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LUMINARY LABS @JENVANDERMEER @LUMINARYLABS
DESIGNING FOR DIGNITY
IN HEALTH TECH
Jen van der Meer
STRATA RX - SEPTEMBER 2013
2
Jen van der Meer
@JENVANDERMEER
3
Jen van der Meer
@JENVANDERMEER
DOES THE TRIPLE AIM SEEM
UNATTAINABLE
Improve
population health
Improve the
patient experience
@JENVANDERMEER
Reduce the per capita
cost of health care
Leslie Patricelli
Meaningful use.
Accountable care.
Can we set the bar higher?
The names of the following incumbent
EMR/EHR providers and the names of patents
and doctors are redacted to protect privacy and
mediocrity.
HIGHER
HIGHER
HIGHER
THE COST OF TECHNOLOGY
Thomas Murphy, MD 2001
So here come the startups.
The internet kids.
To the rescue.
Full disclosure: I am one of those kids.
@JENVANDERMEER
To change the world.
And we actually think this way –as if we could
hold the world in our hands. More ego-maniacal
than surgeons, we are.
We come, inspired.
And improve human lives.
But we are not without fault.
@JENVANDERMEER
We tend
to design
for the
motivated,
and the
healthy.
We get too excited about startup
traction, not excited enough about
evidence-based outcome
Paul Graham’s Startup Curve
We have a huge learning curve to
figure out how to disrupt the cost curve
Data: OECD Health Data 2005 and 2006. Commounwealth Fund National
Scorecard on US Health Performance 2006.
Cost +
Compliance
Incumbents vs. New Entrants
Lifestyle
LET’S SET A
HIGHER BAR
@JENVANDERMEER
@JENVANDERMEER
For each solution born onto the
health tech scene, we ask:
Are patient’s lives enhanced by the addition of data?
Do doctors become more wise?
Do nurses feel more empowered?
Do spouses know how to effectively intervene?
Do adult children of aging parents get more time in their
overly stretched days?
And do these collective interactions actually result in
improved population health?
DATA DESIGN
PRINCIPLES
THAT SET A HIGHER BAR FOR
HEALTH AND HUMAN DIGNITY
@JENVANDERMEER
8 PRINCIPLES: DESIGNING DATA FOR DIGNITY
Ethical Sharing
Sacred Habits Deeper MotivationData Calming
Eye Contact Double Loops The Herd
Utility in Context
Design for…
@JENVANDERMEER @LUMINARYLABS
DESIGN FOR UTILITY,
IN CONTEXT
@JENVANDERMEER
mHealth apps are only beginning to show
the benefits of contextual awareness
Ambient intelligence will become more
anticipatory, adaptive, and transparent
Technology that knows to behave
differently in context to where you are
Simulating a better future mental state
Ambient Commons, Malcolm McCullough
“Preontological awareness is faster”
DESIGN FOR
DATA CALMING
@JENVANDERMEER
The problem of alarm desensitization
The problem of data noise
The problem of the quantified parent –
how to become calm and engaged parent
The payoff when visualization delivers
wisdom, not just noise
DESIGN FOR SACRED
HABITS
@JENVANDERMEER
The smart phone…
The perfect BF Skinner box?
“You want minty refreshing taste now, you
benefit from tooth health later.” – Dan Ariely
Right thing, wrong reason: quantified dog
could lead to self-understanding
DESIGN FOR DEEPER
HUMAN MOTIVATIONS
@JENVANDERMEER
Insert gratuitous Fogg Behavioral Model
chart here
A Behavior Model for Persuasive Design. BJ Fogg. Stanford University 2009.
mHealth apps often fail the motivation
test, never reaching the unhealthy
Deeper motivators: “It feels good to
volunteer simple answer to real questions
people have”
Will altruistic motivators be the most
powerful? “Contribute to Science”
DESIGN FOR
ETHICAL SHARING
@JENVANDERMEER
You have the right to not be sensed
From: Seven Principles for Big Data and Resilience Projects. 9/23/2013
By Kate Crawford, Patrick Meier, Claudia Perlich, Amy Luers, Gustavo Faleiros and Jer Thorp
2013 PopTech & Rockefeller Foundation Bellagio Fellows.
Even if the value of that data delivers a
larger public good
Startups will not necessarily learn the
difference between Informed consent and
permission marketing
The true north: be transparent about data
sharing
DESIGN FOR
EYE CONTACT
@JENVANDERMEER
Facilitate human contact: does this chart
review increase or decrease their
understanding?
Does this device increase engagement,
understanding, and trust? Or distract?
Aim higher. Diminish the use of screens:
wear and forget sensors
DESIGN FOR DOUBLE
LOOP LEARNING
@JENVANDERMEER
Single loop learning
Consequences
Feedback
Decision
Actions
Single loop results, where is the “why”
Double loop learning
Consequences
Feedback
Decision
Actions
Mental Models
Of Real World
Decision
Rules, Strategies
Time until death @amikahmad NYU ITP
Standing at work today
DESIGN FOR
THE HERD
@JENVANDERMEER
Social proof = Positive peer pressure
60
Caregivers are not just a target segment,
They are an interaction paradigm
VA Caregiver pilot distributing 1000
iPads to caregivers of veterans
My herd watches out for me
To save everything, click here:
HealthDataChallenges.com
@JENVANDERMEER | @LuminaryLabs | @HDChallenges
My herd come join us:

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Strata RX 2013 | Designing for Dignity in Health Tech

Editor's Notes

  1. Leslie Patricelli
  2. ARIELY: We need to simulate a better future mental state for remembering. Data entry is not that simulation. Intrinsic information seems increasingly at risk Problem solving as pattern completion Alertness and resilience http://www.eecs.wsu.edu/~cook/pubs/ieee13.pdf A Survey on Ambient Intelligence in Health Care Giovanni Acampora, Member, IEEE, Diane J. Cook, Fellow, IEEE, Parisa Rashidi, Member, IEEE, Athanasios V. Vasilakos, Member, IEEE
  3. HT: @lily ARIELY: We need to simulate a better future mental state for remembering. Data entry is not that simulation. Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people’s capabilities by the means of digital environments that are sensitive, adaptive, and responsive to human needs, habits, gestures, and emotions. Context Aware: It exploits the contextual and situational information. Personalized: It is personalized and tailored to the needs of each individual. Anticipatory: It can anticipate the needs of an individual without the conscious mediation of the individual. Adaptive: It adapts to the changing needs of individuals. Ubiquity: It is embedded and is integrated into our everyday environments. Transparency: It recedes into the background of our daily life in an unobtrusive way http://www.eecs.wsu.edu/~cook/pubs/ieee13.pdf A Survey on Ambient Intelligence in Health Care Giovanni Acampora, Member, IEEE, Diane J. Cook, Fellow, IEEE, Parisa Rashidi, Member, IEEE, Athanasios V. Vasilakos, Member, IEEE
  4. From Ambient Commons: Soldiers and surgeons alike tend to prize their “situational awareness.” The ability to read a context on the fly can mean life or death to these experts. Where a merely competent person would play by the rules, and expert knows when not to and directly plays the situation. Andy Clark (philosopher and cog scientist) and David Chalmers (philosopher) call embodied skills “the extended mind” or “extended cognition.” Engaged action occurs in “memory as pattern re-creation instead of data retrieval; problem solving as pattern completion and transformation; the environment as an active resource, and not just a domain problem; and the body as part of the computational loop, not just an input device. _
  5. http://www.aami.org/publications/bit/2012/JA_alarm_fatigue.pdf Monitor alarm fatigue: An Integrative Review. Maria Cvach, John’s Hopkins Hospital. http://www.farmpd.com/Portals/53820/images/auditory-perception-3.jpghttp://www.aami.org/publications/bit/2012/JA_alarm_fatigue.pdf The constant beeping of alarms on patient monitors de­sensitizes caregivers, causing them to ignore or even disable the sounds that signal that patients may be in danger.
  6. Today healthcare is episodic. Care happens in the doctor’s office, with big gaps between visits. It’s an incomplete picture. But what if we could fill those gaps with data from the sensors in your phone. This information helps us better understand the relationship between behavior and health.
  7. http://irevolution.net/2013/09/23/principles-for-big-data-and-resilience/ Eliminating “preexisting conditions” under accountable care does not lead directly to people wanting to openly share all of their health data. There is still social stigma, fear that such information could make a person un or less employable or less desirable as a mate. This is critically important for new entrants in health tech – health has room for emergent outcomes, but not mercenary moral relativity.
  8. Asthmopolis propeller
  9. Permission marketing is the privilege (not the right) of delivering anticipated, personal and relevant messages to people who actually want to get them. _Seth Godin Informed consent is a process for getting permission before conducting a healthcare intervention on a person. Internet kids need to pause before jumping in with nudge experiments and behavioral economics hacks. And not continue on the slippery path of moral relativity as it relates to personal privacy. There is much more at stake when we build these systems with our health in mind.
  10. Increased chart reviewing led to decreases in patient understanding, possibly because this activity interferes with making eye-contact and communication in general. http://www.sciencedirect.com/science/article/pii/027795369400155M Goals for ambient intelligence: facilitate human contact. oriented towards community and cultural enhancement. help to build knowledge and skills for work, better quality of work, citizenship and consumer choice. inspire trust and confidence. be consistent with long term sustainability — personal, societal and environmental — and with lifelong learning. be made easy to live with and controllable by ordinary people.