doctor as designer?
DESCRIPTION
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.meTRANSCRIPT
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Doctor as Designer?
Joyce Lee, MD, MPH Twitter: @joyclee
http://joycelee.me/
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I have no ties to any pharmaceutical companies
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I am Pediatrician
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Diabetes specialist
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and Pediatric Researcher who studies Obesity and Diabetes
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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?
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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?
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I had the great privilege of learning about design thinking while I was on sabbatical last
year at Stanford
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https://medium.com/@joyclee
And I started blogging about design thinking and its intersection with health
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But this journey started for me as a Personal Design
Experiment
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My son “B” has life-threatening food allergies so he has to carry an
epi-pen with him at all times
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The doctor gave us a paper allergy action plan to show the teachers how and when to use the pens
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But this wasn’t really effective. Could there be something
better?
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Pull him out
of school.
Design Idea
Not an option.
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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
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I was in
Silicon
Valley, so I
made a
youtube
video!
Design Idea
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No actually I had B make the movie, just as any good tiger mom would
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http://ihavefoodallergies.tumblr.com (see 1st video)
He illustrated and narrated this 1st prototype
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And it went viral!!
http://goo.gl/w5RRIl http://goo.gl/EVIhgu
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DESIGN
SUCCESS!!
http://ihavefoodallergies.tumblr.com (see 1st video)
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http://ihavefoodallergies.tumblr.com
And please check out video #2 about handling food and ingredients!
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We also
needed a
Low Fi
Version
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Design Inspiration:
My Medicine X nametag
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Which contain vital information
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Extra resources, and pictures of the “bad allergens”
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How to give the meds using B’s illustrations
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Noun Project Icons from Rodrigo Bruno, James Keuning, Sergi Delgado & Jong Hyuk Kwon.
And more detailed information about allergens
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Design thinking can solve health problems
My First Design Insight
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Design which leverages mobile technology & social media
changes the paradigm of who, what, and how health information is communicated
My Second Design Insight
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The old medicine: Paternalistic
Doctor to patient Off-line and in the office
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The new medicine: Participatory
Patient to Patient Online and at all hours
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Participatory design is therapeutic, and
empowers patients and caregivers
My Third Design Insight
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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…”
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The next part of the journey:
“Learning to design is learning to see”
-Oliver Reichenstein
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I am used to bad design in healthcare
So I never even questioned the design of the Epi-Pen
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The thing is, you don’t know what bad design is, until…
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You see good
design
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I didn’t realize the bad design of the Epi-Pen
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Until I encountered the Auvi-Q
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The Auvi-Q made me realize there are some major design
flaws with the Epi-Pen
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The needle
is opposite
to the cap,
which is
counter-
intuitive
The Most Important Design Flaw
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Life or
death is
stressful!
Don’t make
me think!
That causes problems in emergency situations
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>15,000 Unintentional injections from Epi-Pens in the US
between 1994-2007
There were
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0
500
1000
1500
2000
2500
3000
< 6 yrs 6-12 yrs 18-64 yrs
Total
13-17 yrs >64 yrs
Unintentional Injections with Epinephrine auto-injectors
Simons, 2010
“Wow it’s getting worse with time!”
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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!
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Whoa the
cap &
needle are
at the
same end!
But Auvi-Q found a design solution
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It
tells you
what to
do!
And it even guides the user with it’s own version of “Siri”
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“Bad Design Causes Injury”
“Good Design Saves Lives!”
Design Insight
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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
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It’s thinner
and
shorter &
fits in your
pocket!
But Auvi-Q fixed this problem too
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And it
reminds me
when to
refill
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“Aesthetics Do Matter for Health”
Design Insight
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Revelation: It was designed by two brothers with food allergies!
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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
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I found this article, and I began to see the world through the eyes
of a designer
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“patients frequently do not understand how and when to use [the epi-pen].”
Sicherer, 2011
In medicine, we often blame the patient
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“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
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“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
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“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
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“patients often forget [the device], allow it to expire”
Sicherer, 2011
In medicine, we often blame the patient
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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?
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A designer would never say,
“It’s the user’s fault”
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“Fix the Design and then its no longer
the “Patient’s” problem”
-Joyce Lee, MD, MPH Medical Designer?
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“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 :)
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As a medical designer (MD), instead of seeing the
world like this:
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75%
Wood, 2012
of children fail to meet recommended blood sugar goals in
Type 1 Diabetes
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I now see the world like this:
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75% of health care providers/systems
fail to help children achieve recommended blood sugar goals in
Type 1 Diabetes
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Book knowledge is still important, but is probably
not as critical as…
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Empathy for our Patients
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If we as health care
providers do not think like designers, we will fail in our mission to serve our
patients
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B you are a true “design thiker”; thanks for
teaching me so much
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Joyce Lee, Medical Designer, DEO
Twitter @joyclee http://joycelee.me/ joycelee.tumblr.com
Thanks to: B, S, and E Hyoung O. Lee, MD, Heeja Lee
Friends, Colleagues, Twitter connections, & @CuspConference for inspiring this talk!