The Experience of Using a Jawbone Up: From the Perspectives of a Techie and Designer

December 29th, 2011 - 9:21 am

It’s still dark out.  There’s a band on my arm buzzing and I have no idea why.  My alarm is set for 5:30 am (mostly because I want to get a workout in so that Nadia, my Jawbone partner, will see that I work out daily) and it’s only 5:00 am.  Turns out the settings on my Up are such that it will wake me at a point in my sleep cycle that is most appropriate and least intrusive.  It also turns out that I really think that 30 minutes later would have been least intrusive regardless of my sleep cycle.  I’m not a happy camper, but I’m awake.

Nadia and I have been wearing our Jawbone Ups for about a week and a half now, testing them to understand how technology can create a community and encourage wellness behaviors in users.

Right off the top we had some observations about the technology.   In the most basic terms a Jawbone Up is a wrist band you wear 24/7 that tracks your movement which enables it to understand your physical activity and sleep patterns.  The Up is then paired with your iPhone and a dedicated application that enables sharing of your information with “team members” and lets you take photographs of your food and rate your satisfaction with the meal.

The iPhone app displays all of the data the wrist band collects.  Simply plug it into the earphone jack and the band dumps the data into the app.  You can visualize the data multiple ways with varying degrees of detail.  In addition to viewing the data you have the ability to share it with your team and then comment or message your team through the feed screen.

In order to accurately track different types of activity the Up band has different modes.  The day mode tracks how many steps you take, the sleep mode tracks your sleep cycles and the work out mode can track your physical activity and can be paired with the iPhone app to track the distance of your run using GPS on your phone.   It also allows you to select your favorite songs to pair with your workout.

It should be noted that the app allows you to track your eating habits using photographs of your meals and a survey about how energized you felt after the meal.  Both Nadia and I quickly realized we were not getting any additional value out of this and didn’t use it as part of the experience because of the lack of quantitative data or an ability to verify the data.

The ever clever and tech savvy Nadia decided to give the Up a little test by syncing it at midnight to find out how it would distribute activity over time as it is designed to work on a daily cycle.  Here’s what she found: “It looked like that as soon as it meets the 100% mark on day one, it puts the rest of the steps in the next day, even though I don’t believe that I took 1000 steps in 30mins past midnight! ”

Both of us were initially skeptical of the way the band would be able to accurately track our sleep patterns so, unaware that the other was doing the same, we each decided to lay awake in bed watching TV or reading to see how well the band was able to figure this out.  We were both impressed that the band picked up the fact that we were awake and then felt the sleep tracking was a fairly accurate representation of how we slept.

The band rates your sleep quality, though we are unclear as to how it determines what makes one night’s sleep better than the other.  The app didn’t provide any additional information for the sleep quality score.

 

 

Technically speaking we found a few quirks that we hope will be worked out in the new version:

  • The iPhone application crashed frequently and the syncing often failed too.
  • The other drawback is that the band is only compatible with a “specific” iOS device (always use the same device to synch your data) and does not work with other mobile platforms.  It also does not have a desktop version of the application where you could upload the data if you did not have an iOS device.
  • Regarding the workout mode, I’m an avid elliptical user and because the movement I make is different than that of running the Up was unable to accurately track my workouts, though Nadia felt that it was accurate with running.

Now on to the experience of using the device for a couple of weeks.

Both Nadia and I went into this little experiment expecting to have no problems sharing our activity and sleep habits with each other.  We are friends outside of work and didn’t see any reason to think twice about becoming team members.

We quickly realized that sharing what time you go to sleep, how you sleep, when you work out, and how much you walk during the day reveals a lot of personal information about you to your team members.  Nadia remembers thinking, “Why didn’t Allison sleep very well last night?  What was she doing?”  You can imagine that the reasons for not working out, not sleeping well, or walking 10 miles can often be things you might not want to disclose to everyone you know.   Even the most mundane facts about your life feel like very personal information when you share them unfiltered.

That being said, it did create a kind of community and relationship that we didn’t previously have.  We were able to talk about our health and wellness with an ease that would have otherwise been difficult.  By opening communication lines this band seems to lend itself to being a part of a patient-provider relationship to allow for understanding of nuances and behavior patterns.

Because the Up can be a communication tool, we realized it is very important to be careful when selecting your team members.  This is a situation when a bigger team might not be a better team.  Understanding what you want to get out of the experience of using the band informs who should be on your team.  Are you looking for a competitive relationship that will get you off the couch?  pick the guy in the office who runs 5 miles every morning.  Do you want someone who will be sensitive and encouraging about your wellness challenges?  pick that good friend who won’t make fun of the fact that your work out lasted 3 minutes yesterday.  Who sees your information will not only affect the relationship you have but will affect the way you change your behavior.

We both noticed that we would be excited to check and see if the other had updated their stream with a new data dump.  This encouraged us to dump our own data but curiously didn’t seem to make us want to work out or engage in a new wellness behavior.  The voyeuristic aspect of the Up is fun but didn’t seem to change our behavior patterns.

Another feature of the Up that we were excited to try out was the Challenges tab on the app.  You and your team members can create challenges for each other or sign up for sponsored challenges that encourage you to engage in wellness behaviors.  Daily Feats has partnered with Jawbone to create challenges that allow you to earn points that you can redeem for things in the real world (like charity donations or coupons).  While we initially anticipated that these challenges would motivate us, we quickly learned that we got tired of the constant checking in and logging of our activities required for the challenges.

Speaking of getting tired (I’m still mad about getting up early), Nadia and I both began this experiment with enthusiasm and excitement that after a week and a half has dissipated.  We are now both rather bored with the device.  The constant logging, updating and remembering to switch modes makes the Up a bit of a nuisance.  While you’re not required to update the app frequently, it is the only way to track the data.  Without frequent updates behavior modification is difficult to understand and less likely to happen.  Nadia also questions if the data accuracy falls off if it is not dumped often into the app.

That being said, this is an exciting tool that could potentially create an environment within a relationship that would allow for conversations around health and wellness.  Thinking along those lines we’ve come up with a few things that would make this a better product:

  • Being able to track your heart rate.  This would greatly increase the accuracy of calories burned and the intensity of workouts.
  • Being able to see the data updated via Bluetooth.  This would eliminate the need to constantly dump the data into the phone manually and make it a smarter real-time device.
  • The ability to moderate what you share and don’t share more seamlessly.  There is currently the ability to remove information from your feed, but this requires that you go through multiple steps.  Instead there should be a smarter and easier way to do this.
  • The ability to track calories in and calories out.  If the Up could calculate how many calories you were taking in at meals an individual would be able to better track how many calories were consumed vs. how many were burnt.

Sadly, Allison’s Jawbone Up died today.  This is a well known problem with the devices and they have in fact offered a blanket no questions asked refund to all users.   We will be taking Jawbone up on that offer and look forward to seeing what the next version brings.  Maybe Allison can break that one too.

Nadia Wood is an IT specialist (ok, techie) and Allison Verdoorn is a design researcher (ok, designer) at the Mayo Clinic Center for Innovation.

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By admin | Posted in Conversation, Designer, Experience | Tagged , , , , , , , , , , , | Comments (4)

What if… you tried teaching design thinking to pre-med students?

December 21st, 2011 - 1:39 pm

It’s not unusual to have a handful of visitors drop by the Health Leads desks in Chicago for a day, looking to find out exactly what it is we do. To us as student leadership, it’s always nice to be reminded that there are individuals outside of Health Leads who are interested in social determinants of health, and we welcome the outside perspective. It is pretty unusual, however, for our own interest in the group who is observing us to eclipse their interest in us. This is what happened when Allison and Perry from the Center for Innovation came to visit. Quickly we realized that the kinds of questions they were asking, about what did/didn’t work with Health Leads, reflected the kind of thinking we’d been “trained” to do at the University of Chicago – to walk 360˚ around a problem, welcome any nuances we find, expand our conception of the context the problem exists in, and then pull all of this back together at the end to see what the problem really is after all. Before meeting these CFI representatives, we had absolutely no idea that there was an institutionally endorsed, large-scale model for utilizing this kind of thinking in a practical way. We had no idea there was a group so invested in asking the right questions, encouraging innovation to flourish, or engaging in design thinking. Honestly, we had no idea what design thinking even was. So we decided to come to Mayo to find out.

Design thinking (as we understand it)
If we were looking for a crash course in design thinking, we definitely got it. Certainly, on the one hand, design thinking is about not being afraid to ask the right questions – moving beyond the “how do we improve patient compliance” question to explore the bigger, scarier questions behind it: what are the obstacles to compliance that lie outside of the health care realm, is our current EMR capable of recording that kind of ‘soft’ information, and can we achieve improvement with the current staff members and staff relationships we have in place. It’s about innovating instead of implementing small, band-aid solutions that you can only pray will end up working. It’s the difference between asking “how can we improve this system?” and “is this even the right system in the first place?”

Yet, on the other hand, even beyond asking the right questions and looking at systems with a mind to innovate them, design thinking is about listening carefully and communicating effectively. When you’re dealing with health care, this ends up meaning valuing the patient perspective and the personal challenges providers have in connecting with their patients, as well as with each other. In terms of listening carefully, the CFI has a commitment to observing how a system operates. Talking to the people who circulate in the system, soliciting their opinions and values – these are key elements of the designer’s process. Experimentation – trying out new models, even if you have absolutely no expectation that they will work – is another useful method for gathering information about the context you’re working within. At their core, these experiments are yet another form of active listening. One thing that the CFI really understands is that if you want to find a solution that will work with a specific set of people, you need to make sure you pick up on the quirks of how they interact with each other and the nuances of what is truly important them.

Then, once these insights are gathered, the next step for the designers is to synthesize what they have learned and to communicate it back – to each other and to the people asking for their help. Ideas are “blown up” into beautiful visual, auditory, or even sometimes kinesthetic representations. It’s hard to find a surface you can’t write or draw on in the CFI or, perhaps more importantly, that hasn’t been written or drawn on already. Making insights communicable is an essential step in realizing, and then sequentially conveying, why certain solutions will or will not work. Systems are modeled in visuals that clearly represent the relations between the different cogs in the machine, and bring life to these cogs – reminding us that they are either people themselves, or things that people interact with closely. This allows form, function, and human factors to shape the thoughts and conversations around the problem and its solution. Furthermore, it allows everyone involved to occupy a common mental space. It facilitates clear, effective communication between parties, as well as the trust necessary for someone to say “yes, please help us implement this solution.”

Collaborative warmth
If anything, it was this type of trust, collaboration, and willingness to listen that really seemed to follow us around, popping up in every department we visited and every interaction we had during our visit at Mayo. The commitment of the people who work here to coming together to provide the best care possible is remarkable. Though we were warned about the cold weather before we came to Minnesota, it ended up feeling like one of the warmest places we’d ever been.  

Incredibly enough, the longer we were here, the more this united spirit really seemed to start resonating throughout the clinic physically. From the moment we walked in, it was impossible not be struck by how surprisingly beautiful the Mayo Clinic was. Over time, as our appreciation for the atmosphere of Mayo grew, the wide open atriums, softly waving glass walls, and marble hallways became spaces that atmosphere filled and thrived in. One of Kajsa’s favorite memories of our time here was inevitably the five minutes she got to sit in the Center for the Spirit, a soothing resource patients and their family members can use to absorb some calm and caring while they’re going through difficult times in the clinic. Walking through any part of the clinic, surrounded by art and serenaded by a live piano, we couldn’t help but feel that we might not mind having to be patients here, if the occasion ever arose.

Small-town insights
As we explored the rural surroundings of Rochester, the warmth and connectedness we’d felt inside the clinic proved to be endemic of the people in this area as a whole. We got a good dose of this Minnesota Nice while we tagged along with the team to the towns in Dodge County, getting on-the-ground experience with design research. Our first day, we dropped in on a small restaurant called Country Pleasures and, while chowing down on sandwiches and watermelon, got the inevitable, “Y’all aren’t from around here, are you…I don’t recognize your faces.” The small town feel touched us in other ways as we stopped in Kasson, Dodge Center, West Concord, and Hayfield. We sipped coffee amongst the locals at Omar’s Cafe, treating ourselves to fresh-baked, home-made cinnamon rolls before popping in on the senior center’s holiday party next door. We chatted with the brunch and coffee crowd at Daniel’s, and listened as they reminisced about the old days (when Kasson had 7 grocery stores and 3 new-car dealerships) and shared their hopes and dreams for the community to grow and strengthen.

Not only did we find out that Dodge County led the nation in Relay for Life donations per capita, we learned that the community got a troupe of volunteers together and built their own golf course. Sure, sometimes we got that half-joking accusation, “So what are you tryin’ to sell me?” Sometimes even, “Gonna try to make me pay more taxes, huh?” But through it all – driving from town to town, just sitting down and really listening to people –we immersed ourselves in the community. We saw and heard and felt the warm undertones of pride in all of our conversations. We collected dozens of stories that spoke to peoples’ generosity and the spirit of volunteerism that gave the whole community its profound strength.

It’s amazing how the simplest insights can change your entire perspective on a project. It’s even more amazing that this kind of research isn’t always done before delving into such an endeavor. Wanting to provide social services as part of a larger health care perspective is one thing, but knowing how to best deliver these services – actually knowing what a community wants and needs – is another thing entirely. That kind of intuition and familiarity could not have been captured by surveys or questionnaires or literature searches online. The real complexity of community is flavored by coffee chats, senior holiday parties, and an appreciation of what the community has been, who they are, and where they’re going.

A future of innovation
In between trips to small-town Minnesota, multi-million-dollar grant meetings, and conversations with brilliant people, there’s no doubt that unbeatable opportunities lie within Mayo’s 15 million square feet (and, of course, we plan to do everything but beat down the doors to try to take advantage of all of them). But we’re taking a lot back with us to Chicago as well.

As students on the long and winding road to a career in serving patients, we’ve been extremely lucky to have had the experiences we’ve had. Working with Health Leads pushed us out of the bubble of healthcare as medical care and forced us to think about the social determinants of health. Two plus years of experience taught us to question the systems by which care is delivered, and to think more critically about the parts of the patient perspective you’ll never see unless you solicit more information about the patient’s context. Trying to build our own Health Leads version 2.0 keyed us in to how important institutional infrastructure and culture are to designing and implementing change. We blew up ideas, connected with a community, and dreamed up experiments to inform social service interventions at the CFI – all in service to patients.

Experts in design thinking we may not yet be, but we leave with the warm and fuzzy feeling that our experiences will be put to good use in the future. These past 10 days have been invaluable to our education not only as (hopefully) future physicians, but also as people. Whether we’re developing a new program, learning to become doctors, or just being receptive to design thinking, the ideations of innovation will always inform the way we approach the world.
  
Thanks, CFI. It’s been real.

 

Erica Ting and Kajsa Nichols-Smith are seniors at the University of Chicago and part of the Chicago Health Leads team.  Perry Erdahl, Sr. Project Manager and Allison Verdoorn, Service Designer, both from the Center for Innovation, met them during a site visit to Chicago and had wonderful engaging conversations with them about their work and the CFI approach to design thinking.   The CFI methodology peaked their interest and they contacted the Center wondering if they could spend their winter break at CFI learning more.  For the past two weeks their time here has included shadowing designers, spending time at the medical school, site visits, interviews, many meetings and great collaboration.

Once they graduate from the University of Chicago they are both hoping to attend medical school after a year off. We wish you well, stay in touch!

 

 

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By admin | Posted in Designer | Comments (2)

Experimenting with Flying Cars

December 5th, 2011 - 9:37 am

Recently, I spent a few hours with a neurologist and a neurology RN in a quiet room making 15 minute phone calls to patients.  These patients were scheduled to be seen at the clinic a few weeks later.  We were calling to see what we could find out from them beforehand to better plan their visit.

Our hypothesis: Getting the right information from the patient at the right time will help us get them to the right providers, for the right reasons, also at the right time.

Our vision: Create services and systems that will enable a seamless experience for both patient and provider from making an appointment through returning home to their life and home providers, with information transfers from both patients and care providers, being critical to this success.

If we are successful, our final solution will look nothing like what we did that morning which was the three of us in a room, the EMR, and a phone.  That was just the quickest, easiest way for us to start to get there. This is the value of embedding design in a system as complex as health care:  We can just go ahead and try something, experiment with a larger vision in mind, knowing the small wins and failures can get us somewhere big.

Our insights from these calls concluded that, YES, we could more efficiently and accurately plan patient itineraries if we checked in with them before their visit.  We also realized that if we asked them “What do you want out of your visit here?” we had a much more productive conversation than if we simply asked them to review their symptoms.  Perhaps the biggest win from this small experiment: Almost every patient reported that their call made them feel more confident coming in for their visit. 

Patient confidence can lead to more productive and direct conversation in their visit, and more of a feeling of ownership of their care plan.  That makes for a more complete, cost effective and overall successful system for all stake holders.

We have a long way to go until we get to our final service, system, or product, fully integrated into the clinic.  The great part is we already have physician leadership support to do the right thing, in the most appropriate timeline, for the most sustainable solution.

Our physician leader for this project, and for the larger institutional initiative under which it lives, asked our team the other day for “Flying Cars.”  He wants us to bring him big ideas and take the time to experiment until we get the right parts in place to make them hum.  It’s not a perfect process, but it works to bridge design and health care.  Health care is a tangled web, and it takes time, flexibility, and collaboration to get it right.  Design, when given the access and time to experiment, can do that.

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By Dana Ragouzeos | Posted in Designer, Experience | Tagged , , , , , , , , | Leave a comment

With Excitement and Anxiety

December 2nd, 2011 - 2:26 pm

As are most moments in my life, the prospect of moving back to New York has been marked somewhere between the spectrum of anxiety and excitement—depending on the day.

A little over three years I came to Mayo Clinic for the position as a designer/researcher. I didn’t realize that I would be as moved as I am. Just as others, most of the designers came from the coasts.

Whether we were excited or anxious to experience life in the American Mid-West, we uprooted and came here for a job. I was surrounded by passion for three years– passion for people and passion for change.

And in thinking about this moment of transition, I conducted a small exercise. My last request of my colleagues was to send me an image of what represents transition to them. Here were the results:

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By Caroline Lu | Posted in Designer | Leave a comment

What horse puppets have to teach us about prototyping…

November 30th, 2011 - 6:30 pm

Over Thanksgiving weekend I had the opportunity to see the play Warhorse. It was nothing less than transcendent. No disrespect to Steven Spielberg who has the movie version coming out in the next few weeks but the challenge of creating an emotional resonant character who is a horse on a stage is infinitesimally more difficult than creating that character on film. And when I found myself poised at the edge of my seat, seconds from bawling my eyes out, at the conclusion of a play that couldn’t follow a more traditional narrative arc if it tried, I took this as a sign that there were lessons to be learned in this moment.

If you aren’t familiar with the horse puppets in Warhorse, now may be a good time to check out the TED Talk that the Handspring Puppet Co did earlier this year.

Now that you’re back (amazing, right?!?!)….here are a few thoughts that came to my mind after I saw the play. In some ways, a play is not dissimilar to a prototype.  It is a way of allowing an audience to experience an idea. The goal may be different – new delivery models vs entertainment – but the intent is the same. So if that’s true, then what can we learn from a horse puppet.

1. Don’t set the goal of creating a version that looks real, aim for a version that evokes the right feelings – regardless of the medium.

2. Asking the audience to do more work can be a good thing. The horses in Warhorse had visible human operators around then throughout the entire play. There was never an attempt to pretend that the puppets weren’t puppets. I think because we were asked to play an active role in suspending our disbelief, the result of that suspension was our reward as much at the performers.

3. Every challenge really is an opportunity. As difficult as prototyping many new health care concepts are, I’m not sure they are more difficult than figuring out how to design a stage play around a horse.

4. Perhaps the new metric for prototyping should be that the prototype wins awards and is more amazing and powerful than the final concept. Like I said, I’m sure Spielberg’s Warhorse film will be great – but I can guarantee it won’t be as amazing as the play. Ahem, I mean, the Tony Award winning play.

 

 

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By maggie breslin | Posted in Designer | Comments (1)

Communication Insights for Large Surgical Departments

November 29th, 2011 - 10:03 pm

“A five minute car ride helped us solve our challenge with resident duty hour restrictions.” That is what a transplant surgeon at Mayo Clinic said when we interviewed him about communication within the Department of Surgery. He told us the story of piling into a car with a group of other surgeons to carpool the short distance from Saint Mary’s Hospital to the downtown Gonda Building for a meeting. These were colleagues he knew and worked with at the Mayo Clinic Rochester campus, but they were from other divisions and it was a rare for them to have a few unstructured minutes together to discuss shared challenges.

When the Department of Surgery asked the Center for Innovation to identify new ways for surgeons to communicate with their colleagues, we began by understanding the context of the problem before we proposed concepts. We conducted interviews with surgeons from across the 10 divisions and observed the spaces in which they worked. The resulting insights took the problem as given (new communication modes) and reframed it into the problem as understood (time pressures, fragmentation, knowledge capture and strategic messaging). We discovered that it was less about adding more communications, but much more importantly about removing the barriers to effective communication.

A primary barrier is time pressure – surgeons’ schedules leave little time for them to reach out and build relationships with colleagues outside of their divisions. In the downtime they do have, significant time is spent sorting through the relevant and irrelevant messages in email inboxes rather than engaging in meaningful conversation with colleagues. The email problem is due in part to the primitive mechanisms Outlook provides for prioritizing and organizing exchanges. It is also exacerbated because email is the only mainstream digital communication option. Imagine every time you wanted to say something to someone, you had to write a letter. That is how we are using email today. A robust digital communication framework at the institutional level would alleviate the email burden by channeling short messages, questions, and knowledge sharing to more appropriate platforms: instant messaging, chat rooms, forums, and texting are currently used, but in an uncoordinated, ad hoc way by early adopters.

The barrier of time pressure also leads to the fragmentation of the surgeon community. New surgeons who join the practice have little time or incentive to build relationships with other surgical disciplines beyond their immediate surroundings or with other Mayo Clinic sites. Mid-career surgeons expressed a sense of loss for the days of a close-knit surgeon community, a loss due in part to the rapid increase of the department’s size coupled with the unintentional acceptance of email as a proxy for meaningful conversation. The informal matrix of relationships that face-to-face communication afforded in the past has been underappreciated and undervalued as a component of maintaining an integrated community of practice. Efficiency and utilization are easier to measure, but as we spoke with the surgeons, we came to understand the important role that the quality of communication and relationships play in creating a network through which knowledge can flow.

The diffusion and application of new knowledge is a challenge across the health care delivery system. The microcosm of our department of surgery is no exception. Our interviews and observations highlighted the need for a more cohesive approach to capture and apply new knowledge across the divisions. Each division uses its intranet home page in a different way, with varying degrees of success and support. An effective, integrated framework for online communication and collaboration does not yet exist. There is a declared commitment to collaboration as a core value of the practice, yet the tools available perform poorly and the resources needed have not been operationalized into a formal expectation.

To address these challenges of time pressure, fragmentation, knowledge sharing, and strategic messaging, we offered concepts for prototyping to the Department of Surgery. Ideas were generated through a series of stakeholder brainstorming sessions, and a book of 14 concept themes was developed. Concepts were organized onto a communication framework and rated on their potential to impact the identified challenges. Each concept theme proposed a set of ideas for prototyping that started with small, simple, tactical approaches that built toward a bigger vision that would require longer-term planning and a broader union of forces to create.

A year after the delivery of this concept book to the Department of Surgery, there has been prototyping activity within several of the themes, including Active Meeting. In response to the identified need for unstructured time to allow informal networks and familiarity among surgeons to grow, the first department “Un-Meeting” was held. Instead of a full agenda and lecture hall seating, the department’s 80 surgeons in Rochester gathered in a collaborative space to discuss the burning issues of the day. There was no agenda; instead they organized themselves around the topics that emerged and participated in the discussions they found the most beneficial. This first “Un-Meeting” received high reviews and a second is planned before the end of the year.

A self-identified surgeon “geek group” formed to explore the opportunities presented in technology-based themes of Build It, Make it Easy, and Ask Email Expert. Rather than start from scratch, we connected this group with other areas at Mayo Clinic that were actively working on related projects. Radiology’s Project RADAR, a 2009 CoDE internal innovation award winner, is a clinical practice-driven, online platform that responds to the real-time communication and knowledge needs of individual staff members as they coordinate the flow of patients and tasks involved in the imaging process.

Group Work, Cross Pollination, and Make Space were concept themes based on activities driven by strategic objectives and workspace environments driven by group work. While they offered simple ways to start small through prototyping, these would require institutional support for the space and time needed to build toward the vision proposed. There is a growing activity around operational support for broader collaboration through both explicit expectation and implicit permission. Special councils of cross-disciplinary and cross-site teams continue to form to support enterprise-wide efforts toward best practices and diffusion in many areas. Institutional readiness is a key factor, and as these concept themes wait in the wings, they may morph through informal networks, and may emerge, unrecognizable in unexpected places.

Designing within systems means that the correlation and resonance with proposed concepts is more observable than straightforward cause and effect. We cannot offer up proof today that these concepts will lead to better communication among surgeons. However, in Roger Martin’s words at Transform 2011, we can make the “logical leap of the mind” to arrive at the hypothesis that surgeons who work in a context that actively values and makes space for meaningful, collegial relationships will communicate more effectively and work more cohesively as an integrated community of practice.

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By Rose Anderson | Posted in Designer | Tagged , , | Leave a comment

Care Plan Insights

November 27th, 2011 - 12:07 pm

What is a “care plan” from our perspective as patients? We understand how care plans help health care teams coordinate patient care, but how do we create care plans that are meaningful to us in our everyday lives? A multidisciplinary team at the Mayo Clinic has been working with the Center for Innovation (CFI) to begin to answer this question.

The Care Coordination and Care Plan team began by sharing their observations from qualitative interviews and shadowing with clinic colleagues and patients. Representing a variety of disciplines and areas within the clinic – nursing, primary care, hospital staff, technologists, physicians, designers, systems analysts, content developers, and usability experts – they also each brought previous, related work from each of their areas. The CFI’s Community Health Transformation team synthesized the group’s knowledge and observations into a set of care plan insights. These 13 insights capture the team’s definition of an effective care plan with an emphasis on the patient perspective.

Most importantly, the care plan needs to be “real” to people for them to use it and act on it. Knowing the role that a strong social support network plays in health and well-being, a comprehensive care plan encourages people to think of their care team beyond just their health care providers. It enables care decisions to be made collaboratively with patients and among multiple, invited stakeholders, including remote family members and social service resources. An effective care plan acknowledges that people are part of families and it enables patients to engage their friends and family in supporting their plan.

An asset-based, rather than a deficit-based, care plan supports goal-setting by using the fundamentals of wellness coaching. It focuses on achievements and patient-important outcomes more than failures to meet clinical numbers. It is part of a learning system, which blends the Mayo Clinic shields (practice, education, and research) at the point of care to continuously increase and deliver knowledge about what works for individuals and what may work for people similar to those individuals.

A care plan is intelligent in the way it presents information to different users – patients, caregivers, nurses, physicians, hospitalists – knowing that they each have a different role to play, with different information needs. It serves this knowledge up, at a glance, and just-in-time; built from the ground up for present and future integration into databases both inside and outside of Mayo Clinic. Rather than driving workflows, it is a tool that is responsive to the emergent interactions between people and the service relationships that technology alone cannot fulfill.

These insights are the foundation for what kind of care plan the Care Coordination and Care Plan team will develop. True, this vision feels big, maybe even overwhelming. However, by starting with divergent thinking, acknowledging that the care plan is part of a larger, complex system, and by “thinking big” the team has set this project on a path to deliver not only the expected, but to potentially deliver an unexpected, higher impact breakthrough as well. The Center for Innovation approaches its work with this “think big, start small, move fast” philosophy. The Care Coordination and Care Plan team’s next step will be to “start small” by translating these insights into early, rapid prototypes created to learn and to test assumptions.

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By Rose Anderson | Posted in Designer | Tagged , , , , | Comments (6)

In”Mo”vative

November 23rd, 2011 - 5:11 pm

I believe that Movember has to be one of the best public awareness campaigns out there. My colleague Ryan Rosenweig introduced me to it and I said “why not?”

As someone who rarely goes more than 3 days without shaving (and even then, only on the weekend, when no one will see me in a professional capacity) this is a commitment. When you take into account the fact that I am even forgoing kisses from my wife until I shave, you get a better sense of the grandeur of the commitment I have made.

But why would I do this? Why is this campaign so powerful?

  • It’s personal. I wear it on my face. I talk to people about what I am doing.
  • It’s simple. All I have to do is nothing—as opposed to the something (shave) that I usually do—to get asked about it.
  • It’s social: I wouldn’t have done it if Ryan hadn’t also committed to doing it, and I continue to participate because I know he will continue fostering his meager mo’
  • It’s multi-tiered in its levels of participation: you can wear facial hair, or you can contribute money. In my case I am not paying money, but sacrificing (postponing) physical affection from my wife.

This is an innovative campaign. It is a multifaceted experience that would do Doblin’s 10 types of Innovation proud.

Here’s our invitation to you:

Hi,
As you know it’s Movember, Ryan and I (and there is still a chance for Jey and Perry!) have have joined the movement and will be donating our upper lip to the cause.

Our facial hairs have already generated some laughs, but it’s all in the name of raising vital awareness and funds for cancers affecting men.

As you know, I promised this morning that the top contributor to Matt’s page will get to choose the moustache that graces Matt’s face for the week of November 28. Please recognize that the length and placement of his facial hair may dictate the styles available (he is currently pushing somewhere between 1/4 and 3/8 in length). Final decision is made Monday at 5:00. The moustache will remain intact until Friday December 2.

And Ryan promised that if his donations beat out Matt’s, he will show up at his brother’s wedding with it still intact.
Choose whichever sounds most appealing to you.

Why are we so passionate about men’s health?

  • 1 in 6 men will be diagnosed with prostate cancer in  their lifetime  
  • A man is diagnosed with prostate cancer every 2.2  minutes  
  • 1 in 2 men will be diagnosed with cancer in their  lifetime  
  • 24% of men are less likely to go the doctor compared  to women  

Please support Matt’s efforts by making a donation at http://mobro.co/MonsieurGardner
Please support Ryan’s efforts by making a donation at http://mobro.co/MrBearcat

(Movember is a registered 501 (c)(3) charity, donations are tax deductible to the extent permitted by law.)

Sincerely,

Matt and Ryan

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By Matthew Gardner | Posted in Designer, Experience | Tagged , , , , , , | Comments (1)

Mapping Community Needs – Understanding Gaps and Access Barriers

November 21st, 2011 - 7:09 pm

The Community Health Transformation platform team has been working on developing a tool that would allow for evaluation of an individual’s level of connectedness with community health resources. The tool is a further development of the Social Determinants of Health developed by Dahlgren and Whitehead in their 1991 Policies and Strategies to Promote Social Equity and Health. 

This tool aids in understanding the latent needs of communities by taking a holistic view of an individual’s or community’s health. The tool provides an ability to analyze the community resources that are available and accessed to contribute to an individual’s health and well-being.

To evaluate an individual, one places that person in the center of the tool. The resources present in the innermost ring represent those that are vital for functioning normally with society, such as stable housing, a reliable income and guaranteed healthy food. As that individual is unable to find resources to fulfill the needs contained within that innermost ring, the outer rings represent social service programs within a community that may catch a people as they fall through the first ring.  As the rings move further outward, the resources become more remote and less personalized to the individual.

By mapping multiple individuals within a community or population and overlaying the tools, one can understand the resource gaps within a community as well as perceived barriers to access for individuals.

Community Health Platform team: Allison Verdoorn, Mary Severson, Rose Anderson and Douglas Wood, M.D.

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By admin | Posted in Designer | Comments (4)

The People Who Inspire Us

November 3rd, 2011 - 10:08 pm

For design week, we were asked to print out images of people who have influenced our work. The selections ranged from fellow employees, patients, to artists and authors.

One nurse’s holistic philosophy to patient care, her tenacity and willingness to learn influenced two of our designers. Lorne Michaels, of Saturday Night Live, to another colleague, “has influenced me in seeing that humor can be formed in so many types of situations and can help to handle tough and bad situations. It also has helped me to see the humanity of influential people.” Another colleague said that her 2nd grade teacher taught her to love to read. For me, Eric Weiner’s approach to writing about happiness in his book, The Geography of Bliss, influenced me in that he did not try to define happiness, but rather left his readers with an open ended question for me to define.

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By Caroline Lu | Posted in Designer | Tagged , , , | Comments (1)