Improving the clinical experience for audiologists and Cochlear implant recipients
Transforming 20 years of legacy software into an intuitive, unified platform that opens Cochlear implant fitting to more clinicians worldwide.
Overview
Impact and outcomes
- Successfully launched across thousands of clinics worldwide, improving hearing outcomes for 1 million+ Cochlear implant recipients
- 100% regulatory compliance achieved through systematic usability validation and error documentation
- Market expansion validated by enabling junior audiologists and clinicians without formal audiology training to complete core workflows
- Design system established across all Cochlear clinical software, eliminating user "sanity checks" between applications
- Organisational transformation through 8 core design principles guiding clinical software development
Context
Cochlear provides implantable hearing solutions to people worldwide, continually innovating to support every recipient and those involved in their hearing journey. Their flagship professional software had remained largely unchanged for approximately 20 years, creating an urgent need to modernise, but reduce costs, while retaining market leadership and expanding accessibility to new user segments.
Challenge
How might we:
- Improve the experience of audiologists and Cochlear implant patients
- Enable market growth by making software more accessible to a greater range of clinicians
- Consolidate different software applications to reduce training burden, clinical support, and software maintenance
- Navigate medical device regulatory requirements demanding comprehensive usability validation
- Design seamlessly for both tablet and desktop platforms
1000s
Clinics worldwide
1M+
Implant recipients
44
Design sprints led
220+
Usability sessions
My role and scope
As senior UX designer responsible for the professional suite, I led the complete end-to-end design process over 6 years, from initial planning in December 2015 through launch and optimisation until January 2022.
Product and UX strategy
- Wireframes, prototypes, visual design, and comprehensive design system development
- Facilitated 44 design sprints, conducted 220+ usability sessions, and facilitated 16+ task-based card sorts
- Personally conducted observations and interviews in 12+ different clinics with multiple clinicians in each setting
Design leadership
- Presenting to C-level executives and coordinating across regional teams globally
- Facilitating sessions with developers, product managers, clinical experts, and regulatory teams
- Mentoring 2 junior designers through research and design processes
- Trained regional staff to conduct usability testing in 10 countries
Approach
I developed and delivered a systematic evidence-driven process.
1
Strategy alignment: Stakeholder workshops and product vision development
2
Global research: User interviews, observations, and comprehensive usability studies across multiple regions
3
Analysis and synthesis: User problem statements, persona development, journey mapping, and evidence-based design principles
4
Design and iteration: Progressive design sprints with continuous validation
5
Implementation: Design system creation and developer collaboration through technical constraints
6
Measure: Interviews, observations, surveys for field preview
Strategy
Product strategy
Working closely with stakeholders, I helped translate business objectives into clear, communicable vision. Liaising with stakeholders enabled me to understand the business objectives, perceived benefits to users and assist in creating ways to communicate this idea more broadly across the business.
Key strategic activities
Product vision development: Worked with the Product Manager to develop a one-liner and an elevator pitch for internal alignment.
"A single, intuitive, integrated fitting platform that opens Cochlear implant fitting to more professionals."
Systems thinking: Developed ecosystem diagram for stakeholder alignment on how each major element would interact and the benefits of this interaction
Global coordination: Contributed to ongoing global product calls with regional stakeholders to assist the Product Manager with regional buy-in
Executive presentations: Presented design work to project sponsors at every sprint and key milestones to VP and C-level stakeholders
UX strategy
Based on business and stakeholder needs, I developed a comprehensive process plan for all required UX work packages, inputs, outputs, delivery dates, and resource requirements. This included coordinating dependencies between research phases, design sprints, and validation activities to ensure seamless integration with development cycles and regulatory milestones. Outlined above in the approach.
Research and discovery
Research approach
User interviews and observations
Facilitated sessions in Australia and remotely with US audiologists.
Global research partnership
Engaged external firm for comprehensive international clinician research.
Visual desirability study
Gathered evidence for visual design decisions.
Card sorting
Understood task grouping and workflow preferences.
Analysis and synthesis
Affinity mapping
Analysed interview and observation data to uncover themes and patterns.
Insight generation
Developed insight statements and user stories from research findings.
Workflow understanding
Used card sort activities to map clinician task organisation and sequencing.
Key problem identified
Research revealed fundamental tensions between different professional approaches to cochlear implant fitting. While hearing aid clinicians expressed anxiety about the complexity of cochlear implants, technical experts felt patronised by instructional interface elements, patient-focused clinicians needed tools that supported relationship-building, and technical specialists required guidance that didn't undermine their professional credibility with patients. This multi-layered challenge became central to our design strategy, leading to flexible interface design that could accommodate different professional needs and confidence levels without compromising effectiveness for any group.
The insights became central to our design strategy for market expansion, leading to simplified workflows and more approachable interface design that usability testing later validated could be successfully used by inexperienced clinicians.
Persona development
I developed research-backed personas validated through workshops with regional clinical and marketing leads and ongoing user research.
Design challenge? Vastly different personas
Research revealed four distinct professional approaches to cochlear implant fitting, each with competing interface needs: the highly technical, the patient-focused and audiologists who were new to cochlear implants and requiring guided workflows and more information.
I identified competing priorities between existing user needs and new user accessibility, as well as the desire to cater to Key Opinion Leaders amongst our user base.
This complex user ecosystem required careful design decisions that could accommodate different experience levels and working styles without compromising any group's effectiveness.
This revealed fundamental design tensions: open toolbox versus guided workflows, professional autonomy versus supportive instruction, and efficient expertise versus learning-friendly interfaces.
Persona snapshots
Just enough information to give you some context without getting too detailed.
Christina: the experienced master
Wants autonomy and comprehensive technical control. Has established methodologies and feels patronised by simplification of interface elements. She wants all
"I have my own preferences and fitting method to optimise patient hearing outcomes and don’t need the interface to tell me how to do it”
Helen: the hearing aid expert, but Cochlear implant apprehensive learner
Expanding into Cochlear implants and needs confidence-building support.
"I have a lot of experience with fitting hearing aids, but cochlear implants make me nervous.”
Marie: the patient advocate
Prioritises relationship-building and whole-of-life outcomes over technical precision.
“It’s about feeling confident to go ahead and try something different. Working around patient limitations and giving them a sense of accomplishment.”
Eddy: the mapping technician
Requires guidance but wants to maintain professional credibility with patients.
“I know all the available settings, but I don't have a background in audiology. I want to do the best job I can, so I need some help, but don’t make it obvious on the screen. I want my patients to have confidence in my decisions.”
User journey mapping
Current state
Clinical observation data informed existing journey pain points
Future state
Combined card sort outputs with identified opportunities to design ideal workflows
Design and ideation
Collaborative ideation process
Research foundation
- User research outcome sharing
- Business objective alignment
- Subject matter expert lightning talks
Ideation activities
- How Might We sessions
- Concept card generation
- Iterative sketching
- Traffic light voting for concept prioritisation
- Prototype scope definition
Wireframing and prototyping
- Generated wireframes for team alignment and feedback
- Created prototypes for usability testing with progressive fidelity increases
- Iterated based on testing outcomes
Usability testing
Comprehensive testing strategy
Planning & Coordination
Organized facilitators, observers, participants, and legal agreements
Training Program
Developed facilitator guides and trained regional usability champions
Global Implementation
Enabled local recruitment and testing across regions
Analysis & Reporting
Delivered insights and recommendations to local and regional stakeholders
Testing methodology
Formative Testing: Early and frequent testing of main flows and individual features
Summative Testing: Large-scale worldwide testing of integrated flows and features
Visual design
Design System Development
- Design Audit: Mapped commonalities and differences across existing systems
- Research-Driven Decisions: Conducted visual attribute surveys and desirability studies
- Design Principles: Created foundational principles for consistent decision-making
- Mood Board Validation: Surveyed stakeholders on visual direction options
- Comprehensive System: Built complete design system for scalable implementation
Solution
Final deliverables
- Complete Design System: Scalable foundation for consistent user experience
- Developer Handover: Sketch Cloud and InVision prototypes linked to Jira user stories
- Technical Collaboration: Ongoing support for technical constraints and edge cases
- Detailed Specifications: Behavioral and UI specifications for BAs, developers, and QA teams
The old software
The old software was an open toolbox approach that was visually cluttered, did not guide practice and was overhelming for the uninitiated.
The new software dashboard
The new software encourages a patient focus by starting you off in a patient dashboard, a new screen. Here you can better understand the whole context for the patient, including:
- their hearing goals are – a new feature which helps with specific problem resolution, for example, hearing your grand daughter's high pitched voice at noisy family dinners.
- their hearing hardware – there might be newer sound processors available for them
- usage data – time spent speaking to someone in quiet, to increase their ability to hear
- hearing programs on each processor
New task-based adjustment screens
Rather than a confusing open toolbox, each type of a adjustment has it's own task screen. This means we can guide clincians through each task. This screen measures thresholds, the softest sounds a patient can hear. It's visually a lot cleaner, but has everything they need for this task, instead of all the things for all the tasks. This is less disrtacted and confusing.
We didn't forget Christina, our detailed audiologist
We cleaned up the old toolbox, so Christina had what she needed. In her settings, she could set this to the default screen for her, although we encourage her to give the others a go.
Results
Key outcomes
The project successfully modernised a legacy system that had remained unchanged for two decades, creating a unified platform that reduces training burden while expanding accessibility to new clinician segments. The solution was successfully launched across thousands of clinics, across 180 countries, improving hearing outcomes for 1 million+ Cochlear implant recipients.
Regulatory and Market Success
- Achieved 100% regulatory compliance through systematic usability validation and error documentation.
- Validated market expansion capability by enabling junior audiologists and clinicians without formal audiology training to successfully complete core workflows.
System Integration
- As their first permanant design hire, I established an evidence-based design process now used across all Cochlear clinical software.
- Created 8 core design principles that guide ongoing product development and ensure consistent user experiences.
Post-launch evaluation
Field Research
Developed protocols for clinical setting observations during soft launch.
Performance Assessment
Facilitated interviews and observations in real clinical environments.
Team Development
Mentored associate designer through analysis processes and trained regional staff in usability faciliation.
Continuous Improvement
Used findings to establish future research priorities and product enhancements
The research-driven approach ensured the solution met real user needs while supporting Cochlear's market leadership position and enabling expansion into previously less accessible markets.
Note: For detailed methodology on the global usability strategy and regulatory compliance framework, see separate case study: Custom Sound Pro global usability strategy.
