The iBeacon from Apple is intriguing — how might it be used in healthcare?


SOURCE:  Apple

According to Apple in December 2013, when it was announced:

iBeacon is a new technology that extends Location Services in iOS. Your iOS device can alert apps when you approach or leave a location with an iBeacon. In addition to monitoring location, an app can estimate your proximity to an iBeacon (for example, a display or checkout counter in a retail store). Instead of using latitude and longitude to define the location, iBeacon uses a Bluetooth low energy signal, which iOS devices detect. To learn more about Bluetooth technology, see the official Bluetooth website.

To use iBeacon, you need iOS 7 or later, Bluetooth turned on, and a compatible iOS device:

  • iPhone 4s or later
  • iPad (3rd generation) or later
  • iPad mini or later
  • iPod touch (5th generation) or later
  • You can control which apps and system services access Location Services data, including iBeacon: Tap Settings > Privacy > Location Services.

Healthcare has many vast bricks-and-mortar facilities where we might aim to keep track of providers & patients– not in an inappropriate way, we’d posit– just to ensure the right folks are connected at the right time in the right place.  Think of it this way:

“We need Dr. Jones in Room #14– where is he now?”

Or “We’re ready to see the patient with initials P.R. — where is she now in the building?”

While much of the buzz about iBeacon has related to retail, whereby one could (as an example) get an electronic coupon on the fly, I think there are myriad potential compelling uses in… the medical arena.



SOURCE:  Apple

Thus, inventors everywhere– have something we could consider?

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Pre Spike

Remember the movie Minority Report?  It explored the notion of “Pre-Crime.”


indexSource:  Warner Brothers

There’s an analogue in healthcare– getting to “Pre Spike.”

Think about it– traditional medicine is about a human encounter typically at the time your symptoms pop outside the norm, or AFTER this happens.  Often, you hear the platitude “if we had only caught this earlier….”

That’s why today is the very best time to be a doctor.  In the pre-mHealth era, doctors spent voluminous time COLLECTING the dots (data) … so they could then CONNECT the dots (figure out what’s wrong with you), so the right therapy can ensue.  I imagine this might have been 80/20– with the 80 being dot-collection.

Leaving far too little time in the average seven-minute appointment for the discovery.

Now, as the Tom Cruise character represented in Minority Report in the scene depicted above, there will be plenty of More

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What Takes 4000 Mouse Clicks?



Answer:  A ten hour clinical shift in the Emergency Department.

Recently I ran across 4000 Clicks: a Productivity Analysis of Electronic Medical Records in a Community Hospital ED.  There are some fascinating stats in this paper about EMR use in the Emergency Department:

1.  44% of clinical time in this Emergency Department was spent on data entry into an EHR, nearly double the amount of time spent on patient contact.

2.  It takes 6 mouse clicks to order a 325-mg aspirin.

3.  It take 227 mouse clicks to complete an ED encounter for right upper quadrant abdominal pain.

Makes me wonder, how many mouse clicks did it take you to read this blog post?  Or pay your bills online?

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Hacking Healthcare

What happens when you teach first year medical student to code and be entrepreneurs?

Answer: Great prototypes of original ideas on volunteering in hospitals, choosing a doctor for a virtual visit, and visualizing the business health of a medical practice.

At the advice of a long time friend, I decided to teach an eight class selective at Georgetown University School of Medicine called “Hacking Healthcare.”  I would teach medical student front end web coding.  Besides specializing in Emergency Medicine, I consider learning to code HTML/CSS/Javascript to be one of the turning points in my career.  Coding let me stop being strictly an “idea guy,” and rather become an agent of implementation.  I wanted to share this ability to make ideas happen with a new generation of medical students.  Most medical professionals are great at analysis and criticism, however, few are able to create.  I wanted to teach them to create.

I had four guiding principles More

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  1. Mike Bright: Another instance of microvolunteering in hospitals is this call-out for research on how microvolunteering actions might benefit a patient. http://helpfromhome.org/do-more/volunteer-for-us/promoting-microvolunteering-to-hospitals

Next Big Thing, Predicted: Hydration Sensor



Given how ubiquitous fitness trackers have become (even before fitness watches appear in droves in 2015 and beyond), think hydration tracking next.

About 3.3 million fitness bands and activity trackers were sold between April 2013 and March 2014 in the U.S. through bricks-and-mortar retailers or large-scale e-commerce sites, according to the NPD Group.

But no one ends up in the Emergency Room for being too sedentary…

Consider the Annals of Epidemiology, Volume 17, Issue 9 , Page 736, September 2007, and this article by S. Kim More

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Revisualizing Strokes


Inspired by The Beauty of Health Data contest for the upcoming Health Datapalooza, some of us tried our hands at a few visualizations.

We ran across the NINDS data in an appendix to A Graphic Reanalysis of the NINDS Trial (Ann Emerg Med 2009; 54(3):329-36) and thought it was a gold mine of interesting data.

Hoping to better see the natural history of stroke, we came up with one nice visualization of the data. Since it is animated, we cannot submit it.  But if you would like the check it out, you can on YouTube.  It uses patients who had no neurological deficit before their stroke (approx 550) and follows their NIH Stroke Scale (NIHSS) at a few different data points.  You can see each patient get worse or better throughout the study (at one day after stroke, 7-10 days after stroke, and 90 days after stroke). The y axis is the baseline NIHSS severity of stroke, while the x axis is the NIHSS severity of stroke over time. At twenty four hours, the severity of stroke appears to be all over the board, however, at 90 days, patients tend to get better (move to the left) or succumb (move to the right with an NIHSS of 42). More

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How Medicine Can Learn From Javascript Callbacks

mobile-health-02-smallDid you just execute a callback?

Chances are … yes.  If you use browsers (which you obviously do if you are reading this), chances are you are using “javascript.”  Javascript goes hand in hand with the modern web.  You are using it right now.  And javascript is full of callbacks.

These are not HCAHPS callbacks for patient satisfaction.  Those are important, but for other reasons.

Rather, these callbacks in programming languages like javascript are things that happen when something else happens.  As a real world example of a callback, imagine a doctor in… More

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Recommended Reading for Health Care Innovators

crowdsourced-mindmap-health-innovation-readingWhat’s in your break room?

At the MedStar Institute for Innovation (MI2), we have the usual… a fridge, some cabinet space, a sink, a microwave, a coffee maker (essential), and… a BAWB a huge whiteboard. It is only 3 weeks old now, but so far it’s been great for the occasional inspiring quote, funny doodle, or important message.

As we closed out 2013, though, it began to take on a new, much cooler function. More

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  1. Basem Hammami: Hi, I am a healthcare architect with a passion for innovation in HC design. I came across your site while…

    • Ed Tori: Thanks for the feedback, Basem. Let me know if you come across any great health innovation reading and some of…

Thoughts on the mHealth Summit


The mHealthSummit gets bigger by the year (5,000 attendees from 60 countries this time around), and here are three takeaways from the event just ended, at the National Harbor in Washington, D.C. from December 9-11, 2013:

  1. ENORMOUS:  Increasingly the vendors are BIG.  In mHealthSummits past, the exhibitors typically had highly innovative products, but were not firms you’d recognize.  Now, the names are like this:  Sprint, AT&T, Verizon, Qualcomm, Intel.  Of course, many small companies also participated, and many of these are very well funded given the tsunami of venture capital funds that have hit the beach.
  2. EVIDENCE:  In the old days (you know, 18 months ago), your emblematic mHealth vendor would say “we think our ___ works.”  Now, vendors tend to have More
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@MI2Innovation Making Healthcare Safety Contagious

On October 16th, Allan Fong MS, Raj Ratwani PhD and Sarah Henrickson Parker PhD from the MedStar Health Institute for Innovation Human Factors Engineering group will travel to New York City as one of eight teams selected from over 250 entrants who submitted healthcare innovation projects to the Robert Wood Johnson Foundation Pioneer Project. The team’s project, entitled Creating a Social Epidemic of Safety, aims to harness the power of natural social networks within healthcare organizations to identify those who can influence an epidemic of safety. In their words:

In healthcare, we try change culture through training, meetings and seminars on how to be safe. But we are convinced that at the sharp end of care, where the rubber meets the road,  it’s actually relationships, not lectures or signs on the wall that influence people’s actions.  Previous research in the social sciences has shown time and again how difficult it is to change human behavior; but it has also shown that if people are going to change their behavior, it’s because of the power of social influence…By utilizing technological advances in sociometric measurement and analysis to identify and target social influencers within a healthcare system, we will use their influence to improve safety.


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The Power of Storytelling in Medicine

First published on Educate the Young

In the Co.Create section of Fast Company magazine recently, Jonathan Gottschall, author of The Storytelling Animal, writes about the science supporting story as the most powerful means of communicating in his article, Why Storytelling Is the Ultimate Weapon. He writes:

…Until recently we’ve only been able to speculate about story’s persuasive effects. But over the last several decades psychology has begun a serious study of how story affects the human mind. Results repeatedly show that our attitudes, fears, hopes, and values are strongly influenced by story. In fact, fiction seems to be more effective at changing beliefs than writing that is specifically designed to persuade through argument and evidence…

The more absorbed the reader is in the story being told, the more likely he or she is to be changed by it, according to his research. We know that stories shape entire societal belief systems–and Gottschall uses the example of how we once believed the world was flat. Until Columbus discovered America, people lived in fear of falling off the end of the earth. How powerful is story? More

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8 Must-Haves To Innovate

Incentives for Innovation - Charles Lindbergh and Raymond Orteig
Medical futurist, software architect, and health IT strategist, Dr. Michael Gillam launches his first of many Dispatches from… Somewhere in the Future – Serving as faculty at Singularity University’s FutureMed Program, Dr. Gillam extracts the best of his notes from prior sessions. As a prelude to future posts, he kicks off with 8 Must-Haves for creating innovation in your organization. More

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Activity Tracking, Part 2 of 2

mHealth and Self Fitness TrackingThe #2 and #3 Health app on the iPhone are for those who track their activity– running, walking, biking, etc.  The #2 slot is held by Nike+, and #3 by RunKeeper.

FitnessKeeper, Inc. is the company behind RunKeeper.  They’re based in Boston, and were founded in 2008.

Today they claim 17 million RunKeeper users in more than 200 countries all over the world– and to date the app has only been in English. More

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Congratulations to Code-a-palooza Winners Hippocratic Code (aka MI2 Team)

MedStar Health Innovation Team Wins Code-a-paloozaA team of MedStar Health physicians at the MedStar Institute for Innovation (MI2) recently won an intense, government-sponsored competition to develop a computer-based application that employs multiple sources of healthcare data to help doctors deliver high-quality, low-cost care. The competition, Code-a-palooza, was part of Health Datapalooza IV, held June 3-4 in Washington, D.C., an annual event that brings together a broad coalition of policymakers, consumers and leading experts in government, industry and health care to showcase innovative applications of health data to improve quality and lower costs. More

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Games for Health – Hospital Invaders and HAIs

Hospital Invaders - the Prevent and Eradicate Infection App from MI2The doctor is in… And it’s you.

Scary bugs are descending on your hospital. And depending on what you do, you will either wipe them out or make them stronger.

Once deadly infections are now the target of a fun and exciting game from the MedStar Institute for Innovation (MI2) – Hospital Invaders. More

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Activity Tracking, Part 1 of 2

Fitness Tracking and mHealthFitness Tracking, along with Diet and Exercise, is a Top 3 category in Health & Fitness on smartphones and tablets in America today.

Losing weight is thought to be a two-sided coin, portion control and exercise, and a large percentage of those tracking daily fitness are battling obesity.

Philips, a 121-year old Dutch electronics company operating worldwide, has a small tracker called DirectLife, and the results have been compelling… More

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The Next Wave In Patient Safety? #resiliencemed

Resilience Engineering in HealthcareHealthcare is not a machine to be oiled. It is not something that can be shaved, and tweaked, and optimized to a point of lean flawlessness.

Rather, healthcare is a complex-adaptive system. As such, it’s models for safety and efficiency cannot (indeed must not) rely on the “retrospectoscope” of hindsight. And it certainly, must not name-blame-shame-and-train when handling error or inefficiency. Resilience Engineering may well be the cutting edge of patient safety science. Here’s how you can participate… More

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Good Design, Bad Design – 3 Must-Know Principles

Human Factors and Design - Did You Ever Pull on a Push Door?Have you ever pulled on a door when you should have pushed? How about hitting “Reply to All” when you meant to send it to only one person? Have you ever found yourself having to “think too much” when trying to complete a simple task?

Well, check out this video. It’s not your fault… More

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The Hidden Influence of Our Social Networks

The Hidden Influence of Social Networks - How Might We Leverage Their Power In Health and Innovation?Does the health of your friends’ friends’ friends have any relationship to your own? How about to your outlook on life? Your general happiness or grumpiness? Your approach to problems and opportunities?

In this TED video, Nicholas Christakis, the author of Connected, explores the hidden (and quite powerful) influence of our social networks. More

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Cognitive Illusions: Barriers to Healthcare Innovation?

Cognitive Illusions: Barriers to Health Innovation?In a world of evidence-based guidelines, reams of patient education material, penalties for readmissions, and board rooms full of red and green report cards, many of us quietly wonder… Are we missing something? Because… it just doesn’t feel right.

In this TED video, Dan Ariely, the author of Predictably Irrational, raises the question: “Are we in control of our decisions?” More

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Innovation and Facility Design Workshop

Innovation and Strategic Design for HealthcareThe patients are sicker. There’s fewer staff. Technology is outpacing your facility’s ability to adopt it. Data management systems are being revamped. The Emergency Department is over-capacity. And in the midst of all of this, you must be prepared for larger scale emergency. Such is the plight of ED Directors everywhere.

So, you want a re-design. You want an overhaul. Well, guess what? You’ve got one shot… a one-time opportunity to employ evidence-based physical design strategies. The Center For Health Design and MI2 hear you. More

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Creative Health Innovation Funding

Funding Health Innovation With Crowdfunding Or Through Progressive EmployersAction is a necessary ingredient for innovation. And health innovations are notoriously difficult to fund – often relying heavily on the time-consuming process of obtaining grants or yielding some ownership through venture capital. Well, new opportunities are presenting themselves. Health innovations may be funded through crowdsourcing sites like Kickstarter and through progressive employers like MedStar Health.

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Health Innovation Adoption Curves – From Scurvy To 2025

Health Innovation History - Vasco de Gama & Scurvy PreventionIt took consuming citrus fruits for the prevention of scurvy 264 years from discovery to widespread adoption. Today, the time from discovery to implementation is estimated at 17 or 18 years. How much can we close this gap? In this video from FutureMed, medical futurist Dr. Michael Gillam explores this answer and where he expects us to be in 2025.

Watch for Dr. Gillam’s Dispatches From…Somewhere In The Future coming exclusively to MI2.org soon. More

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Another Cool Example of Biomimicry in Healthcare Innovation

Biomimicry and Health Innovations - Another Cool ExampleBiomimicry comes from bio- and mimesis, literally “to imitate life”. Biomimicry is a structured look at how the natural world has solved problems or created opportunities and attempting to apply those strategies to design, engineering, invention, health and wellness, and more.

Often thought of as a “new” discipline, technically, it is actually quite ancient. Much of how we learn comes from mimicking. And indeed, many developments throughout medical history have come from mimicking nature – the natural world within ourselves and outside of our own species. More

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Good Design, Poor Design

Design in Everyday Healthcare - Opportunities for InnovationWe see them every day… Or do we? All around us, in every nook and cranny of healthcare, there are opportunities for improvement and opportunities for outright innovation.

It may not be a new device, gadget or widget, however. More likely, it will come in the form of a simple design element. And there’s no one better than you to bring it about. After all, you live it every day.

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Can Games Help Cure Disease?

Games As Health Innovations?Can games help us prevent or cure disease? Improve patient compliance? Make a safer health environment? Or improve medical education?

In this TED MED talk, Steve Cole from HopeLab discusses cancer therapy and the game Remission. Watch this video and explore the role of play and games in health innovation. More

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No Innovation Without…

Health Innovations - There Are None Without...Watch innovators from Twitter, FourSquare, MakerBot, ShopKick, Deviant Art, Adafruit Technologies, and more as they discuss innovation and its one essential ingredient, common to all innovation.

There is no change, no reform, no betterment, no genius, no artistry, no brilliance, and no innovation without… More

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Edison Sheds Light on a Key Quality of Innovators

Health Innovations Lessons From The Life of Thomas EdisonMost people believe that Thomas Alva Edison invented the electric light bulb. This isn’t true, but for all practical purposes, it might as well be. While working electric light bulbs had been demonstrated as early as 1800 in laboratory conditions, Edison was the first to develop an electric light bulb that could be manufactured and operated efficiently enough to be attractive for municipalities, businesses and, later, families. More

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Metaphorically Speaking

Our Words, Our Metaphors and Innovation In HealthcareHealthcare has its own lexicon, its own jargon, and its own set of metaphors. This language we use, the words we choose, the manner in which we forge them into sentences, and the metaphors we use to sculpt ideas can all have a profound impact on innovation in the healthcare space… for better or for worse.

Watch this James Geary video from the TED talks: More

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MedStar Inventor Forums – A First Hand Account

Dr. Mark Smith at the MedStar Inventor ForumsA diverse crowd filled the True Auditorium at Washington Hospital Center on June 14, 2011. Associates in scrubs, suits, lab coats, and street clothes, representing every part of the MedStar family voluntarily stayed late at work or came in on a day off to catch the inaugural MedStar Inventor Forum.  The buzz in the room before the presentation began was energizing; clearly, despite the crowd’s differences, everyone shared a common interest — invention that advances health — and a common trait —the ability to think differently. More

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Biomimicry and Innovation – The Anticrobial Secrets of Shark Skin

Sometimes, in order to find the best solutions, we need to look no further than nature itself. Researchers from a variety of disciplines have tapped into this idea and are busy at work studying sharks.

Mimicking sharks seems only natural when you consider the marvel of their design. With a hydrodynamic shape, water moves smoothly over the More

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To Better is Human™ – MedStar Health Forms 
National Center to Advance Patient Safety

National Center for Human Factors in Healthcare(Washington, DC) August 1, 2011 — MedStar Health has announced the formation of the “National Center for Human Factors in Healthcare,” a unique scientific research center that applies safety science methods to healthcare.

The mission of the Center is to improve patient safety in today’s complex world of medicine, identify and test ways to better protect patients from harm, and help create an ultra-safe care environment at MedStar Health and beyond. More

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  1. James Davis: awesome post. very informative. thanks.

Innovation in Learning – Changing Education Paradigms

Innovation in Learning - Changing Education ParadigmsWhen something has been around for decades and remains virtually unchanged, one of two things holds true…

(a) It is so well-designed, it is not in need of change, or

(b) It is in need of change and is therefore, ripe for innovation. More

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  1. Amit: Two thumbs up!

  2. Jeff: Salman Khan: Let's use video to reinvent education: http://www.ted.com/talks/salman_khan_let_s_use_video_to_reinvent_education.html

Patient Safety and the BP Gulf Oil Spill Disaster?

BP Oil Spill and Patient SafetyTo Better Is Human™… That is the mantra with which Dr. Fairbanks leads MedStar Health’s human factors engineering efforts. Some may find despair in disaster. But a strong urge within all of us seeks the opportunity in it. Watch this intriguing video on what we can learn from the BP oil disaster.

In this 30 minute video series from MI2′s Innovations In… Patient Safety Forum, Dr. Terry Fairbanks explores the similarities in the culture of BP prior to the oil disaster of 2010 and the “House of Medicine”. More

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Sliced Bread – What Took So Long?

One of the best ideas since sliced breadYou have an idea… You might even think that it will be the greatest thing since sliced bread.

There’s a problem though. It’s success does not depend on the value of your idea, alone… It depends more on its distribution.

In short, it’s the spread, not the bread. More

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Great Minds Think… Together

Cleveland Clinic and MedStar Health Form Collaborative Innovation AllianceCleveland Clinic and MedStar Health Form Collaborative Innovation Alliance
Initiative to Enhance Technology Development and Commercialization

Tuesday, Jan. 11, 2011, Cleveland, OH/Columbia, MD: Cleveland Clinic and MedStar Health have agreed to create an Innovation Alliance to benefit patients through collaborative innovation projects, research, clinical investigation, and commercialization application. More

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Game-Changers – A Tale of Two Footballs

Sports innovation - football's debt to soccerVery few football fans under the age of 60 can tell you who Pete Gogolak is, but when he stepped onto the field wearing a Buffalo Bills jersey in the autumn of 1964, he irrevocably changed the face of the game. He took a fairly mundane part of the game, the field goal, applied some old world logic, and voila, the wheels were set in motion that changed the way field goals would be kicked from there on out. More

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The Oil Industry Preventing PE? – The Story of the Greenfield Filter

Intersectional thinking - Greenfield filterFaced with a common postoperative problem, preventing thromboemboli (blood clots) without using blood thinners, Dr. Lazar Greenfield had to look outside of healthcare for a solution. He considered filters, but the only filters used up until that time tended to create more problems than they solved. Flat screen filters would only add to venous obstruction and provide a nidus for more thrombus – creating a situation every bit as serious as the one it was intended to prevent.

So, where could Dr. Greenfield look to find a workable design for his intravenous filter? More

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Advancing Translational Research by Design 11/9/10

Building sciences and design“Advancing Translational Research by Design” – The MedStar Institute for Innovation (MI2) Center for Building Sciences and the Center for Advanced Design and Research (CADRE) are pleased to sponsor “Advancing Translational Research by Design”. This expert panel intends to focus on the design features for clinical facilities (bed towers and outpatient units) that could potentially enhance the translational research process. More

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ER Design Could Be a Bridge to the Future

Emergency Preparedness - Facility Design InnovationThe MedStar Institute for Innovation’s (MI2) own Ella Franklin was featured in a Hospital & Health Networks Magazine (H&HN) article that covered MI2′s Bridge to ER One emergency preparedness project. In addition to highlighting ER One’s unique facility design and innovative processes, More

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Mining the Periphery – Gold Rush’s 1st Millionaire Found No Gold

Sam BrannanSometimes the path is obvious… it’s an easy choice. After all, everyone’s heading that way. Well, sometimes, what you seek lies not in the obvious choice. Sometimes, it’s in the periphery. Let’s take a trip back to the mid 1800′s to meet California’s first millionaire.

During the Gold Rush of 1849, Sam Brannan earned his fortune, but not by panning for it in the American River… More

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Game-Changers – Innovators Not Afraid to Flop

Have you ever asked yourself why we do something a certain way? Most likely your answer will be, “Because that’s the way we’ve always done it.” Or maybe, “Because my parents always did it this way.” Perhaps you’ve said, “ If it ain’t broken, don’t fix it.”

There are a myriad of excuses why we’re seemingly satisfied with the so-called status quo. But they’re just that: excuses. It takes a truly innovative person to go against the flow and create a new way, a better way, of doing things. More

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Lessons in Failure – Why 3M’s Post-It Notes Almost Didn’t Happen

These days, there is hardly a household, business, or even computer screen that isn’t covered in some variation of those popular little yellow adhesive notes. How many households and businesses today would be shocked to know that the all-purpose Post-It® Note almost didn’t happen?

When Dr. Spencer Silver of the 3M Company accidentally discovered a new adhesive in 1968, he found it fascinating. It had an unusual structure that couldn’t be dissolved or melted. But because it was such a weak adhesive, it had no apparent use. After promoting it within the company for five years, he set it aside. More

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Biomimicry – It’s A Bird, It’s A Train

Operating at speeds exceeding 200 miles per hour, the Shinkansen “bullet trains” of Japan have carried more passengers than any other rail line in the world. The trains offer high speed passage between several of Japan’s More

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