In this Strata RX presentation, Jen van der Meer of Luminary Labs challenges health tech startups to design for a higher aim, offering 8 design principals to enhance the lives of the patients they serve.
4. DOES THE TRIPLE AIM SEEM
UNATTAINABLE
Improve
population health
Improve the
patient experience
@JENVANDERMEER
Reduce the per capita
cost of health care
6. Meaningful use.
Accountable care.
Can we set the bar higher?
The names of the following incumbent
EMR/EHR providers and the names of patents
and doctors are redacted to protect privacy and
mediocrity.
11. So here come the startups.
The internet kids.
To the rescue.
Full disclosure: I am one of those kids.
@JENVANDERMEER
12. To change the world.
And we actually think this way –as if we could
hold the world in our hands. More ego-maniacal
than surgeons, we are.
We come, inspired.
And improve human lives.
15. We get too excited about startup
traction, not excited enough about
evidence-based outcome
Paul Graham’s Startup Curve
16. We have a huge learning curve to
figure out how to disrupt the cost curve
Data: OECD Health Data 2005 and 2006. Commounwealth Fund National
Scorecard on US Health Performance 2006.
19. @JENVANDERMEER
For each solution born onto the
health tech scene, we ask:
Are patient’s lives enhanced by the addition of data?
Do doctors become more wise?
Do nurses feel more empowered?
Do spouses know how to effectively intervene?
Do adult children of aging parents get more time in their
overly stretched days?
And do these collective interactions actually result in
improved population health?
43. You have the right to not be sensed
From: Seven Principles for Big Data and Resilience Projects. 9/23/2013
By Kate Crawford, Patrick Meier, Claudia Perlich, Amy Luers, Gustavo Faleiros and Jer Thorp
2013 PopTech & Rockefeller Foundation Bellagio Fellows.
44. Even if the value of that data delivers a
larger public good
45. Startups will not necessarily learn the
difference between Informed consent and
permission marketing
ARIELY: We need to simulate a better future mental state for remembering. Data entry is not that simulation.
Intrinsic information seems increasingly at risk
Problem solving as pattern completion
Alertness and resilience
http://www.eecs.wsu.edu/~cook/pubs/ieee13.pdf
A Survey on Ambient Intelligence in Health Care Giovanni Acampora, Member, IEEE, Diane J. Cook, Fellow, IEEE, Parisa Rashidi, Member, IEEE, Athanasios V. Vasilakos, Member, IEEE
HT: @lily
ARIELY: We need to simulate a better future mental state for remembering. Data entry is not that simulation.
Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people’s capabilities
by the means of digital environments that are sensitive, adaptive,
and responsive to human needs, habits, gestures, and emotions.
Context Aware: It exploits the contextual and situational information.
Personalized: It is personalized and tailored to the needs of each individual.
Anticipatory: It can anticipate the needs of an individual without the conscious mediation of the individual.
Adaptive: It adapts to the changing needs of individuals.
Ubiquity: It is embedded and is integrated into our everyday environments.
Transparency: It recedes into the background of our daily life in an unobtrusive way
http://www.eecs.wsu.edu/~cook/pubs/ieee13.pdf
A Survey on Ambient Intelligence in Health Care Giovanni Acampora, Member, IEEE, Diane J. Cook, Fellow, IEEE, Parisa Rashidi, Member, IEEE, Athanasios V. Vasilakos, Member, IEEE
From Ambient Commons:
Soldiers and surgeons alike tend to prize their “situational awareness.” The ability to read a context on the fly can mean life or death to these experts. Where a merely competent person would play by the rules, and expert knows when not to and directly plays the situation.
Andy Clark (philosopher and cog scientist) and David Chalmers (philosopher) call embodied skills “the extended mind” or “extended cognition.” Engaged action occurs in “memory as pattern re-creation instead of data retrieval; problem solving as pattern completion and transformation; the environment as an active resource, and not just a domain problem; and the body as part of the computational loop, not just an input device. _
http://www.aami.org/publications/bit/2012/JA_alarm_fatigue.pdf
Monitor alarm fatigue: An Integrative Review. Maria Cvach, John’s Hopkins Hospital.
http://www.farmpd.com/Portals/53820/images/auditory-perception-3.jpghttp://www.aami.org/publications/bit/2012/JA_alarm_fatigue.pdf
The constant beeping of alarms on patient monitors desensitizes caregivers, causing them to ignore or even disable the sounds that signal that patients may be in danger.
Today healthcare is episodic. Care happens in the doctor’s office, with big gaps between visits. It’s an incomplete picture. But what if we could fill those gaps with data from the sensors in your phone.
This information helps us better understand the relationship between behavior and health.
http://irevolution.net/2013/09/23/principles-for-big-data-and-resilience/
Eliminating “preexisting conditions” under accountable care does not lead directly to people wanting to openly share all of their health data.There is still social stigma, fear that such information could make a person un or less employable or less desirable as a mate.
This is critically important for new entrants in health tech – health has room for emergent outcomes, but not mercenary moral relativity.
Asthmopolis propeller
Permission marketing is the privilege (not the right) of delivering anticipated, personal and relevant messages to people who actually want to get them. _Seth Godin
Informed consent is a process for getting permission before conducting a healthcare intervention on a person.
Internet kids need to pause before jumping in with nudge experiments and behavioral economics hacks.
And not continue on the slippery path of moral relativity as it relates to personal privacy.
There is much more at stake when we build these systems with our health in mind.
Increased chart reviewing led to decreases in patient understanding, possibly because this activity interferes with making eye-contact and communication in general.
http://www.sciencedirect.com/science/article/pii/027795369400155M
Goals for ambient intelligence:
facilitate human contact.
oriented towards community and cultural enhancement.
help to build knowledge and skills for work, better quality of work, citizenship and consumer choice.
inspire trust and confidence.
be consistent with long term sustainability — personal, societal and environmental — and with lifelong learning.
be made easy to live with and controllable by ordinary people.