doctor as designer?
Post on 14-Nov-2014
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Doctor as Designer?
Joyce Lee, MD, MPH Twitter: @joyclee
http://joycelee.me/
I have no ties to any pharmaceutical companies
I am Pediatrician
Diabetes specialist
and Pediatric Researcher who studies Obesity and Diabetes
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?
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?
I had the great privilege of learning about design thinking while I was on sabbatical last
year at Stanford
https://medium.com/@joyclee
And I started blogging about design thinking and its intersection with health
But this journey started for me as a Personal Design
Experiment
My son “B” has life-threatening food allergies so he has to carry an
epi-pen with him at all times
The doctor gave us a paper allergy action plan to show the teachers how and when to use the pens
But this wasn’t really effective. Could there be something
better?
Pull him out
of school.
Design Idea
Not an option.
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
I was in
Silicon
Valley, so I
made a
youtube
video!
Design Idea
No actually I had B make the movie, just as any good tiger mom would
http://ihavefoodallergies.tumblr.com (see 1st video)
He illustrated and narrated this 1st prototype
And it went viral!!
http://goo.gl/w5RRIl http://goo.gl/EVIhgu
DESIGN
SUCCESS!!
http://ihavefoodallergies.tumblr.com (see 1st video)
http://ihavefoodallergies.tumblr.com
And please check out video #2 about handling food and ingredients!
We also
needed a
Low Fi
Version
Design Inspiration:
My Medicine X nametag
Which contain vital information
Extra resources, and pictures of the “bad allergens”
How to give the meds using B’s illustrations
Noun Project Icons from Rodrigo Bruno, James Keuning, Sergi Delgado & Jong Hyuk Kwon.
And more detailed information about allergens
Design thinking can solve health problems
My First Design Insight
Design which leverages mobile technology & social media
changes the paradigm of who, what, and how health information is communicated
My Second Design Insight
The old medicine: Paternalistic
Doctor to patient Off-line and in the office
The new medicine: Participatory
Patient to Patient Online and at all hours
Participatory design is therapeutic, and
empowers patients and caregivers
My Third Design Insight
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…”
The next part of the journey:
“Learning to design is learning to see”
-Oliver Reichenstein
I am used to bad design in healthcare
So I never even questioned the design of the Epi-Pen
The thing is, you don’t know what bad design is, until…
You see good
design
I didn’t realize the bad design of the Epi-Pen
Until I encountered the Auvi-Q
The Auvi-Q made me realize there are some major design
flaws with the Epi-Pen
The needle
is opposite
to the cap,
which is
counter-
intuitive
The Most Important Design Flaw
Life or
death is
stressful!
Don’t make
me think!
That causes problems in emergency situations
>15,000 Unintentional injections from Epi-Pens in the US
between 1994-2007
There were
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!”
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!
Whoa the
cap &
needle are
at the
same end!
But Auvi-Q found a design solution
It
tells you
what to
do!
And it even guides the user with it’s own version of “Siri”
“Bad Design Causes Injury”
“Good Design Saves Lives!”
Design Insight
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
It’s thinner
and
shorter &
fits in your
pocket!
But Auvi-Q fixed this problem too
And it
reminds me
when to
refill
“Aesthetics Do Matter for Health”
Design Insight
Revelation: It was designed by two brothers with food allergies!
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
I found this article, and I began to see the world through the eyes
of a designer
“patients frequently do not understand how and when to use [the epi-pen].”
Sicherer, 2011
In medicine, we often blame the patient
“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
“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
“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
“patients often forget [the device], allow it to expire”
Sicherer, 2011
In medicine, we often blame the patient
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?
A designer would never say,
“It’s the user’s fault”
“Fix the Design and then its no longer
the “Patient’s” problem”
-Joyce Lee, MD, MPH Medical Designer?
“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 :)
As a medical designer (MD), instead of seeing the
world like this:
75%
Wood, 2012
of children fail to meet recommended blood sugar goals in
Type 1 Diabetes
I now see the world like this:
75% of health care providers/systems
fail to help children achieve recommended blood sugar goals in
Type 1 Diabetes
Book knowledge is still important, but is probably
not as critical as…
Empathy for our Patients
If we as health care
providers do not think like designers, we will fail in our mission to serve our
patients
B you are a true “design thiker”; thanks for
teaching me so much
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!
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