Medical Futures Lab

I recently had a conversation with my friend who is a first year medical student and I made a comment about his new iPad. He began to tell me that his medical school requires that every new student purchase an iPad, a policy that is becoming a norm at medical schools around the nation. While most hospitals don’t allow electronic medical records to be viewed on an iPad, there are many useful mobile applications for medical students or doctors to use when they are making rounds or studying. Here are three that are especially popular or newly created:

source: techvibes.com

• Epocrates- Probably the most popular and well-known app used by medical professionals. It allows medical professionals to look up most drugs, and view the correct dosage amounts for children and adults. It also allows shows side effects and harmful interactions with other drugs. It has been used to replace the physician’s desk reference book.
• Touch Surgery- This is a relatively new app designed to help surgeons in training to learn the steps of an operation. It was created to help make up for the hours of surgical residents being cut, which means less time in the operating room practicing needed skills. The app is also designed to improve patient safety and to give medical students and surgical residents a boost of confidence before trying the procedure on a patient. 
• Up To Date- This app has an abundance of reference information that physicians can look up when trying to make a treatment decision. It is often used to look up innovative treatment approaches that physicians report have been successful in the past, when normal treatment options aren’t working.

These new apps, especially Epocrates and Up To Date, have the potential to make medical training less about memorizing thousands of pieces information and instead place a larger emphasis on understanding. Instead of essentially having medical training turn physician’s into walking computers, physicians now have the ability to carry around unlimited information with them on a tablet.

The increasing use of mobile apps is inevitable in the future of medical care, so the question becomes to what extent should physicians rely on these applications. A trusting patient-physician relationship often stems from the belief that our doctor has much more knowledge about our condition then us, but perhaps this view is becoming outdated. As information is readily available online, it is reasonable to assume that a patient could be more informed about their condition then their doctor. Medical training needs to change to accommodate this shifting relationship, with a greater emphasis on understanding a patient’s needs and trying to incorporate them into a treatment plan. It needs to not only teach physicians information, but also how to find needed information. However, we must stay wary of becoming too dependent on these applications, and not focus our time looking at a screen instead of the patient.

Stanford Medicine’s MedX Live is a phenomenal venue for public dialogue on healthcare innovation. Recently, MedX Live invited IDEO Health and Wellness Director Dennis Boyle to discuss design thinking in medicine. The talk (video here) is worth viewing in its entirety; Boyle brings a seasoned experience and a forward-thinking vision that offer exceptional insight for aspiring health innovators.

What resonated most strongly, for me, was Boyle’s advice to the Stanford students in attendance: pay attention to workarounds as opportunities for impactful design. In many ways, this mindset captures perfectly what we’re doing in the Medical Media Arts Lab: observing workflows, identifying opportunities, and developing human centered solutions.

Workarounds are a fantastic concept for design thinking in healthcare, because anyone who’s ever stepped into a hospital knows too well how much happens at the margins of the clinical workflow.

In the Cardiovascular ICU, workarounds happen every day. Before rounds, fellows record the salient features of a patient’s electronic record onto scraps of paper. They use these notes to present patients and make annotations, then go back to the EMR to make edits and document a plan of care after rounds. We realized that this two-hour digital-analog-digital exercise could be avoided if EMRs were re-designed to align with clinical needs. We realized that if we could design a platform for streamlining, analyzing, and relaying clinical data, we could make technology that worked for physicians, and not against them.

Thus, I present a challenge for every physician, administrator, designer, and patient. Ask yourself the following questions:

1. What are of workarounds I encounter in my daily routines?
2. How does the ‘standard’ design fail to encompass my needs?
3. If functional constraints—cost, culture, time, technical expertise—were no object, what would I do differently? What goals would I achieve?
4. What would have to happen to bring those ideas to light?

Of course, these are uphill challenges. It’s easier to default to the status quo, because “it’s what we’ve always done.” It’s easier to constrain ourselves with “Why not?” than to explore opportunities with “Why?” But if we think critically about our surroundings, if we question our assumptions, and if we take resolute actions towards a creative destruction of the clinical environment, we can transform healthcare and put patients and providers back in control.

*Note: To view the presentation, skip ahead to the 12:05 mark.