In October, 2008, Medicare—the United States' government program that pays 40% of the nation's hospital bills—decided to stop covering hospital failures. This meant that a litany of preventable mistakes, including treatments resulting from surgical errors, patient accidents and infections, were now the financial responsibility of the hospital. As a result, medical accidents went from being a source of hospital revenue to a massive financial drain. The good news is that medical institutions were finally forced into the business of disease prevention, at least once people were in their care.
What can be done to prevent costly medical mistakes? The hospital reform with the greatest potential is also the easiest to implement, at least in theory. According to the Committee to Reduce Infection Deaths statistics, hospital acquired infections kill more people in America than AIDS, breast cancer and auto accidents combined. Furthermore, the vast majority of the patients that acquire such infections in hospitals—and more than 5 percent of patients do—get them from the hands of health care providers. Thankfully, hospitals have become increasingly concerned with hand hygiene. The dirty hands of doctors and nurses aren't just gross—they are an extremely expensive and potentially fatal act of carelessness. Hospital staffers, in order to follow protocol, need to wash their hands hundreds of times a day. Their failure to follow protocol perfectly is their personal responsibility but non-compliance on such a broad scale is also a failure of the medical system that creates the rules and environment that lead non-compliance.
The medical industry's acknowledgment of hand hygiene as a systemic problem has led to the establishment and growing influence of Infection Control and Prevention Units. For Infection Control and Prevention, solving handwashing takes the form of cheeky posters of doctors reminding everyone to wash their hands, developing inane training videos demonstrating how to properly wash your hands and implementing incentive programs where health care workers reward each other with certificates when they observe a co-workers consistent compliance. In the hospital where I have focused my research, these certificates were returned unused.
One increasingly popular but misguided program has to been to implement paternalistic monitoring of nurses and other providers, who are forced to undergo increasing levels of surveillance. Whether it is video monitoring systems borrowed from meat manufacturing plants or sensor systems that read the alcohol content on hands, staff are cajoled into changing their behavior by receiving real time feedback combined with their fear that their personal compliance level is now public knowledge. There is no carrot—there is only a stick.
Despite growing desperation, few designers have bothered to do much of anything that might make washing or sanitizing hands more appealing. A recent scientific study pointed to "perceived busyness" as one of the primary deterrents to compliance. But this only demonstrates the silliness of current reforms. After all, if followed literally, the prescribed protocol for hand cleaning would require so much of the health care workers time that they wouldn't actually be able to perform the rest of their job. During a recent observation, nurses were consistently walking from supply closets to narcotic storage bins to patients rooms with their hands full. How, then, can they follow protocol and wash their hands correctly when they enter the room? Are monitoring systems supposed to solve these problems? Or are we merely putting increased strain on an already stressed population without offering any design solutions?
The overall cost of healthcare in the U.S. has reached a whopping $2.6 trillion, up from $256 billion in 1980, and $724 billion in 1990. In many ways, it seems that the rate of innovation in healthcare is moving in inverse proportion, with fewer truly significant interventions being created to tackle our collective health issues. While the quantified self movement has people talking (and measuring) all things health, and cool new products like the Jawbone UP are mainstreaming consumer wellness products, health innovation has remained somewhat niche. However, there has been a recent shift in the players in this space that bodes well for all of our health, despite the fact that these entities have sometimes been seen as our least likely allies.
These challenges are focused on tackling some of the most pressing health concerns in the US, but they are simultaneously supporting radical entrepreneurship. Each of the innovation challenges below are slightly different in their process (some have demo days and mentorships in addition to prize monies), but they are all unique in that they reward great ideas with cash while not taking any equity stake from the entrepreneur (quite a contrast to the VC and incubator model). It's free money and support, and may just get really great concepts in the hands of people who need them. Keep an eye on the following challenges, or better yet, submit your ideas:
Pfizer and Janssen Alzheimer's Challenge: Create concepts for early diagnosis and monitoring for people with Alzheimer's Deadline: March 16
Sanofi Data Design Diabetes Innovation Challenge: Improve health and experience for people with Type 1 or Type 2 diabetes Deadline: March 23
Allscripts Million Hearts Initiative CDS Challenge: Improve the clinical decision support functionality for people with cardiovascular disease Deadline: July 6
It's never been a better time to be a designer because healthcare innovation is going to depend on real human-centered design and non-traditional problem-solving. $100K of unrestricted cash ain't so bad either....
Nike's latest piece of wearable technology is the FuelBand, which resembles a futuristic, minimalist watch. The device contains an accelerometer that tracks your motion and calculates calories burned. Sound boring? It could have been—but like Apple, Nike has designed the product to be part of an ecosystem in order to ensure the sum exceeds the parts, and to provide the user with a new, novel experience.
In this case the ecosystem consists of the FuelBand and your smartphone or your laptop. Through either of the latter two devices, you program in your daily targets for the energy you'd like to expend.
Hannes Harms is set to complete his MA/MSC at the prestigious Royal College of Art this year, and his graduation project is a worthy complement to Ergonomidesign's "miniMe," which we saw yesterday. Harms's ultrasound concept is a perfect example of a 'specialized device' within a future health ecosystem:
"Sono" is a concept of a mobile and wireless sonography-system, which does not just enable an uncommitted handling of the probe but also enables an unlimited connectivity to installed screens in modern hospitals... the "Sono"-probe becomes a wireless daily diagnosis device and perfectly fits into the doctors' pocket. It is to be seen as the modern stethoscope, since vital functions and heart-beats are precisely to be monitored with modern ultrasound as well.
This way, the doctor doesn't just get an auditive feedback on the patients heartrate, but can directly see a visualization next to the ultrasound image.
The ergonomic handle of the screen device enables the doctor to carry the optional display unit with him or to place it at the patients bed table. Therefor he can use the foldable stand on the backside.
As with Harms' previously-seen "NutriSmart" food concept, he's looking years, if not decades, into the future. Still, the renderings and video are convincing enough to ground the works in the present: hardware and cost aside, the "Sono" simply integrates existing diagnostic technology into a single device.
During the last 5 years, medical ultrasound technology took giant steps forward. If a patient gets into the hospital, seconds can decide about his health and his future sickness. This is why the demand for mobile diagnosis devices is getting bigger and bigger. In times of miniaturization of diagnosis devices, the quality of modern ultrasound-systems has increased enormously throughout the last years. Autarkic sound-circles and new bandwidths are going to enable probes to be run wireless.
After over 40 years of pioneering work in the Life Science industry, a multidisciplinary design team at Ergonomidesign put together their take on the future for the Health Care industry. Their challenge was to envision the future and develop possible solutions for the world to test, use and reflect on. The outcome has generated many discussions, both in the Design and Life Science industries as well as with politicians and policymakers in the European Union.
This article describes how Ergonomidesign developed a vision of the future for Life Sciences and how this served as a guide as their designers prototyped how we might manage our own health and interact with doctors, family and other medical professionals and services in the year 2015.
An Integrated Future of Health Care in the Year 2015
In 2009 Ergonomidesign's strategists and futuring experts set out to analyze macro, life science, social and technology trends set ten to twenty years out. We knew that health care was changing and that we could be a part of shaping the future. We also knew that people were seamlessly integrating technologies into their day-to-day activities, social lives and health care management. What we needed was a clear vision about how different the future should or could be.
Trends suggested that by the year 2015, desktop computers as we know them today, will be relics of the past. Rapid advances in screen technology and the diminishing size of microprocessors will make it possible to invent new archetypes for the computer, coupled with new gestural and semantic languages. In an age of ubiquitous computing, our walls, tables and other elements in our environment will become platforms for us to interact on. It will involve access to information, and exchange and generation of data. Most importantly, these interactions will involve people connecting with people in the most serendipitous ways, through a system that is constantly aware and always connected, if desired.
Our research suggested that as we move towards the future of health care, people will increasingly need to feel involved and in control of their own health. People will also need tools to help them collaborate closely with health care providers, doctors and other people they trust to help them manage their health.
Our strategic work resulted in an eco-system that described the Integrated Future of Health Care in the year 2015 with the patient at the center of all activities, services, devices and products.
Our strategic work resulted in an eco-system that described the Integrated Future of Health Care in the year 2015 with the patient at the center of all activities, services, devices and products.
Bringing the Vision to Life
The vision needed to be grounded in the experiences of real patients. We introduced two characters that were assigned lifestyles and diseases as we tried to highlight potential real life scenarios. Throughout the entire design process, we leveraged the real world needs as we developed a service solution that would be as seamless, natural and effective as possible.
The two characters Hanna and Bernhard.
To tangibly visualize our characters and a glimpse of the future, the team developed the eco-system described in the Integrated Future of Health Care into an application for the Microsoft Surface platform (Surface application). This technology was chosen for its unique ability to invite people into interactions and conversations around the display. Representing a future smart surface, it also provided our team with the opportunity to explore natural user interfaces (NUI) and at the same time challenged the team to design for a full 360-degree interaction and multi-input, multi-user collaboration.
An early sketch of the application for Microsoft Surface.
Our aim was to illustrate the body as a container of biometric data. The simple act of placing your hand on 'a table' or any other type of smart surface, triggered an enlightened experience, e.g. you will be able to share and compare your biometric data with people you trust, subscribe to personalized treatment software and also have easy and constant access to your health care professionals.
Rapid-prototyping company Proto Labs recently announced the third award-winner in their ongoing "Cool Idea!" program, an open call for designers and entrepreneurs to enter their projects for a chance to win up to $100,000 worth of Firstcut CNC-machined and/or Protomold injection molded parts: Whirlwind Wheelchair's RoughRider.
Whirlwind Wheelchair International is a San Francisco-based non-profit organization that it is "dedicated to improving the lives of people with disabilities in the developing world while also promoting sustainable local economic development in the process," with a specific focus on providing high-quality wheelchairs to those who need them.
Their flagship product, the RoughRider, is a durable, low-cost, all-purpose wheelchair, which has found an enthusiastic audience of over 25,000 riders in over 40 countries. Now, after over three decades of improving the lives of the less fortunate, they are making the assistive device available in the United States.
In preparation for the release to a mainstream U.S. audience, the RoughRider underwent a redesign with the addition of lightweight side panels to make it better looking and customizable, something U.S. customers will love. As a Cool Idea! Award recipient, Proto Labs provided Whirlwind Wheelchair International with the key side panels needed for an initial U.S. launch.
Existing features of the RoughRider, which was developed for use on "muddy village paths [and] rough pot-holed urban streets" alike, include a long wheelbase for stability, heavy-duty casters in front and mountain bike wheels in back, and five-position rear axle.
Perhaps most importantly, the tires, tubes, hardware and bearings are readily available in nearly every corner of the world—"in bicycle shops, motorcycle shops, and hardware stores wherever you go."
Whirlwind Wheelchair International founder Ralf Hotchkiss believes that it is high time for American riders to have a more rugged option for a wheelchair: "Scores of wheelchair riders in the U.S. have inquired about purchasing the RoughRider specifically for off-pavement adventures that are difficult with U.S. style wheelchairs. Entering the U.S. market at this time will provide Whirlwind with a wealth of critical feedback from well-informed consumers, and may raise enough funds to do much-needed development of the innovations coming in from riders in developing countries. Besides, some U.S. riders who have ridden the Rough Rider had so much fun that they would love to get one for themselves. We will do whatever is necessary to make this happen."
We were lucky to get a tour of the Patient Safety Training Center in the basement of the Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, NH. Although the name sounds rather banal, the Center actually operates like a "hospital within a hospital" used for medical simulations. The purpose of the facility is to train any hospital employee who might come in contact with a patient during their stay, whether it's a doctor, a security guard or even a janitor.
Since opening three years ago, the Center has seen between 5,000 to 10,000 educators and trainees pass through each year. The main hallway is lined with a nurses' station and an assortment of rooms, including an ICU, clinic rooms, a neo-natal room and an Emergency Department which can be reconfigured into an operating room. Likewise, each of the various rooms takes on a variety of roles depending on the simulation's needs, akin to a television set. A room used for clinic rotations for Dartmouth Medical School students in the morning might be transformed into, say, a living room for training nurses in home care in the afternoon.
The Patient Safety Training Center has also taken their simulations outside the fake hospital hallway. For the Dartmouth-Hitchcock Advanced Response Team (DHART), the hospital's medical transport helicopter crew, the Center put together a simulation of more theatrical proportions. In order to recreate a fire in the patient compartment of the DHART helicopter, the Center's staff put a helicopter on a moving lift inside the DHART hanger and added in dry ice, recorded sounds, and a strobe light to simulate the spinning rotors. While helicopter fire training sessions may be few and far between, the staff at the Patient Safety Training Center "like to think we can do anything down here."
The Gio is a small, sleek one-handed blood glucose (BG) meter designed to make testing fast and instinctive. It combines existing technologies (meter, lancet device, and lancet/strip drum) in a sleek and portable form that can be used at work, on the street, while exercising, even while walking fast to a late appointment. Displaying BG results only, the Gio offers a radically simple and clean user experience.
The device itself is intuitive and ergonomic, neither over- nor under-designed, and duly unassuming. The "Gio" is so discreet, in fact, that it might be mistaken for something else—an office accessory, candy dispenser or even a toy—such that a user would still be wise to keep it somewhere safe.
- On-the-go usability: needs just one hand and no surface
- Fast: 7 second total test time vs. ˜70 seconds with current meters
- Less pain: lancet drum automatically changes lancets
- Compatible with all application and other devices via bluetooth and mini-USB
- Self-contained and durable: no external case needed
- Dual-sided screen for fast testing with either hand
- Clear viewing lens keeps port clean while allowing visibility
- Lancing depth adjustment via intuitive finger pressure
- Fits in your pocket
The Mayo Transform Symposium was inspiring, yes. People from design, healthcare and corporations all came together and talked about what is going on in healthcare, and how we can work to change it. As mentioned in the first post on the conference, the complexity of changing that system is daunting, but several groups and individuals are tackling it in their own ways.
John Thackara further emphasized the theme of breaking out of a static hospitals-as-institutions structure, attacking the Mayo directly for the giant physical energy-depleting structures it embodies. He pointed out that 95% of healthcare happens outside the medical system—between caregivers and families (just as most of life happens outside the medical system.) Thackara argued that we need to see health and well-being as properties of a social-ecological context. His key point was that healthcare should not be about intervening in peoples' lives when needed, but rather being in them at all times, which then subverts any need for interference.
Architect Michael Murphy, co-founder of MASS Design Group, presented a perfect example of healthcare becoming part of the community in which it works with a project on a hospital he worked on in Rwanda. The Butaro Hospital was built in a beautiful, mountainous region where 400,000 people were underserved by 0 doctors. One of the biggest concerns in designing the hospital was to combat Extremely Drug Resistant Tuberculosis, which is contracted via the air, when two strains of TB mix. In the design of a standard hospital ward in Rwanda, hallways provided an ideal mixing place for this deadly strain of TB.
To minimize air mixing, Murphy and his team designed the hospital itself as a preventative mechanism for TB. They created the hospital with several separate buildings, essentially removing all hallways from the basic architecture. Additionally, they used simple architectural methods to increase ventilation, with fans, UVGI lights in the ceiling to clean air, and high windows to move air in and out. Additional considerations were made toward patient experience, by designing rooms with patient beds pointed at windows rather than other sick patients.
Mayo Clinic's Center for Innovation
Just as Murphy's Butaro Hospital is an example of Thackara's notion of healthcare being in communities at all time, so is the Center of Innovation itself. What may have been most inspiring about the whole conference is the work they are doing at CFI, their existence and the fact that they hold the Transform Symposium each year. Lorna Ross, Creative Lead and Manager of the CFI and her team are working on that exact principle of being in the community that they are working to change—in one of the most advanced medical facilities in the world.
The complexity of the healthcare system is hard to wrap your head around. Even (maybe especially) after a long day of conversing on and listening to ideas on the topic. The Mayo Transform2011 Symposium seeks to both open up and tear down this complexity, with its varied roster of passionate people working in a tough arena where the past, present and future in healthcare converge.
And hospitals are (or should be) a thing of the past in healthcare. At least, hospitals as we think of them: giant institutional campuses where we go when we are sick. (That this came up repeatedly today at the Mayo Clinic, one of the most renowned of these institutions, is indicative of the terrific work being done there.)
As many of the speakers noted today, the key to future healthcare is in designing for the patient, from a holistic perspective, rather than merely at the touchpoint of the hospital. The most insightful and exciting ideas expressed at Transform were with those finding the opportunities to break away from the institution of the traditional hospital.
The concept was exemplified in the breakout session, "Unlocking the Power of Sharing Data," in which the speakers emphasized the necessity and eventuality of every individual's health records being in a shared system for managing their health. This concept immediately seems scary—health data is private, and very personal. To share it, or have it sitting on some server somewhere, feels exposed.
Have an awesome, show-off worthy, surround-sound stereo system at home? Apparently, no matter how high-fallutin' that sound gets, you aren't hearing it in 3D. "Pure Stereo 3D Audio" to be exact. Whereas surround-sound systems literally, well, "surround" you with audio, 3D sound plays the audio correctly spatially—so that what is on your left is actually heard on the left, and same with the right. Edgar Choueiri, rocket scientist by day, audio engineer by night developed Pure Stereo 3D Audio, recently unveiled by Kurt Andersen of NPR's Studio 360.
Choueiri is Director of Princeton's Electric Propulsion and Plasma Dynamics Lab, and thanks to his audiophile obsession and a grant from Princeton, also their 3D Audio and Applied Acoustics Lab. The phenomenon is best explained in the Studio 360 story and the 3D3A site, but as we understand it, Choueiri developed a digital filter applied to the audio signal, which eliminates "crosstalk," freeing up rich sound already on the recording. Crosstalk is the interference that naturally occurs in stereo when the right ear hears interference sound from the left, and vice versa. Prior to Choueiri's breakthrough, crosstalk cancellation had been attempted, but always produced problems in the tone of what we hear.
Studio 360 has some samples of water splashing for listening, embedded below, and some music samples in the story. There really is something noticeably different and rich in the sounds. To listen, sit equidistant between your left and right speakers.
Today, the BMW Guggenheim Lab launched their 6-year global tour; first stop: New York City's East Village. Part think tank, part exhibition space, part public forum, the LAB explores challenges facing today's cities and bustling urban populations through a carefully curated program of events. Over the next 2.5 weeks, five LAB Team members grapple with the theme of "Confronting Comfort" through over 100 free public programs—workshops, speakers, exhibitions and screenings. Kicking off the series, tonight the LAB hosts a screening of the documentary Blank City, which chronicles avant-garde filmmaking and renegade movements of New York City in the '70s and '80s.
The five LAB members are a mix of global thinkers and local activists—Omar Freilla (Founder of Green Worker Cooperatives, Bronx), Charles Montgomery (Journalist and Urban Experimentalist), Olatunbosun Obayomi (Microbiologist and Inventor) and Studio ZUS (Architects and Urabnist). A true public experiment, the theme of "Confronting Comfort" hopes to explore how urban environments can be made more responsive to peoples' needs, how a balance can be found between modern notions of individual versus collective comfort and how the urgent need for environmental and social responsibility can be met. Speakers include Elizabeth Diller, Sakia Sasson, David Simon, Juliet Schor, Interboro Partners, Assaf Biderman and Jake Barton.
BMW Guggenheim LAB New York City site before construction
Nestled between two buildings, the LAB is housed in a mobile structure by Tokyo-based Atelier Bow-Wow. The architecture serves as a sort of public theater for staging programming. With a loggia serving as architectural inspiration, the bi-level, open-air space is structured like a traditional theater with a fly system of rigs suspending a "toolbox"—for changing over the space from program to program—in the upper level to create a multi-functional and flexible open-loft floorplan.
As a special thank you, Core77 readers can receive a discount to this year's symposium. Register today by selecting "Group Fee." Under: "How did you hear about Transform?" check "OTHER" and note Core77.
Core77 is proud to be a Media Sponsor for this year's Transform2011 symposium, hosted by the Mayo Clinic's Center for Innovation in Rochester, Minnesota. A groundbreaking multidisciplinary gathering, Transform2011 will focus on the challenges of the health care delivery system through the lens of design—disruptive ideas, innovation, social media, games, technology development, advocacy, environments and shifting populations. The focus of the annual symposium is to encourage partnership, participation and engagement from professionals across disciplines with a common goal to affect change in the healthcare delivery system.
This year, Transform has invited a powerhouse of design thinkers and business leaders to participate in the symposium including William Drenttel (DesignObserver), John Thackara (Doors of Perception), Mariana Amatullo (Designmatters), Chris Hacker (Johnson & Johnson), James Hackett (Steelcase) and our own Allan Chochinov, just to name a few. We recently told you about a unique opportunity to be part of the conversation through the iSpot challenge and gave you a look into the Mayo Clinic CFI's design process. Today we're digging in a little deeper to learn more about the potential of design to transform our current healthcare delivery system.
Core77 had an opportunity to speak with two of this year's speakers: Doug Powell (AIGA and HealthSimple) and Maggie Breslin (Mayo Clinic Center for Innovation). Read on to hear more about their perspective on this year's conference.
When Doug Powell's daughter Maya was diagnosed with Type 1 diabetes, he and his wife Lisa Schwartz Powell embarked on a project to create a well-designed tool to help demystify and manage the disease. The result was Type1Tools, a kid-friendly, intuitive educational product with an emphasis on colorful graphics and simplified information. In 2005, the Powells created HealthSimple to bring their approach to a broader audience. As a designer who has worked to bridge the gap between design and the healthcare industry, Powell has a unique perspective on the ways that design can help shape the future of the healthcare industry. Powell explains the urgency and importance of bringing designers and healthcare professionals to the same table:
We need to illuminate to the embedded leaders in the healthcare community what the real opportunity is and the breadth of that opportunity. In certain pockets, design is being implemented and utilized really pretty effectively. For example, the Mayo Center for Innovation is really a leader in this space—in patient room design they look at what that environment is like and what opportunity is there to create an experience for the patient that has a potentially positive effect on their health. That's revelatory; that's really a huge, huge step. But, at the same time there's lots of open opportunity for designers to effectively make our case. Thus far, we've done an okay job of that but we need to continually do better to refine our story, keep finding new ways to connect with that audience and introduce new examples of effective design in the healthcare space.
Maggie Breslin, Senior Designer/Researcher at the Center for Innovation, pioneered the role at the Mayo Clinic in 2005. The organization was one of the first groups to embrace design as an inroad to healthcare solutions, bringing designers in-house in the mid-aughts. With a background in communication and media, Breslin brings a unique perspective to not only her role at the Center for Innovation, but also as a a designer. We spoke with Breslin about the importance of storytelling and the role of design in working to bring about new solutions for the healthcare delivery system.
Core77: Can you kind of tell us a little bit about just the importance of storytelling in your work, both as a designer and the Mayo Clinic?
Maggie Breslin: One of the sort of mini founding principles of the Center for Innovation is this real commitment to the idea that you can be multi-disciplinary and that any kind of solution to our healthcare delivery problem is going to come by bringing people together who haven't normally been at the table to think about the problem and to think about solutions and to really engage each other in the way of advancing ideas.
Imagine a chronic disease, so widespread that it could affect 1 in 3 Americans by the year 2050. Currently 100 million people in the United States lives with diabetes. Sanofi-aventis U.S. believes combining Data, Diabetes, and Design will impact our nation's wellness significantly. The global health care provider is sponsoring the first-ever open innovation challenge combating the diabetes epidemic by integrating open data with a human-centered view into diabetes epidemic.
"Innovation" has many definitions—for this Challenge, they're not looking for the cleverest idea, the best eye-candy, the most bleeding-edge technology. They are looking for a solution that brings together the strength of insight enabled by open data sets and the empathetic connection provided through human-centered design to meaningfully help people living with diabetes in the United States.
Building on the spirit of a code-a-thon, the challenge casts the widest net for data-informed diabetes solutions, culls the best interventions and incubates the strongest ideas. This challenge is structured to drive entrepreneurship and innovation. The best and most human-centered ideas will be mentored by industry leaders, and all intellectual property and equity will remain the property of its creators. Total awards top $200k, and invaluable support will be provided for game-changing solutions.
Hurry, submissions end on July 30th but the good news is that the entry form is short! See full breakdown of the Awards after the jump and check out the schedule and jury, which includes Todd Park, the CTO of the United States Department of Health and Human Services!