Tuesday 16 September 2014

The IDEO Design Challenge

The Design Track for ePatients at the Stanford Medicine X Conference this year was an experience that demonstrated the value of teamwork. Where else could you see a cardiac surgeon, a researcher, GP doctors and a venture capitalist working with a patient to find answers to a health problem posed by a patient?

This is the way the challenge worked: two months before the MedX Conference the patients involved submitted problem statements to Dennis Boyle and his team at IDEO; participants got a (helpfully) pared down list back with requests for clarifications. We also received background links about design thinking and a copy  of the book "Creative Confidence: Unleashing the Creative Potential Within Us All".

To start our day at IDEO we had a tour. The company has done amazing work in design and their workplace is full of people doing work that they love. Then we broke up into teams and I presented my 'How Might We' problem statements, that are a hallmark at IDEO. We had a terrific facilitator, Tanya Rinderknecht, who nudged our team back on track when we started to get too ambitious in expanding the areas we wanted to cover.

In design thinking there is much consultation and questioning with the users of the potential solution. The statement the team chose to work on was "How might we convey new symptoms to Doctors and be believed. I find that when symptoms don't fit the mold, it's back to the same round of doctors for the same verdicts and no progress."

Through the intensive questioning, brainstorming, conceptualizing and prototyping the whole team kept on moving ahead and making steady progress. What we came up with as a solution was a patient toolbox. Each team presented at the end of our IDEO day: All five patients involved presented on the main stage at MedX on Sunday, outlining what we learned,  as well as describing our prototypes - everything from a new way of finding your path with chronic disease to a video demonstration of a new online tool.

I was happy to have one of the Tools we devised to demonstrate with me on stage. Here are the signs we made to facilitate communication with doctors in certain situations. (I  would want to have a good relationship with a doctor before I started to use these unexpectedly.)  Doctors could adapt signs like this to use in their practice as a way to enable patients to have more input and better conversations during their appointments. Some issues of concern that seldom arise might then be discussed. With these signs health literacy is not an issue.

Here they are with some short explanations:

Studies show that patients are usually interrupted by the doctor within 11 to 18 seconds. This is a "Please don't interrupt me so soon"

Yes, I am interested in that treatment but what about side effects?

"But doctor I'm in pain. Can you help me?"

"Please slow down. I need to understand."

"Will this affect my sex life?" (a difficult topic for some doctors to raise)

Yes, I'll try this for now, but what about the future?"

"Doctor. You've got it. Thank you."

"Thumbs up on a great job." (Note: This can be turned upside down when appropriate)

You can feel free to copy these pictures for your own signs, or use them as the prototypes that they are. I've already had a suggestion for another sign: A picture of a brain and the words "I have a brain." Feel free to add more sign ideas in the comments.

We also produced a jargon buzzer, a board game to enable goal-oriented planning between doctor and patient, and an the use of an attention getting flashing light that was demonstrated by Dr. Marc R Katz in the most memorable picture of the day.

There he is happily preparing to play the role of a difficult patient. His iPhone acted as a strobe light that would only stop when felt he had a way forward or a level of comfort with the planned treatment.

I was the one who played the Dr as we acted out our prototypes and finally was able to articulate the answer that satisfied him when we had no diagnosis or way forward. Once I said "We don't have an answer for you yet, but we'll work together until we solve this" he turned off the strobe.

Dennis Boyle of IDEO graciously gave the go ahead to post these signs. Our team produced two more tools and the lessons I learned based on this experience were illuminating.

At the end of the day I thought my team was brilliant because our prototype tools to improve communication between doctor and patient were simple and effective. However when I wrote the presentation of our results for the main stage, I realized that the whole team that was responsible for our prototypes,  included the patient

That lesson has stayed with me and guided my actions as an active patient advisor ever since then. 


  1. I'd vote for the "I have a brain" sign! Wow - how did you get involved in all this, Annette? I guess it helps living close to a big city. Although a big city is across the water from me, it's just too much energy and expense to think about going there.

    Do you have any posts on your background on how you got into the whole MedX thing, and maybe links about what it's about (I realize this may be a post in itself, so feel free to answer as you're able).

    I do agree that I would not spring these signs on a doctor unannounced. Most doctors I know would feel threatened and/or annoyed by my cheek at communicating! How wonderful it would be if they became a standard!

    I'd like a "You're not listening to me." and a "Yes I look well because I am adept at hiding my pain". :)

    Thanks as always, Annette. xxxx

  2. Love the idea for "I have a brain" and the funny thing is I just bought a skull with a removable brain so I am ready for that one.. And the other is perfect too "I worked hard to look this good" I saw a pain chart for a chronic patient. All of the faces were smiley faces. You can get so good at hiding it that people can't tell.
    Summerplum, on the MedX pain panel that CarlyRM moderated, said that she does not feel pain the same way anymore - she has to rely on physical manifestations and blood pressure to judge her pain levels.

    I got into MedX at first by watching the livestream last year. It impressed me because it was so patient oriented and the people who were presenting were so smart in original and meaningful ways. When I thought of applying, it actually took a push from someone who had been there and urged me to apply. It was a goal and now I want to go back.
    I have been to conferences in the past where the designation patient on your badge guaranteed that many people would not talk to you. On Monday I go to #PX14. It's a patient experience conference. Sometimes you see that type of conference with no patients at all, so this looks like real progress I'll let you know.

    I have 5 posts tagged MedX and two tagged Stanford MedX. They might overlap