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

Dispatches From… Somewhere In The Future will contain some of Dr. Gillam’s best insights from the most recent FutureMed Program at Singularity University as well as what’s new in healthcare (and what will be new in healthcare).

More About Michael Gillam

Michael Gillam, MD, FACEP, is a medical informaticist, researcher, software architect, health IT strategist and board certified in emergency medicine. Most recently, he was a partner level physician executive and Director of the Microsoft Healthcare Innovation Lab which served as an incubation, technology transfer, and prototyping lab for next generation health informatics technologies. He was one of four physician directors of the team that built and sold the software which became one of Microsoft’s flagship products in healthcare, Microsoft Amalga™. He has served as Chair of Informatics for both the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP). Dr. Gillam has directed projects spanning technologies including: natural user interfaces in healthcare; advanced data visualization; biosurveillance; RFID tracking; automated facial image capture; enterprise search in healthcare; unified communications; gesture based interface control; Surface computing; augmented reality; and medical robotics.

Related Links:

• Future Med
• About Singularity University

Image source:

• http://upload.wikimedia.org/wikipedia/commons/5/50/Vasco-da-gama-2.jpg

– public domain in the US due to expired copyright

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. Where biomimicry is new, is in the structured approach to “asking nature” and, of course, the institutions and the disciplines spawning from it.

Biomimicry has tremendous potential for innovations in health and wellness. Here is another awe-inspiring example of biomimicry and how profound its impact can be if applied to the medical sciences and health innovation.

The Sandcastle Worm

Source: Fred Hayes for the University of Utah (Creative Commons)

How can this aid us in health innovation? Well, in orthopedics, there are several strategies and devices for repairing simple or mildly complex bone fractures. But what about highly complex fractures? You know, the ones we often describe as “shattered”? Their small fragments are too small, numerous, and complex to bind with hardware. We are often limited to replacement surgeries. But what if we could borrow that same strategy that the sandcastle worm uses to bind the small particles of sand, to collect and bind small particles of bone?

Biomimicry Monday on Twitter

Interested in seeing more interesting cases of biomimicry? Follow MI2 on Twitter where we started Biomimicry Monday. Every Monday we highlight interesting cases of biomimicry from various industries, not just healthcare innovation.

Related Links – Bio-glue and health innovations:

• Sandcastle Worms, Bio-glue, and Innovations in Orthopedics
• Biomimicry Examples on MI2.org
• Follow MI2 on Twitter – Where Every Monday is Biomimicry Monday

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.

The first step is to begin looking for things (and processes) in your day-to-day that are designed well.

For example, I was in the L&D suite while my wife was delivering my sixth child. Now, she wasn’t too thrilled about it, but when it’s your sixth child and you’re not the one in labor, you begin to notice things you might not have noticed before. When I was asked to help reposition the bed, I had to unlock it, and I noticed the foot pedal. Yeah, a foot pedal.

Here’s what I saw:

To some, this is just a foot pedal. We stomp on them all of the time in the hospital, but we usually only notice them when they don’t work.

Well, this one seemed pretty elegant to me for the following reasons:

1. It can never be put on upside when manufacturing it,
2. Green means “go”,
3. Red/orange means “stop/brake”,
4. No matter how it is assembled green is on the right,
5. It has a grip-type surface, yet it can be cleaned.

Appreciating good design when you see it will accomplish a few things. (a) You will begin to see things from a fresh perspective. Unconscious competence, being on autopilot, being in a groove, or whatever you want to call it, has its place. But taking a moment to “be present” in any one moment of your day can be quite refreshing. (b) When the time comes to invest in new equipment or to change a process or to edit a form, these successful design elements you’ve noticed around you will inform your discussions and choices for others things in the workplace. Your contribution to that committee you’ve been on will have impacted scores of people. (c) You will begin to ask yourself, “How can we make this better?” And from there, the possibilities are endless.

OK, but what happens when you come upon something that was designed poorly? Well, instead of just accepting it, or worse, complaining about it, why not fix it? Improve it? Better it?

The impact of doing so will go far beyond just you. It might prevent medical errors… It might save time… It might save money… Hey, it might even earn you some money, depending on what it is. At worst, you have contributed to making the world we live and work and heal in a little better.

Take this elevator in a hospital parking garage, for example. When I approached it, I pushed the button and waited for the elevator, like anyone would have. Seconds later a (very) loud voice startled me as it came through the speakers, “Is everything ok?”

Well, it turns out that I hit the Emergency Call button.

What’s worse? I’ve done it more than once over the past few years of visiting this hospital.

Now, I’m a semi-intelligent life form (on most days). Why did this happen?

Let’s have a look:

The fact is, the error was mine. Perhaps I should have read the signs. Perhaps I should have paid closer attention to what I was doing.

True. But the next time you are waiting for an elevator, pay close attention to what people do when they first approach it. Some will be looking at their phones, some engaged in conversation, and some a tad flustered with navigating the institution. No one reads the signs. No one pays exquisite attention to the task of pushing an elevator button.

Elegant design would account for this human element.

Here are some of the components you may notice from the elevator in the photo.

1. The Emergency Call button and the elevator button are at the exact same height, just on opposite sides of the doors.
2. The Emergency Call button is closer to the elevator door than the elevator button.
3. The buttons themselves offer no visual or tactile distinctions – one is plain metallic & the other is plain metallic with a dot in the center
4. The elevator button (not the emergency button) has an image of flames above it.
5. The parking level is color coded (red, or reddish) the same as the emergency call button paint.

I wonder how many times a day security is accidentally called simply because of the design of these elevator buttons… This is an opportunity… for applying a simple fix to something that inconveniences patrons and potentially pulls security away from important functions.

Find examples in your day-to-day and share them with us. Send your examples of good design and poor design to my email ed.tori [at] mi2 [dot] org. Or share them with us on Twitter (@MI2innovation).

Learn more about the MedStar Institute for Innovation’s efforts to bring good design to all aspects of healthcare and health innovations:

• Human Factors Engineering in Healthcare
• Center for Building Sciences
• Design and Patient Safety Lessons from the BP Oil Disaster
• Data Visualization – links coming soon
• Healthcare Delivery Processes – links coming soon

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.

Learn More About:

• TED MED
• HopeLab

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

Of course, Thomas Edison invented much more than the electric light bulb. By the time of his death in 1931, he held 1,093 United States patents and several in England, Germany, and France as well. These include the phonograph (his first significant invention), a motion picture camera, and numerous other inventions that revolutionized the electric and communications industries. One of the companies he developed, General Electric, is still a major business force in the world today.

But for all of his multitude of successes, both in inventing and business, Edison’s path to success was fraught with many “failures”. Attributing his stubborn drive to push through failures and succeed to his Dutch heritage, Edison refused to accept failure as final. Through a combination of doggedly pursuing his goals to the end and a willingness to see success even in his failures (many of his patented inventions were developed while he was working on a product that was intended to do something entirely different) the “Wizard of Menlo Park” persevered to become the most famous inventor in modern history.

The incandescent light bulb for which he is most famous probably illustrates his perseverance better than anything else. Far from an instant success, Edison spent nearly a year trying dozens of filament materials and other variations of the light bulb before he had developed a product worth patenting. Even then, the light bulb’s “long life” was about thirteen hours. Altogether, it took over two years, and literally thousands of failed experiments, before Edison put together the right combination of bamboo filament, vacuum pressure, and other factors that enabled the first practical electrical incandescent light bulb to reach a marketable life of 1,200 usage-hours. Two years later, the bulbs were first used in public buildings, and within two decades, electric lighting had taken over the world, fulfilling Edison’s prediction that he would make electric lighting so affordable that only wealthy people would burn candles.

If you have an idea that you’ve shelved because someone laughed… or it seemed impractical… or didn’t work like you thought it would… maybe it’s time to bring it back down, look it over, tweak it a bit, and try again. It might take several, or even dozens of attempts, but if it’s a good idea, act on it… You never know when a little tweak or a new connection could produce something that changes the face of the healthcare.

Watch this James Geary video from the TED talks:

Whenever we give a thing a name that belongs to something else, we give it a whole network of analogies too.

Skeptical at first, I expected the Forum to be like others I’ve attended that promised clarity, yet left me further befuddled.  I was delighted to find that the MedStar Inventor Forum presentations were logical, easy to understand, and most importantly, led by our own trusted colleagues.  The presenters shared first-hand experience about healthcare commercialization while explaining a comprehensive set of services – collectively known as MedStar Inventor Services – which benefit both the inventor and MedStar Health equally.  Thomas Graham, MD, a surgeon-inventor who was formerly Chairman of the Curtis National Hand Center at Union Memorial Hospital and is now Chairman of Cleveland Clinic Innovations, highlighted the dangers of entering the entrepreneurial world ill-prepared.  Dr. Graham noted that commercialization of an invention involves a demanding time investment and a steep learning curve given the differences between the worlds of business and medicine. He concluded that had it existed, MedStar Inventor Services would have saved him much pain and ensured a better return on his investment from the outset.

MedStar Inventor Services, led by Amit Shah, MD was launched in January 2011 by MedStar Institute for Innovation (MI2) in collaboration with MedStar Health Research Institute, under the leadership of Mark Smith, MD, and Neil Weissman, MD, respectively.  The service arose as the first tangible expression of the new Innovation Alliance between MedStar Health and the Cleveland Clinic. MedStar’s new partner, the 50-person Cleveland Clinic Innovations team, brings 10 years of experience and a track record of success to the table: 330 patents secured, 35 new companies created, $450 million in equity investments won, and, incredibly, $50 million placed directly into the pockets of inventors.



The first round of Inventor Forums was held at four MedStar hospitals in Baltimore and Washington, DC.  Recently, I learned that these forums attracted 260 associates representing more than 15 MedStar entities.  Furthermore, among the associates who registered, 49% said that they already had (24%) or might have (25%) an idea that could make a great invention.  It was incredible to hear that, from software applications and medical devices to pharmaceuticals and biologic materials, MedStar inventions already take a variety of forms.

Moreover, inventors are approaching MedStar Inventor Services at various stages of development—from back of the napkin drawings to fully prototyped inventions with testing data and business plans in hand.  The 45 inventors that have been engaged so far are physicians, surgeons, nurses, scientists, pharmacists, technicians, engineers, and administrators at 13 different MedStar entities.

At last, here is a service that is tailored specifically for us and that isn’t riddled with catch-22s and fine print intended to be overlooked by those of us without a background in intellectual property law!  I’ve found MedStar Inventor Services representatives to be approachable, helpful, and interested in working with inventors in each step of the process.  With such a great service at our fingertips, we have a new incentive to convert roadblocks in our daily work into opportunities to devise solutions that advance health, and realize some personal gain while we’re at it!

Mimicking sharks seems only natural when you consider the marvel of their design. With a hydrodynamic shape, water moves smoothly over the surface of the shark’s skin, despite the fact that the skin is anything but smooth. Dermal denticles cover the skin in series of ribbed individual scales with longitudinal grooves. Bearing these “little skin teeth,” sharks are able to move quickly and seamlessly through the water. While some might think the roughness of their skin would cause them to slow down a bit, the exact opposite is true.

When a smooth-surfaced object passes through water, water coming at the object is moving slower than that which is flowing away from it. Turbulence results as the waters merge, thus slowing down the object. However, because sharkskin is not smooth, the scales channel the flow of water, speeding up the slower water and attracting the faster water toward the shark. The result is less of a speed discrepancy and less turbulence. The shark is able to glide effortlessly through the water with greater speed which would only be impeded by smooth skin.
How can this knowledge aid in manmade inventions? Who would benefit from this design?

The Speedo company for one. Incorporating this unique design into their swimwear prior to the 2000 Olympic games, the goal of faster swimmers was realized when eighty percent of the metals won in the swimming competitions were awarded to those wearing Speedo’s Fastskin suits. Plus, of the fifteen swimming world records, thirteen of them were broken by swimmers donning the “shark skin” suits.

Boat manufacturers have long been studying sharkskin as well, hoping to come up with surfaces that will glide more efficiently through bodies of water. The advantage to boat surfaces modeled after sharkskin evolves from the shark’s incredible ability to stay free of the usual speed hindrances existing in the ocean. Barnacle larvae, bacteria, algae and other ectoparasites cling to most everything passing through the water. ..except sharks. The design of the skin reduces the friction needed for most of these parasites to adhere to it. An additional benefit is the apparent “self-cleaning” properties of the skin, which constantly purges itself of the seemingly tenacious parasites that do manage to grab on. When mimicking this in the exterior design of boats, not only do the boats operate more efficiently due to the reduction (of close to 30%) of organisms sticking to the hull, it also results in far less toxins being used to clean the exterior surfaces of the vessel. Invasive marine species are less apt to be transported from one location to another as well.

And it’s not just the skin boat designers are studying. BioPower Systems is one company trying to incorporate a shark’s tail-like design into their boats, looking to convert wave energy into electrical energy. While the common blade-style generators are apt to injure marine life, the newer design does not.

The most promising and exciting possibilities when it comes to mimicking sharks, however, may be in the pursuit of health innovations. With hospital-acquired infections being a major concern, the development of antimicrobial surfaces of medical devices modeled after shark skin could be an answer to solving this growing problem. Cancer research is also being done to determine if these amazing creatures hold the key to immunity.

Nature has already solved some tough problems… perhaps all we have to do is look.

Biomimicry Monday on Twitter

Interested in seeing more interesting cases of biomimicry? Follow MI2 on Twitter where we started Biomimicry Monday. Every Monday we highlight interesting cases of biomimicry from various industries, not just healthcare innovation.

Image sources:

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. The Center is the largest human factors engineering enterprise in the U.S. that is situated within a healthcare system. It is the product of a collaborative effort of the MedStar Institute for Innovation (MI2) and MedStar Health Research Institute (MHRI).

The National Center for Human Factors Engineering in Healthcare utilizes the same safety science that has created dramatic improvements in safety in other domains— specifically in the military and in the aviation, transportation, and nuclear energy industries. The Center applies these methods to all aspects of healthcare: to medical devices and instruments, to systems and processes of care, and to the overall work environment.

“The science of safety is not new. The techniques that our Center applies began to emerge in the 1940s when the military and the aviation industry began to learn that a scientifically driven optimized design of the human-technology interface has a direct impact on error rates, efficiency, and safety. Healthcare as an industry has been fairly slow to apply this safety science to health systems,” says Rollin J. (Terry) Fairbanks, MD, MS, the Center’s Director. “Our Center has gathered expert human factors scientists to work within healthcare, and we will benefit from close collaboration with other parts of the MedStar Institute for Innovation, specifically the Simulation and Training Environment Lab (SiTEL), the Center for Infonovation (information technology), Building Sciences Center, and MedStar Inventor Services.”

The Center includes a core scientific staff of Human Factors Engineers who work side-by-side with MedStar Health’s care providers, clinical researchers, and leadership teams to improve the design of work processes, medical devices, and care environments with a goal of optimizing efficiency, maximizing safety, minimizing error, and preventing harm to patients when errors do occur. Fairbanks and his team have established a highly-qualified collaborative of faculty affiliates in different domains from within MedStar Health and from multiple organizations throughout the US and Europe, with human factors engineering programs throughout North America, and with government agencies responsible for healthcare.

“Applying human factors engineering and safety science to healthcare provides an unprecedented opportunity to make dramatic and sweeping changes to not only improve patient outcomes, but improve the efficiency of the healthcare system, create a better understanding of a patient’s medical condition, design more intuitive medical devices, create safer healthcare working conditions, and design more effective communication between care providers. We want to innovate a new generation of patient-centered care,” said Fairbanks.

“A core value of MedStar Health is putting ‘patients first,’” states William L. Thomas, MD, Executive Vice President, Medical Affairs and Chief Medical Officer, MedStar Health. “This is the lens through which we evaluate our medical, educational, and research investments. By applying the rigor of safety science to patient safety, we see the work of this Center as one of several key investments MedStar Health is making to advance health in our communities. MedStar Health is proud to be a national leader in this fertile area of study. “

About the National Center for Human Factors Engineering in Healthcare

Located in Washington, DC, the National Center for Human Factors Engineering in Healthcare brings together human factors engineers, health services researchers, and clinicians to conduct basic safety science and applied research to improve healthcare quality, efficiency, reliability and safety. A part of the MedStar Institute for Innovation (MI2) and the MedStar Health Research Institute (MHRI), the Center’s home and “research lab” is MedStar Health, a $4B not-for-profit healthcare system in the Maryland and Washington regions. The MedStar Health system is academically affiliated with Georgetown University School of Medicine, and includes nine hospitals and more than 20 health-related companies in more than 100 locations. The Center benefits from established collaborations with many academic institutions and hospital systems, and MedStar is part of the NIH-sponsored Georgetown-Howard Universities Center for Clinical and Translational Science (CTSA) research collaborative. Visit us at www.MedicalHumanFactors.net.

About MedStar Health

MedStar Health combines the best aspects of academic medicine, research, innovation and treatments with a complete spectrum of clinical services to advance patient care. As the largest health care provider in the Maryland and Washington, DC regions, MedStar’s nine hospitals, the MedStar Health Research Institute and 20 other health-related companies are recognized regionally and nationally for excellence in medical care. MedStar has one of the largest graduate medical education programs in the country training over 1,100 medical residents annually. MedStar also has a major academic affiliation with Georgetown University. MedStar Health is a $4 billion, not-for-profit, regional health care system based in Columbia, MD, that is also one of the largest employers in the region. Its 26,000 associates and 5,300 affiliated physicians all support MedStar Health’s patient-first philosophy that combines care, compassion and clinical excellence with an emphasis on customer service. Visit us at www.MedStarHealth.org.