On Wednesday we were back in our old stomping grounds, the teleconference room at AIG (thanks to IT guy Sushil for letting us take over his room for a week). There were a few more junior and senior endoscopists as well as some technicians that we were still hoping to interview, so we armed ourselves with some samosas from the hospital café and posted up in the teleconference room to continue performing our study at AIG. Luckily, we were able to catch Dr. Mohan Ramchandani and Dr. Rajesh Gupta as well as one of the senior technicians to perform the study. We had great conversations with each of them and got some invaluable advice to guide the future of our projects so we were happy to head back to the hotel at the end of the day. Since we left AIG a little later that day we got caught in a bit of Hyderabadi traffic but, luckily, the diverse and ever-present car horns on the roads of India still leave Emma in fits of laughter (though probably confusing to our Uber drivers) so it was an enjoyable ride back. We rounded out the evening at the delicious Mainland China where we prepped ourselves for our last day of the study.
As Thursday was the last day available for our usability study, we had to rally the troops to make it the most productive and successful day yet! Since we still had a few doctors left at AIG who wanted to take part in the study, and had left Pune on Tuesday knowing there were more stakeholders who wished they had been able to participate, we decided to split up the team to cover all of our bases. For that reason, we sent Conor and Regina back to Pune to interview the last few physicians at Deenanath Mangeshkar Hospital, while Jess, Jake, and Emma stayed behind at AIG to cover the last few physicians there.
To start out by speaking about Pune, we’d returned because we’d been invited by Dr. Bapaye to spend some more time with him on our usability study as well as been offered to perform the study with three other ERCP fellows that Dr. Bapaye is training. It was an extremely productive day at DMH filled with frantic notetaking as we were able to interview five more endoscopists and two nurses. In addition, we got to sip some filter coffee and watch a game of cricket in the conference room with some endoscopists in between cases (we think we’re finally starting to understand the rules of cricket, score that century!)
Meanwhile, Jess, Jake, and Emma remained in Hyderabad for their final day of interviews at AIG. The Hyderabad team sought to find a meeting time with the last few physicians that had not performed our usability study, as well as talk to a few more technicians about our solution concepts. We also finally had the chance to discuss the process by which reusable products (e.g. sphincterotomes, guidewires, etc.) were sterilized between procedures. We were fortunate to begin our day with Dr. Rajeev Shandil, a visiting physician from New Delhi. Receiving insight from another experienced physician who works at a lower volume specialty center in a different geographical location than AIG was a valuable addition to diversify the viewpoints on our concepts as we reach the end of our trip. Dr. Shandil provided key counterpoints and validations to complement the unique feedback provided by the unique patient volume and business model adopted by AIG.
We were able to interview our final physician directly after Dr. Shandil before moving on to our time with technicians in the afternoon. After interviewing a tech on solution concepts, we added some additional questions that had been developed in response to our time in India. We have gained an increased understanding as to the importance (in reality, nigh on a requirement) placed on the reusability of tools used in the operating room, and therefore the necessity of any solutions embodiments that we develop to fit these needs.
After asking about the sterilization process that technicians follow to clean tools between procedures, we arranged to see the sterilization process firsthand. We were taken up a few floors to a large piece of equipment, an ethylene oxide sterilization chamber, where a nurse explained the 8 hour process by which she adjusts conditions within the chamber to appropriately sterilize equipment placed in the machine. Key metrics and details such as pressure, temperature, and timing will allow us to subject our future embodiments to equivalent tests back in the US. As a result, we can return in the future knowing that what we present to physicians can stand up to the same cleaning and reuse standards expected of the Indian endoscopic environment.
We finished our day where our time at AIG began: in the operating room. A few final follow-up questions for Dr. Rakesh and witnessing some pre-sterilization cleaning of tools by techs post-procedure brought our time at AIG to a productive close. A few final pictures with technicians eager to capture the memory, a grateful thank you to Sushil for allowing us to use his office space for our interviews, and a heartfelt goodbye to Suresh as we entered the Uber to return to the hotel made for a sincere conclusion to this leg of our study in India.
Overall, we are proud of the information that we have gathered and enthused by some of the insights that we have gained. While certain overarching themes and major takeaways are already apparent, we have several hours of audio and pages upon pages of notes to process upon our return to the States. Before Anant left on Wednesday to return to the US we were already discussing the techniques learned in our coursework this summer and how we intend to apply them to the information gained during this study in order to analyze what we have learned. We look forward to beginning the prototyping process in the fall, shaped by the insights gained from our time spent in India over the past several weeks.
Yet, before we return to the states, the team has decided to remain in India for a few extra days in order to relax and celebrate our hard work. We will be enjoying the countryside of Kerala, and Indian state famous for its rural nature, expansive tea agriculture, and stunning mountainous terrain. Stay tuned for one final picture-based blog post where we share the sights and sites of our last few days in India. Here is a sneak peak of the team on our first day of relaxation, celebrating a usability study well done!