switch every object in the scene on and off. I designed the flows and features for all those steps. That way the clinician saw not just the bone, but also the condition of the gums.
From the plan to the drill
Those were the years the iPad arrived. Nobel Biocare was working on a drill unit you control with an iPad (OsseoCare Pro), and the plan from NobelClinician had to get there: the implants and every step of the procedure. The cloud was not a given yet, so syncing a plan between a desktop program and a tablet took a lot of thought. Who may still change what, and when? How do you show the steps during the procedure? What does the dashboard of a drill look like on an iPad, and which controls do you use? It was still the age of skeuomorphism, when an interface looked as real as possible, before Apple made everything flat with iOS 7 in 2013.
Jaw surgery, from scratch
For maxillofacial surgery there was to be all-new software, and I laid its foundations. Sometimes a jaw has to be cut and repositioned, for example after trauma or when the jaws are misaligned. The software had to help prepare such an operation. The scans of the jaws had to go in, and this time the nerves too, because those must not be touched. With points and planes you cut the jaw digitally and move the parts to their new position. The way of working borrowed a lot from Photoshop: tools and layers.
Where it started
This is where I learned the craft I still practise: understanding how someone works, turning that into a design a team can build, and checking with the people who will use it whether it is right. Back then for dentists and surgeons, with sticky notes and printed tickets instead of a digital board.
