Doctor as Designer?
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Doctor as Designer?



These slides are adapted from a talk that I gave this year at the 2013 Cusp Conference, which is a conference about the design of everything. It's about my personal journey from medical doctor to ...

These slides are adapted from a talk that I gave this year at the 2013 Cusp Conference, which is a conference about the design of everything. It's about my personal journey from medical doctor to medical "designer" and why we as medical professionals must become design thinkers. I was honored to be presenting at the event and it literally was the most amazing conference I have ever attended in my life! Thank you to Dave Mason and the folks at Multiple.



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  • Any and all opinions that I express about any products are unfettered by any monetary influence
  • I am Associate professorof Pediatrics at the University of Michigan. In the clinical setting, I provide medical care to children and their families at mott children’s hospital.
  • I specialize in pediatric endocrinology, so that means I mostly take care of kids with type 1 diabetes.
  • I am also a researcher. I perform clinical research which means that I work with real live patients and I also conduct health child health policy research, mostly focused on measuing the burden and long term health consequences of childhood diabetes and obesity. I also c0-direct a program focused on the use of mobile technology andinteractive data visualizations for helping children manage their chronic disease. Finally, I have a strong interest in social media for connecting patients and providers and for enhancing communication among researchers.
  • I started a blog focused on the intersection between design thinking and health. I will be sharing excerpts of posts throughout this talk.
  • So what I want to share with you today is my personal evoluation as a design thinker which was heavily influenced by my kids, b and s.
  • Both of my children have severe life threatening food allergies. My son B for example is allergic to dairy, nuts and aggs, and if he is exposed to even just a small amount of allergen he can develop a generalized allergic reaction called analphylaxis, which can cause difficulty breathing, shock and can be fatal.
  •  You get something called a food allergy action plan from the allergist, which is 2 sheets of paper printed out, that you are supposed to give to the teachers, outlining allergy symptoms and when to use the epipen for serious reactions and when to use the medication called an antihistamine for the mild reaction.
  • It’s a piece of paper. It’s blak and white it’s got a lot of words. Unfortunately…this is how we print out pt instructions even using our sophisticated emrs.
  • So we had just arrived in silicon valley, the epicentre of social media (google youtube. khan academy,) Make a videoAll of his teachers have smartphones. And with an iphone and some screencasting software,  . my son had just learned to read and write the previous year. I sat down and drafted a script for the video, He then helped create the illustrations for the video, and narrated the entire script himself.
  • Design thinking can help you solve health problems. This was my first exercise in design thinking: Identified the problem, ideate solutions, created and tested prototypes, and we found a prototype that worked! I didn’t set out to make a prototype, I just had a problem that needed to be fixed, so I came up with a design solution.
  • New medicine is peer to peer patient to patient. Sharing online on social media, on online communities. You must follow…..SO as much as I am disturbed by Howard Tullman’s talk yesterday about social media and the dark side, THERE IS A POSITIVE SIDE TO SOCIAL MEDIA IN MEDICINE.
  • Finally this was an example of Participatory Design (in which patient and family helped to create and design the solution). I can say for myself that it was a therapeutic and empowering experience for our family. I had peace of mind that I could make an accessible place online that his teachers could refer to anytime as a reference, but more importantly it was a great opportunity for him to practice his writing and illustration skills, and learn more about his own health condition, especially the second video which focused on “tricky allergic ingredients. Finally, there is no doubt in my mind that the video really resonated because it was done with B’s drawings and his voice as the narrator instead of his mother’s., making for more effective learning (I made sure to add the Thanks for taking care of me slide to that they understood how cute he was , so that they would be extra careful).
  • I MADE SOMe prototypes with my first design experiments but the other thing I learned to do this year is learn to see like a designer. And again, this transformation, was again mediated by
  • In medicine, we are used to pretty dismal design, whether its our web browsers, out pagers that we use in the hospital or our medical Devices. So you just learn to accept the status quo. And you don’t have high expectations. Design suckiness….there’s a lot of that in healthcare.
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  • Tools providers, clinics health systems
  • Joyce Lee, MD, MPHAssociate ProfessorCo-Director, Program on Mobile Technology in Child HealthPediatric Endocrinology and Health Services ResearchChild Health Evaluation and Research UnitUniversity of Michigan300 NIB, Room 6E18, Campus Box 5456Ann Arbor, MI 48109-5456Tel: 734-615-3139 Fax: 734-936-0941Email: joyclee@umich.edu @joyclee

Doctor as Designer? Presentation Transcript

  • 1. Doctor as Designer? Joyce Lee, MD, MPH Twitter: @joyclee
  • 2. I have no ties to any pharmaceutical companies
  • 3. I am Pediatrician
  • 4. Diabetes specialist
  • 5. and Pediatric Researcher who studies Obesity and Diabetes
  • 6. I have no formal training as a designer, but these were my notes from when I was studying for my medical board exams. Does this count as design?
  • 7. This is design, right? “A priesthood of folk in black turtlenecks and designer glasses working on small things.” So how does this have anything to do with me, a physician?
  • 8. I had the great privilege of learning about design thinking while I was on sabbatical last year at Stanford
  • 9. And I started blogging about design thinking and its intersection with health
  • 10. But this journey started for me as a Personal Design Experiment
  • 11. My son “B” has life-threatening food allergies so he has to carry an epi-pen with him at all times
  • 12. The doctor gave us a paper allergy action plan to show the teachers how and when to use the pens
  • 13. But this wasn’t really effective. Could there be something better?
  • 14. Design Idea Pull him out of school. Not an option.
  • 15. Design Idea Teach 6 yo signs of anaphylaxis & when to give meds Not feasible, I sometimes don’t know when to give the medication and I am an MD!
  • 16. Design Idea I was in Silicon Valley, so I made a youtube video!
  • 17. No actually I had B make the movie, just as any good tiger mom would
  • 18. He illustrated and narrated this 1st prototype (see 1st video)
  • 19. I blogged about it
  • 20. And it went viral!!
  • 21. DESIGN SUCCESS!! (see 1st video)
  • 22. And please check out video #2 about handling food and ingredients!
  • 23. We also needed a Low Fi Version
  • 24. Design Inspiration: My Medicine X nametag
  • 25. So I made these nametags
  • 26. Which contain vital information
  • 27. Extra resources, and pictures of the “bad allergens”
  • 28. How to give the meds using B’s illustrations
  • 29. And more detailed information about allergens Noun Project Icons from Rodrigo Bruno, James Keuning, Sergi Delgado & Jong Hyuk Kwon.
  • 30. My First Design Insight Design thinking can solve health problems
  • 31. My Second Design Insight Design which leverages mobile technology & social media changes the paradigm of who, what, and how health information is communicated
  • 32. The old medicine: Paternalistic Doctor to patient Off-line and in the office
  • 33. The new medicine: Participatory Patient to Patient Online and at all hours
  • 34. My Third Design Insight Participatory design is therapeutic, and empowers patients and caregivers
  • 35. Anyone can “design” a health solution, even a 6 year old boy! I felt safer, and B learned a lot of fancy words! “lactalbumin, lactoglobulin, whey…”
  • 36. The next part of the journey: “Learning to design is learning to see” -Oliver Reichenstein
  • 37. I am used to bad design in healthcare So I never even questioned the design of the Epi-Pen
  • 38. The thing is, you don’t know what bad design is, until…
  • 39. You see good design
  • 40. I didn’t realize the bad design of the Epi-Pen
  • 41. Until I encountered the Auvi-Q
  • 42. Check out this video:
  • 43. The Auvi-Q made me realize there are some major design flaws with the Epi-Pen
  • 44. The Most Important Design Flaw The needle is opposite to the cap, which is counterintuitive
  • 45. That causes problems in emergency situations Life or death is stressful! Don’t make me think!
  • 46. There were >15,000 Unintentional injections from Epi-Pens in the US between 1994-2007
  • 47. Unintentional Injections with Epinephrine auto-injectors 3000 “Wow it’s getting worse with time!” 2500 2000 1500 1000 500 0 Total 18-64 yrs 6-12 yrs < 6 yrs 13-17 yrs >64 yrs Simons, 2010
  • 48. Trained health care providers can’t even use the pen properly! “Despite instructions rendered on the package insert, a large number of health care professionals including nurses, paramedics, and physicians inadvertently self-inject while attempting to administer the EpiPen to patients. One recent report chronicles a 6year experience at a single US poison center that fielded 365 epinephrine injections to the hand.” Greenberg, 2010
  • 49. But Auvi-Q found a design solution Whoa the cap & needle are at the same end!
  • 50. And it even guides the user with it’s own version of “Siri” It tells you what to do!
  • 51. Design Insight “Bad Design Causes Injury” “Good Design Saves Lives!”
  • 52. Another Epi Pen Design Flaw It’s an awkward size, & doesn’t fit in your pockets So people don’t carry the pens with them
  • 53. But Auvi-Q fixed this problem too It’s thinner and shorter & fits in your pocket!
  • 54. And it reminds me when to refill
  • 55. Design Insight “Aesthetics Do Matter for Health”
  • 56. Revelation: It was designed by two brothers with food allergies!
  • 57. When I started pulling this blog post together, I went back to the scientific literature to see what it had to say about the design of the epi pen
  • 58. I found this article, and I began to see the world through the eyes of a designer
  • 59. In medicine, we often blame the patient “patients frequently do not understand how and when to use [the epi-pen].” Sicherer, 2011
  • 60. But is it a patient problem or is it a design problem? “patients frequently do not understand how and when to use [the epi-pen].” Design flaw: The needle is opposite to the cap Sicherer, 2011
  • 61. In medicine, we often blame the patient “Children had only used their EpiPen device in 29% of recurrent anaphylaxis reactions. This is perhaps unsurprising because a fear of needles/injections is common” Sicherer, 2011
  • 62. But is it a patient problem or is it a design problem? “Children had only used their EpiPen device in 29% of recurrent anaphylaxis reactions. This is perhaps unsurprising because a fear of needles/injections is common” Design Flaw: It’s confusing to use in a scary emergency Sicherer, 2011
  • 63. In medicine, we often blame the patient “patients often forget [the device], allow it to expire” Sicherer, 2011
  • 64. But is it a patient problem or is it a design problem? “patients often forget [the device], allow it to expire” Design Flaw:It’s too long & wide & where’s the app to go w/it? Sicherer, 2011
  • 65.
  • 66. A designer would never say, “It’s the user’s fault”
  • 67. “Fix the Design and then its no longer the “Patient’s” problem” -Joyce Lee, MD, MPH Medical Designer?
  • 68. “Patient” problems are really “Design” problems -Joyce Lee, MD, MPH DEO* (Design Executive Officer?) *Check out @mgiudice for the def’n of a DEO; she’s the one who told me that I could call myself a DEO :)
  • 69. Could Doctors have something to learn from Designers?
  • 70. As a medical designer (MD), instead of seeing the world like this:
  • 71. 75% of children fail to meet recommended blood sugar goals in Type 1 Diabetes Wood, 2012
  • 72. I now see the world like this:
  • 73. 75% of health care providers/systems fail to help children achieve recommended blood sugar goals in Type 1 Diabetes
  • 74. Clinic is a Design Thinking Problem every 15 minutes
  • 75. Book knowledge is still important, but is probably not as critical as…
  • 76. Empathy for our Patients
  • 77. If we as health care providers do not think like designers, we will fail in our mission to serve our patients
  • 78. B you are a true “design thiker”; thanks for teaching me so much
  • 79. Joyce Lee, Medical Designer, DEO Twitter @joyclee Thanks to: B, S, and E Hyoung O. Lee, MD, Heeja Lee Friends, Colleagues, Twitter connections, & @CuspConference for inspiring this talk!