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. http://joycelee.me

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. https://medium.com/@joyclee
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. Pull him out of
school.
Design Idea
Not an option.

15. Design Idea
Not feasible, I sometimes don’t know
when to give the medication and I
am an MD!
Teach 6 yo
signs of
anaphylaxis &
when to give
meds

16. I was in
Silicon Valley,
so I made a
youtube
video!
Design Idea

17. No actually I had B make the movie,
just as any good tiger mom would

18. http://ihavefoodallergies.tumblr.com
(see 1st video)
He illustrated and narrated
this 1st prototype

19. I blogged about it
http://goo.gl/984r9R

20. And it went viral!!
http://goo.gl/w5RRIl http://goo.gl/EVIhgu

21. DESIGN
SUCCESS!!
http://ihavefoodallergies.tumblr.com
(see 1st video)

22. http://ihavefoodallergies.tumblr.com
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
http://goo.gl/6MwfeT

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. Noun Project Icons from Rodrigo Bruno, James Keuning, Sergi Delgado & Jong Hyuk Kwon.
And more detailed information about
allergens

30. Design thinking can solve
health problems
My First Design Insight

31. Design which leverages
mobile technology & social media
changes the paradigm of
who, what, and how health
information is communicated
My Second Design Insight

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. Participatory design is
therapeutic, and
empowers patients and
caregivers
My Third Design Insight

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:
http://www.auvi-q.com/auvi-q-demo

43. The Auvi-Q made me realize
there are some major design
flaws with the Epi-Pen

44. The needle is
opposite to
the cap, which
is counter-
intuitive
The Most Important Design Flaw

45. Life or death
is stressful!
Don’t make
me think!
That causes problems in
emergency situations

46. >15,000
Unintentional injections
from Epi-Pens in the US
between 1994-2007
There were

47. 0
500
1000
1500
2000
2500
3000
< 6 yrs
6-12 yrs18-64 yrs
Total
13-17 yrs
>64 yrs
Unintentional Injections with
Epinephrine auto-injectors
Simons, 2010
“Wow it’s getting worse with time!”

48. Greenberg, 2010
“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 6-
year experience at a single US poison center
that fielded 365 epinephrine injections to the
hand.”
Trained health care providers can’t
even use the pen properly!

49. Whoa the cap
& needle are
at the same
end!
But Auvi-Q found a design solution

50. It
tells you
what to
do!
And it even guides the user with
it’s own version of “Siri”

51. “Bad Design Causes Injury”
“Good Design Saves Lives!”
Design Insight

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. It’s thinner
and
shorter & fits
in your
pocket!
But Auvi-Q fixed this problem too

54. And it
reminds me
when to refill

55. “Aesthetics Do Matter
for Health”
Design Insight

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. “patients frequently do not understand
how and when to use [the epi-pen].”
Sicherer, 2011
In medicine, we often blame the
patient

60. “patients frequently do not understand
how and when to use [the epi-pen].”
Sicherer, 2011
But is it a patient problem or is it
a design problem?
Design flaw:
The needle is
opposite to
the cap

61. “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
In medicine, we often blame the
patient

62. “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
But is it a patient problem or is it
a design problem?
Design Flaw:
It’s confusing
to use in a
scary
emergency

63. “patients often forget [the device],
allow it to expire”
Sicherer, 2011
In medicine, we often blame the
patient

64. But is it a patient problem or is it
a design problem?
“patients often forget [the device],
allow it to expire”
Sicherer, 2011
Design
Flaw:It’s too
long & wide &
where’s the
app to go w/
it?

65. http://goo.gl/M2Sxs5

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?
http://goo.gl/L6yQ0V

70. As a medical designer (MD),
instead of seeing the
world like this:

71. 75%
Wood, 2012
of children fail to meet
recommended blood sugar goals in
Type 1 Diabetes

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
http://goo.gl/j9GR1F

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
http://www.doctorasdesigner.com
Thanks to: B, S, and E
Hyoung O. Lee, MD, Heeja Lee
Friends, Colleagues, Twitter connections, &
@CuspConference for inspiring this talk!