Author Archives: alisonchang

Apr 25 2014
Communication, Culture, Design, Education, Health, Story

Final Thoughts about the Medical Media Arts Lab

 

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Last night was our final critique of our semester in Medical Media Arts Lab. It’s been a incredible journey being able to see a simple idea turn into a feasible project in just a few short months!

Here have been my three biggest takeaways:

1. Having a passion is so important. Many times throughout the semester I would feel discouraged or unmotivated, especially in the beginning when we were trying to figure out what exactly was the question we were trying to answer. Were we trying to make an exhibit to educate people about artificial heart technology or to tell the untold story of Dr. Akers’ contribution? After the first critique many of the comments expressed the same. But as Mijin mentioned in our presentation, it was the passion and excitement of the audience members during our first presentation that made us realize we had something bigger on our hands than we expected and helped us go back to the drawing board and see our problem in a different light. It was also encouraging each time we conducted an oral history interview with the individuals involved in the artificial heart project in the 1960’s. They each were so willing to share their story and eager to see it come to life in the present day, and the energy was contagious. Without a passion and an intrinsic motivation to continue, this project wouldn’t be happening.

2. Teamwork is essential. Our prototype and ideas honestly wouldn’t have come this far without the team I was in. Emily is an amazing speaker and hard worker, Mijin has valuable resources and skills with capturing stories from the past, and I contribute with my skills in digital media. This can be applied beyond the scope of our project into the subject of healthcare as well. All semester we’ve been talking about how to improve the communication, through whatever medium, between physician and patient. We’ve been talking about changing the conversation of the physician-patient relationship from the patient being a passive follower to the patient having an active voice and contribution to the dialogue about their healthcare. This can only happen if both the patient and doctor see themselves as a team rather than two opposing sides of a problem.

3. Start with Why. This is technically taken from Simon Sinek’s TED talk, but it’s been a common critique through the design process and practicing our presentations as well. Each time we’ve come up with a cool idea for a display we wanted to include in the exhibit, we were always stopped and asked “Why?” Would implementing this idea bring us closer to our goal, or do we want to add it because it looks cool? I saw the same principle applied in the other projects as well as they gave their final critiques. Many of the other teams designed a mobile app as part of their solution to their problem, but I liked how the ICU team recognized that although using an iPad to display information about rounds would be cool and in line with the digital health literacy trends of today, the current limitations of technology suggest that using a more traditional medium like a giant display screen would suit their problem’s needs a lot better.

I’m so thankful to my team members, our amazing problem-owners Dr. Grande-Allen and Dr. Igo, Dr. Ostherr and the teaching team, and all the individuals who helped us get to where we are today. I’ll be graduating this semester and moving to a different city so my contribution to our Artificial Hearts Project has come to an end, but it’s been an honor to be a part of this amazing process, and I can’t wait to visit when the exhibition opens!

Apr 23 2014
Health, Humanities, Humanity

Artificial Intelligence and Healthcare

I’m taking a philosophy class that touches a lot upon what cognition really means. Which led me to thinking – if we’re becoming closer and closer to developing artificial intelligence that rivals human intelligence, could we develop artificial intelligence to solve problems within healthcare?

Solutions are already in the works. A 2013 study from Indiana University showed that artificial intelligence machines were able to diagnose and reduce the cost of healthcare better than physicians by 50%! Using 500 randomly selected patients from that group for simulations, the two compared actual doctor performance and patient outcomes against sequential decision-making models, all using real patient data. They found great disparity in the cost per unit of outcome change when the artificial intelligence model’s cost of $189 was compared to the treatment-as-usual cost of $497.

However, one problem with replacing physicians with artificial intelligence may be the possibility of removing the doctor-patient relationship from the equation and undermines the importance of human relationship in the treatment process.

We are reaching a time in our society that we are slowly developing the tools needed to create intelligent beings that could solve problems. But a key distinction so far is that our goals in artificial intelligence have always been to create something as good or better than an average human.

But what if we switched that around? What if our goal was actually to create an artificial intelligence that had a problem itself? For example, could we develop an artificial intelligence that thinks like a patient in order to understand patient behavior?

There are plenty of virtual reality programs that exist for doctors to test their skills on surgery on specific parts of the human body, and now we know artificial intelligence could even replace doctors in diagnosis, but could there be one day be an artificial intelligence modeled after a sick person – an intelligent agent that may not be biologically (mainly because if it’s a robot it may not be made of biological parts) sick but we install a state of mind into it that would make it behave as it was sick? I’m talking about creating a robot patient who we would somehow program into thinking it has cancer, and doctors could be able to talk to the robot and it would respond and behave the same way as a cancer patient. It would be a great tool for doctors to understand patient behavior and how to meet their needs relationally, and I can see the uses it may have in studying psychology and philosophy as well.

As a Cognitive Science major, I can’t help but wonder since scientists, philosophers, and engineers have not been able to agree on an exact theory and replica of an artificial intelligence that represents a normal, healthy human, then how much harder would it be to create an accurate artificial intelligence that is a replica of someone who is sick.  After all, to model something that we might called defective, do you need to have a complete understanding of the original, non-defective object first?

Another complication would be distinguishing whether we could create a patient based on what is called “weak artificial intelligence” vs. “strong artificial intelligence”. Weak artificial intelligence is being able to create a machine that behaves intelligently, but strong artificial intelligence is creating a machine that can actually think. The current goal of researchers is to create strong artificial intelligence, which is why you have supercomputers like Watson who apparently can solve problems and answer questions by finding the information on its own. So if we even were able to create a machine that can behave like a patient, would it be because it has weak or strong artificial intelligence?

I believe there are many factors to consider both in philosophy and in technology before this possibility could ever be achieved. But for now, perhaps the best way to understand patient behavior is to communicate with the patient.

 

Apr 15 2014
Health, Humanity, Medicine

Taking Heart Transplants to the Next Level…But Should We?

This is so crazy how relevant this is to our project, but I saw this news story shared on my Facebook newsfeed: Link here because I can’t embed the video for some reason.

While we’re working on telling the story of artificial hearts in the Texas Medical Center, at the same time researchers in the Texas Heart Institute right here in Houston are taking heart transplants to the next level. Bypassing even a total artificial heart transplant, they are now using stem cells to manipulate pigs’ hearts into hearts that can work in humans. In the video, you can see so far they have successfully been able to transforms the cells the pig’s heart into a mold of a human heart and the next step is to insert cells inside the heart so that it will properly perform the pumping functions. It was crazy how the reporter was able to hold this modified heart (still white from being grown by stem cells) and squeeze it like it was a toy.

However, the meat of the piece started when the reporter started questioning Dr. Doris Taylor, the head researcher, on the ethical implications of conducting this stem cell research. I was surprised at how quickly Dr. Taylor defended her work, probably because this was a commonly asked and attacked question. Instead of thinking about the lives that may be lost by using stem cells, she reasoned that because she had the ability and the tools able to save lives, even if those tools were stem cells, it would be “morally wrong not to go forward using those tools”.

I noticed in this video how they utilized emotional (ethos) and moral (pathos) appeal to convince the viewer to support the stem cell research. The beginning of the news piece features a young woman who, suffering from a terminal heart disease, waited and eventually received a traditional heart transplant from a dying man. I was kind of confused at first because I thought the news piece was going to be more of this young woman’s story but instead turned into a news story about stem cell research. However, they brought her back at the end of the piece and asked her if she would support someone getting a heart made out of stem cells, and with tears in her eyes, the patient talked about how lucky she was to get a heart and how if it was possible in any way for others in need to get the same she was all for it. Now, I do have my own opinions about whether it’s morally right to conduct stem cell research and I won’t be sharing it here, but to me it was an obvious storytelling tactic to get viewers to sympathize and support stem cell research.

The concept of ethical conduct in research and treatment has been an ongoing issue for the physician. Dr. Akers faced similar concerns and backlash when he performed testing of artificial hearts on animals and in society today the hot topic is the consequences of using stem cells. I am not a medical student, but I have heard that when a student first enters medical school they must recite the Hippocratic Oath that states they will vow to take care of the patient as best they can and do no harm to them. But for the physician (and the government), is the best way possible a solution that involves stem cells and should stem cell research be considered unfairly taking a life from another to save someone else? Or is it indeed is morally wrong not to use whatever means possible to save a person’s life?

Mar 22 2014
Design, Electronic Medical Record, Health

“Healthbook” App for iOS 8

According to rumors, the newest version of the Apple OS system, iOS 8, will include an Apple-designed app called “Healthbook” that will be a “preinstalled app that can track data points including a user’s blood pressure, hydration, heart rate and potentially other statistics like glucose levels. It could also remind users to take medications at certain times during the day.” According to the description and concept art, Healthbook intends to be an all-in-one resource for all kinds of self-tracking, including dietary monitoring, fitness, filling prescription. It is not clear whether it intends to self-diagnose any diseases.

Concept images for the “Healthbook” iOS App, courtesy of MacRumors

iOS 8 is expected to be announced at Apple’s annual World Wide Developers Conference in June 2014. This means that Healthbook could become available as early as this fall. It is also predicted that the Healthbook App will also be integrated with the upcoming iWatch.

What will having a preinstalled application on such an widely accessible device like the iPhone mean for the healthcare movement, especially self-trackers? Although the app stores contains hundreds of thousands of health-related applications, will having an official Apple-designed healthcare mobile application increase a user’s proclivity to become an e-patient, self-tracker, or  be more aware of their health?  How will Healthbook take into consideration the major issues regarding self-tracking applications such as privacy and user control?

And what about Apple’s design strategy? What features or GUI aspects will differentiate it from other self-tracking applications in the App Store and on Android? Reports claim it will use a similar card-based design strategy similar to Passbook, another Apple-developed application that keeps all your forms of payment, such as credit cards, in one place and was meant to serve as a virtual wallet of sorts. Will having all your health data in one place be seen as efficient and beneficial, or dangerous in regards to privacy?

My guess? Healthbook will receive a lot of early hype and attention, especially as the release of iOS 8 draws closer, and upon official release many curious users and e-patients galore will use the application in its early stages. However, unless Healthbook provides some sort of dynamic, engaging experience beyond being a basic self-tracker application, users who are were not originally intrinsically motivated to monitor their health will become bored by it and eventually stop using it. As we have learned, most self-trackers are not those who are in need of medical attention, but those who already have an interest in maintaining their health, and unless Apple brings something new to the table with Healthbook, the average user will see Healthbook not as a life-saving tool, but a new toy or game, and will quickly become bored once it loses its novelty.

Here’s two suggestions for how Apple can distinguish Healthbook from its competitors and engage the interests of users who have not had previous interest in self-tracking their health lifestyles:

  • For the dietary/calorie tracker, add fun facts to inform and put their diet into perspective. For example, if after a run a user burns 200 calories, Healthbook can joke “You just burned off a bag of chips”. 
  • Have a goal-setting feature that includes specific suggestions on how to achieve that goal. For example, if a user wanted to lose 10 pounds, Healthbook could not only suggest how many miles they should run a week, but also suggest dietary restrictions and specific workout routines the user can engage in to create a total body regime that will help reach the user’s goal.

Whether these features or something even better (as Apple’s forte is coming up with what the user needs before they even need it) will be included in the Healthbook application remains to be seen. I am personally very glad Apple is trying to create an accessible and beneficial device that could provide better awareness of personal health. Apple has reinvented the personal computer, music, cellphone, and tablet industries, and I hope it can achieve the same success in revolutionizing the mobile healthcare space.

Mar 09 2014
Design

22 Tips on Storytelling from Pixar

Our group’s primary challenge and main research question is “How to best tell the story of Rice University and Dr. William Akers’s contribution to the development of the artificial heart in the Texas Medical Center?”.

So here are some tips from some of the nation’s best storytellers…the folks from Disney’s Pixar Animation Studios.

It may seem strange to be seeking advice from the makers of family films, but we must remember these are the guys that can take literally anything (toys, cars, rats, robots, an old man and a house full of balloons), and turn it into a story that touches the heart of people of all ages.

Thus, even though we’re not writing an original story, being able to take the information that we have and compile it into a compelling, relatable narrative will be key to making this project a success.

In 2012 storyboard artist Emma Coats (@lawnrocket) from Pixar tweeted 22 tips she wanted to impart from her time there and some folks from No Film School compiled it together into a nice list.

Among the 22 tips, here are the few that I think are most relevant to our project:

1. You gotta keep in mind what’s interesting to you as an audience, not what’s fun to do as a writer. They can be very different.

This has been another primary research question that we have been struggling with. We need to identify our audience so that we can identify what would be compelling to them. Presenting Dr. Akers’ story would be much different if we were talking to a group of biomedical engineers than if we were to a group of artificial heart patients. I think we are trying to aim for something in the middle – a story that can showcase the impressive technical designs of Dr. Akers’ work while reminding us that his contributions have served to save many lives, perhaps even lives of the people who will end up coming across this story.

7. Come up with your ending before you figure out your middle. Seriously. Endings are hard, get yours working up front.

This is a good point to make that also ties into the question, what is our ultimate goal in telling this story? Do we want it to just be historical and talk about a certain time period? Do we want to tie it back to the present? Do we want to utilize this story to call people to action? If so, what do we want our audience to do?

11. Putting it on paper lets you start fixing it. If it stays in your head, a perfect idea, you’ll never share it with anyone.

The post-it note activity we’ve been doing in class has really served this purpose. For example, in the last class we were able to brainstorm a really beautiful analogy for our project that I think will be a framework for how we are going to write the story going forward. All because we were just writing ideas on post-its.

15. If you were your character, in this situation, how would you feel? Honesty lends credibility to unbelievable situations.

16. What are the stakes? Give us reason to root for the character. What happens if they don’t succeed? Stack the odds against.

This is the part that is easier as documentary storytellers because instead of imaging the motivations of our characters we can simply ask our characters how they felt at the time – for example, when we interview Dr. Akers. In our research, we’ve begun to get a better sense of our characters’ personalities as we’ve learned a bit about what other important figures at the time, such as Dr. Liotta, thought about Dr. Akers and Dr. Akers. In terms of stakes, our problem-owner and our team were drawn to Dr. Akers when we heard that he felt unappreciated for his contribution to the design of the artificial heart, and that made him a more relatable person to which we could understand why he wanted his story to be told.But what would be the stakes for society if Dr. Akers’ story isn’t told? Who would benefit knowing more about Rice University’s involvement in the development of the artificial heart? Would current students be encouraged to pursue cardiology or biomedical engineering? Would prospective students be more likely to apply to Rice University? Would more heart patients want to be treated at the Texas Medical Center?

One idea I have moving forward is to write out the story of Dr. Akers’ and the artificial hearts as a script for a short film. Instead of primarily seeing legends such as Dr. Debakey and Dr. Akers as pioneers who I admire, I’ll write them into characters with struggles, opinions, and motivations. Being able to capture even the most basic story in an narrative form will help us see ultimately go forward with our problem session.

 

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