Slownovation in Healthcare? Atul Gawande travels back in time through the lens of the history to uncover biases in sociotechnical practices and finds an archetypal problem: Fixation on technology, while ignoring the simple field fix. He compares two medical practice innovations from over 150 years ago, in the recent New Yorker article Slow Ideas. The invention of general anesthesia allowed doctors to spend enough time working on a patient to actually get the job done. Modern surgery was impossible without it. But nearly coinciding with this invention was the discovery of antiseptic (and thereby sterile technique) by Joseph Lister. Using carbolic acid to clean hands and instruments saved patients the horrible death by infection following a reasonably successful surgery in the late 1800’s. Dr. Gawande asks “why did it take so long for antiseptic practice to diffuse into practice?” Its a good question. Read it. Then solve the puzzle for …
Challenges & Opportunities of Healthcare Innovation Centers
As an innovation research consultant working with healthcare services, I’d say one of the most significant trends in the last two years has been the creation of multidisciplinary, cross-service healthcare innovation centers. In a recent interview with Clinical Innovation and Technology magazine, I learned about their recent issue which featured this trend and revealed new developments I had not encountered in my book research (most of which was more than two years ago!) All Rise with Innovation (by Beth Walsh) A number of US institutions are establishing innovation centers for organizing clinical and knowledge competencies across the organization for internal enterprise-wide impacts. While some of the rationale for their development is attributed to the changes caused by the Affordable Care Act, some hospitals are getting into innovation because others are finding it valuable. In another article in the same issue, Lyle Berkowitz supports my thesis in Design for Care by …
(What can we change with) The Care Design Network?
Design for Care was written with the help and advice from a book development community (on the Ning platform). Recently converted to a practitioner hub, the Care Design Network offers a full-featured online community for continuing with the journey of design engagement. The previous URL designforcare.com now points to the Rosenfeld Media site for the book. But wait, don’t buy the book on Amazon! The publisher site offers a better deal, providing the print book plus digital versions for PDF, ePub & Mobi. The community hosts about 500 people now, from around the world, but primarily North America. The intention is to enable design practitioners, researchers, consultants, and healthcare professionals to find each other’s good work, learn from one other, and post events and opportunities for projects or conference teams. I will be giving ongoing talks and workshops related to the book, and with the book writing done, I will …
The Unintended Consequences of Uncaring Automation
I’m completing the final sections of the manuscript for the two-year project researching and writing the Rosenfeld Media book Design for Care. A central theme weaving together the 8 chapters is systemic design, the adoption of a whole system (social cybernetic) approach to the complex design situations in healthcare. Variations in this thinking range from the medical competency of systems-based practice to the “whole human” perspective recently promoted by the emeritus U London professor BM Hegde. Where we must insist on systemic design is in the design of systems, specifically in the integration of enterprise level IT in clinical practice. One of the more heavy-handed systems problems clinics and healthcare professionals face is the introduction and integration of electronic medical records (EMR) systems. While some of these systems are better than others, they can significantly divert clinical organizations from a patient-centered care model. They are a quite a boon to …
