Designing healthcare products and services is not for the faint of heart. Innovating here means going up against long R&D timelines inside a complex, interconnected system where the stakes are often extremely high.
On this episode, we’re joined by Thomas Sutton, Chief Design Officer at frog. Thomas is leaving the pond after 16 years, but before he takes on a new role leading Design for Digital Health R&D at AstraZeneca, he offers his insight into designing healthcare products and services around the patients and providers who will use them. Find out why changing the healthcare system to improve health outcomes for all requires patience, passion and lots of courage.
Design Mind frogcast
Episode 12: Innovation Work Takes Courage
Guest: Thomas Sutton, Chief Design Officer, frog
[00:09] Welcome to the Design Mind frogcast. Each episode, we go behind the scenes to meet the people designing what’s next in the world of products, services and experiences, both here at frog and far, far outside the pond. I’m Elizabeth Wood [EW].
[00:27] Today on our show, we’re talking design, science and invention, specifically when it comes to healthcare applications. To do this, we’re joined by Thomas Sutton [TS], the Chief Design Officer at frog—well, at least for now. Unfortunately for us, he’ll soon be moving on from the pond to take an important role on AstraZeneca’s Digital Health R&D team. But I’ll let him talk speak more to that shortly. Thomas launched the frog studio in Milan over 16 years ago. Since then, he has spent his time at frog building a portfolio of innovative products and services, as well as intentionally building an organization that can thrive–even without him. Here’s Thomas now.
[01:04] TS: I was attracted very early to the idea that you could imagine something that didn’t currently exist in the world and bring it into existence. And, you know, I remember very, very early, probably when I was three or four years old, starting to be allowed to use my father’s tools in the garage to bang together bits of wood with nails and these kinds of things. And it was magical to me to be able to create something that previously didn’t exist.
[01:32] I always sought out in my project work things that had an element of innovation to them, that were not simply giving new form to a known object or known category, but trying to explore new kinds of objects and new kinds of product categories.
[01:53] I’m Thomas Sutton. I’m the Chief Design Officer of frog in Europe. And I’m actually just about to leave frog to embark on a new journey at AstraZeneca, where I’ll be leading design in the Digital Health R&D team.
[02:07] When I started at frog, there was a whole world of exciting things that I wanted to dig my teeth into. In particular, around the convergence of physical products with digital solutions and services, and how in a complex domain like healthcare, you could kind of work on all of those levers at once and try to generate some system change. That’s what I’ve been working on ever since to some degree.
[02:33] I’m super excited about the team that I’m joining sits in the R&D side of the business at AstraZeneca. So it’s Digital Health R&D, and is explicitly looking at both the future of the clinical trial itself as an endeavor, right? So how can we use the power of digital to create a more patient-centered clinical trial experience? And obviously faster, better, more efficient, more effective clinical trials, but also can we measure new endpoints? How do we define success in clinical trials from a patient perspective, not from a pure biomedical perspective and so on? So those are the challenges that I’ve been spending a lot of my time on in frog over the last few years. And so it’s very, from a content perspective, you know, there’s a high degree of continuity, in terms of the areas of focus.
[03:23] EW: During our conversation, Thomas described growing up in a small, university town in New Zealand as being a very free life for a child, full of nature and places to explore. But what it didn’t have, at least at the time, was a very lively design scene. After finishing industrial design school in Wellington and spending some time creating design systems in a museum environment, he set his sights on the European design community, eventually making his way to Milan.
[03:49] TS: I kind of looked around me at little ol’ New Zealand, and there were maybe three or four places at the time where I could have applied for a job. And not much more. I thought, gosh, this is going to get a little too cozy a little too quickly. Maybe now’s a good time for me to try my luck elsewhere and get some experience overseas. And so, you know, I bought a big map of Europe and a plane ticket and an Interrail Pass, sold all my stuff, packed what I had into a backpack and flew to Frankfurt. This was 1997—most design studios did not have websites. So I went to the Frankfurt Public Library and got out some design magazines. I looked at who was posting, you know, advertisements or interesting projects in design magazines and wrote down their addresses and went to visit them. That was my job hunting plan.
[04:38] I had made a bunch of postcards with a piece of my portfolio on them. And so I would kind of look up the address of the studio in the yellow pages, send them a postcard the week before and then kind of show up with my portfolio and knock on the door saying, “Hey, I’m that guy who sent you a postcard last week. Can I come in for an interview?”
[05:00] I did send a postcard to the frog studio in Altensteig. It was going to be one of my last stops in that trip because Germany was the last country on the tour. You know, fortunately or unfortunately, on the second stop of that trip, I was offered a job. They had an urgent need for another designer the following week, and if I could start right away the job was mine. It was like, “Well, guys, you know, I’ve still got Spain and France and Portugal and the Netherlands to visit. My Interrail Pass only lasts for another two months. Can I just finish that and then come back and start in four weeks?” Like, “Nope. You need to start next week.” It was all very casual or very random or perhaps you know very meant to be that Milan was where I ended up.
[05:48] I vividly remember arriving in Milan in November 1997. Milan in winter is foggy and cold. I arrived on a Sunday, and in the 90s in Italy, everything was closed on Sunday. So at this closed-down city, foggy, cold, gray…it was, like, the worst possible first impression. I remember hating it at first sight and thinking this is definitely not the place where I’m going to stay and live. Twenty-four years later here I am, still in Milan, and absolutely loving the place. Obviously, I met my partner here, and we had kids who’ve grown up as Italian girls, and that’s a big part of it becoming my home.
[06:32] EW: Upon finding a home in Italy, Thomas found that the sensibilities of his new country were, perhaps serendipitously, ideal conditions for his work as a designer.
[06:42] TS: I think there is something in Italian culture that is a very good fit for design. It’s very intellectual and academic in some ways. And there’s an enormous respect for culture and knowledge. And I, you know, I think knowledge and curiosity and creativity are kind of intimately linked. But there’s also this, you know, ability to improvise and to manage ambiguity, which is a critical skill in design. A lot of what design is about is managing a kind of cloud of ambiguity, a cloud of ambiguous possibilities. And the longer you can keep that cloud open and ambiguous and develop competing contradictory hypotheses within that cloud, the better outcomes one’s able to get out of a creative process.
[07:32] I think Italians are masters of ambiguity and accepting the coexistence of contradictory facts. This is a land where it can be A and B and C at the same time, which is enormously frustrating if you’re dealing with the bureaucracy, but extremely valuable when you’re dealing with creative hypotheses in the context of design.
[07:54] This is something that I’ve thought about a lot is, how does the personality of an organization or a community develop, right? I’ve had this tremendous privilege of being able to open a design studio for frog. So there was no frog studio in Milan. When I joined frog, it was to open a studio in Milan. And what I can see looking back on that is that there is a tremendous amount of my personality and my belief system that has kind of been built into the way that that organization has developed. Not that I had a master plan, but each micro decision that one makes, each person that one chooses to hire, each communication that one makes as a leader in an organization, they’re all little bricks that build up an organizational culture.
[08:55] EW: It’s no surprise then that Thomas’s work on healthcare has deeply influenced the work in the Milan studio. In the last few years alone, the Milan studio has been involved with dozens of healthcare programs, from collaborating on a range of devices for GE Healthcare to recently helping launch the telehealth venture HealthHero. Even before joining frog, Thomas was passionate about what can be done to improve health outcomes in a complex system, dominated by long research and development timelines, and often with super high stakes.
[09:25] TS: I kind of fell into design for healthcare almost immediately when I landed in Europe. The first project I worked on, actually, when I started working in Milan back in 1997 was an attempt to combine a glucose meter with a 1997 mobile phone. It was a super interesting kind of precursor to what would later become, you know, this whole domain of mobile health, which no one was talking about at the time. Of course, the project failed very quickly when we realized that at the time, it took nine months end-to-end to design and develop and launch a new mobile phone, and seven years to design, develop and launch a new glucose meter. And so there was a fundamental incompatibility of these two worlds of consumer products and the way that that business runs and healthcare products and the way that runs, which still exists today.
[10:14] Although, no one would try in that very literal way to merge a consumer electronic device with a healthcare device. Now that we have, you know, Bluetooth connectivity and we think about connecting things in a completely different way. But the challenge of connecting worlds that move at a different pace and with different constraints, so that we can take advantage of the amazing potential of the consumer devices and consumer ecosystems that surround us for the purposes of healthcare, that challenge remains today.
[10:49] The early 2010s, there was the first wave of very kind of Gung Ho tech startups who were going to revolutionize healthcare. And they all got up and did their TED Talks. And were just so overconfident about how everyone else had been getting it wrong. And they were going to completely change the healthcare system. None of those companies still exist. None of them were successful. A lot of people learned a lot from that wave. And the current wave of, you know, what we see in the 2020s of a first generation of really successful what we can call “digital therapeutics,” so digital products that actually generate a health outcome. They have recognized the need to kind of combine design with science—and use, you know, the best of those two lenses and ways of thinking and ways of engaging with reality to arrive to outcomes. Design on its own isn’t sufficient. You know, scientific inquiry on its own is insufficient. Combining the two is what’s bringing really exciting work today.
[12:00] The nature of the systemic work that I’m doing, which relies a lot on abstractions, which is very much a kind of social science-y way of looking at the world. Almost as a counterbalance to that, in my free time I like to do very, very down to earth practical things. So I have a large garden. I spend a lot of time gardening. For me, the garden is my most frequent metaphor for innovation. You know, designers often have a kind of aspiration to burn everything to the ground and build up new. And the garden teaches you to be incrementalists. Give things time to see how they play out, right? That’s why we talk about ecosystems, right? Ecosystem is biological phenomenon that has those characteristics. So if we’re going to be designing ecosystems, we need to take much more of a gardener’s approach than an architect’s approach.
[13:54] I was torn during my studies in the early years of my career, by this idea that perhaps design was something frivolous. Was I throwing my talent away? Was I throwing my intellect away on something that wasn’t that important? Or wasn’t that challenging? Or wasn’t that deep? Some of the bias coming from a family of scientists or very practical people, builders and farmers, and design was somewhere in the middle—a little bit hard to define. That’s part of what attracted me to healthcare work, when I first came into contact with that was I immediately understood that this was that this was very challenging, right, that it had a complexity and a layering of the problems to solve that I wasn’t seeing in other areas of work that I’ve been involved with to that date. And also that there was something kind of fundamentally meaningful about it.
[14:45] If you could make healthcare products and services and experiences that were more efficient, more pleasurable, more reassuring, that help resolve some of the systemic challenges that one sees in healthcare systems, right, that was all value that I could feel really good about and say, hey, I’m not wasting my talent and my effort here. This is something that has value also outside the world of designers and our specific professional concerns.
[15:15] If you are creating healthcare solutions, you have an obligation to ensure first that they do no harm and second that they are actually effective and useful, right? The timelines for doing that, for generating evidence around that and for arriving to solutions that generate desired outcomes are not the same set of constraints that you have around launching consumer product. When launching consumer products, ultimately, your bar is: Will people buy it and use it? And if they do, you’re satisfied. Does it make their life better? You’re not the judge of that. Let them be the judge of that. It’s a consumer product. That’s not the same in healthcare. You actually have an obligation if you’re selling something as a healthcare product that. yes, you have proof it’s a positive outcome for that person. And that’s a whole different pathway to arrive to that.
[16:13] EW: During Thomas’s time at frog, he’s seen his fair share of health and wellness programs, working with clients at some of the largest, most well known brands in the space—and also plenty of the scrappier startups.
[16:25] TS: There’s a special place in my heart for the work that we’ve done over the years for health-tech entrepreneurs. One of the first was for a company called Aspect Imaging. We worked with Aspect to create the world’s very first magnetic resonance imaging MRI machine for neonatal babies. And the unique thing about this machine was because of the core technology that Aspect Imaging have, which is a self-shielding MRI machine, it doesn’t need to be placed in a special room and it could be placed directly in the neonatal intensive care unit.
[17:03] This is a classic kind of zero-to-one project, you know, there’s nothing you can lean on. There’s no existing product like it, no one has ever done this before. The technology is different. The workflow is different, the care pathways are different. The context of use is different from any MRI machine that’s ever been designed before. And so you have to go kind of back to first principles. Think about all the possible scenarios of how such a machine could be designed, could be articulated. And start to take those into the use environment. Test it with real users, learn from your experience, prototype it, test it, prototype it again, until you arrive to the very first instance of a new type of thing. And that’s just such a tremendously satisfying thing to do in any context, but especially in a context where it’s so fundamentally meaningful.
[17:53] What’s been really great in the last three, four years is just seeing how much more mature our clients are in terms of their understanding of the challenges and opportunities in digital health, how much more mature we are as consultants in terms of our ability to navigate and guide them, and how much more of our work in digital health actually makes it to market and has an impact on people’s lives.
[18:23] I think to successfully do innovation work requires a lot of courage. And that courage can come from different sources, right? The reason why there is the archetype of the egotistical engineer with unstoppable vision, that’s one of the sources of courage. If you have absolute faith in yourself that you are right, that your vision is right, that’s one of the ways that you can have courage. It’s a very dangerous way to have courage because nine out of 10 of such entrepreneurs are in fact wrong. But when you have the opportunity to partner with one who is right, and who has a vision that actually makes sense, that’s a very exciting roller coaster to be on.
[19:04] That’s not the only way that one can have courage, right? And I think, you know, one of the big challenges that many of the larger companies that we work with have is how do they enable an environment where their employees can be courageous? When so much of the way that large companies are run is not about encouraging courageousness. It’s about encouraging obedience, efficiency, conformity, minimization of error, right, a whole lot of other characteristics—which, in some ways, you know, are dehumanizing characteristics, right? It’s about getting people to act less like people and more like cogs in a machine. And guess what, cogs in a machine is not where innovation comes from. Right? Innovation comes from people being courageous and caring about the significance of their work and feeling ownership over their work, right? And that’s an ongoing challenge.
[20:07] EW: For Thomas, a human-centered design approach is essential in creating new products, services and experiences, but also when leading organizations—and building a legacy.
[20:18] TS: When I started at frog, I was still as is typical of many young designers, I guess, very bound up in the work. My portfolio was a representation of me, my identity, who I was. And then over time, as you see projects come and go, some of them are more successful, and some of them are less successful. And as you see people come and go in an organization, the thing that I look back on now and that I treasure now the most is the people more than the projects. And my professional pride is much more about the people in the organization. And the broader organization, the frog diaspora of people who have passed through during my time here because I can look at that and say, you know, not only have you had the opportunity to have an influence and build, you know, this business, build this community and organization, but also as a leading organization, as a leading community within the design industry, to have an impact, you know, at scale across the industry at large. And I can look across, you know, the leader of every major experience design studio in Milan is a former frog. I can look at that and say, well, that’s great. You know, we built a community here in our local city.
[21:45] One of the things that I early on learned about leadership and in particular leadership in a growing organization is that it’s a constant process of divesting yourself of responsibilities. We opened the studio in Milan, there were four of us. So my role as general manager was also to be the only creative director and the only project manager and the operations manager and financial accountant and facilities manager and IT guy for the team. As you grow an organization, you start to hire people explicitly to divest yourself of responsibilities, right? So we hired our first program manager, and I was like, okay, I’m gonna carve out this piece of my professional role. And you’ll take it forward and do it better than me. It’s this essentially constant search to make yourself redundant, right? By building an organization that is self-sustaining and is able to operate without you. But because the organization is growing and evolving, right, you never quite succeed. Because what you’re focusing on in a leadership role is what’s next.
[22:53] When I took on the Chief Design Officer role in frog, my first thought was, what’s my succession plan? Who’s gonna take over when I leave, if I leave? And I think that needs to be every leader’s first thought. There’s nothing worse than leaders who try to make themselves the bottleneck or the fundamental point for every decision.
[23:16] I do hope I’ve left behind some lasting things in terms of some of my core values. I think I have a core idea that you can only do good creative work in an environment that is kind and generous. You can’t do good creative work in an environment which is competitive and selfish. And I see, you know, some of our management consulting competitors trying to build design organizations and I think that’s their weak spot. That’s their Achilles heel. They have a culture which is competitive and individualistic, and you can’t do good creative work in a competitive, individualistic culture. It’s all about leaning into each other’s gaps, completing each other, doing interdisciplinary work in a way which is accepting of the strengths and limitations of other people. And, you know, if anything is to be my legacy in frog, I would hope that it’s that.
[24:20] EW: That’s our show. The Design Mind frogcast was brought to you by frog, a global design and strategy consultancy that is part of Capgemini Invent. Check today’s show notes for transcripts and more from our conversation, including a link to our Aspect Imaging case study among others. We really want to thank Thomas Sutton, soon-to-be frog alum, and future Head of Design for Digital Health R&D at AstraZeneca, for sharing his insights from a career in healthcare innovation. We’re really going to miss you here at frog, Thomas. We also want to thank you, dear listener. If you like what you heard, tell your friends. Rate and review to help others find us, and be sure to follow us wherever you listen to podcasts. Find lots more to think about from our global frog team at frogdesign.com/designmind. Follow frog on Twitter at @frogdesign and @frog_design on Instagram. And if you have any thoughts about the show, we’d love to hear from you. Reach out at email@example.com. Thanks for listening. Now go make your mark.
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