1. Improving Outcomes
2. Reducing Costs
3. Extending Access.

There are, according to Research2Guidance, over 97,000 health or fitness apps in the Google Play (Android) or iTunes (iPhone) store, 58% of which are free, 42% of which cost $.99 and up.

We’re calling this recurring column “Now or Later?” because that‘s what mHealth has become — in any given healthcare segment, mHealth can deliver one or more of the above effects either Now, or Later.

And if Later, it’s likely to be relatively soon.  Think months, not years.

First, a definition:  mHealth is health screening, diagnosis and even therapy delivered in whole or in part via the smartphone or tablet, or a small proprietary device that moves its data via cell phone networks or broadband.

This means that even in developing countries, where traditional phone lines have never been rooted, there is a terrific opportunity to serve patients, because cell networks have gone in, or are going in.  Access is being extended.

Three phenomena have collided here in 2013 to make mHealth torrid:

a.  The cost of sending data via big wireless network players such as AT&T and Verizon has declined and continues to decline precipitously.

b.  There used to be mHealth vendors that were small-but-mighty.  Increasingly, they are big-and-mighty, with significant funding or revenue from traditional offerings, and the ability to persist in what will be a marathon, not a sprint.

c.  Healthcare is a triangle and mHealth swiftly moves data from corner-to-corner:  Patients, Doctors and Health Insurance Companies.  There’s a saying we have when we think about especially Patients & Doctors– you have to collect the dots before you can connect the dots.  And mHealth means more dots moved in real-time or near real-time to medical professionals who make the essential interpretations.

How about you? — any health or fitness apps on your smartphone, or tablet?  In the next blog post, we’ll highlight the apps in healthcare that America is finding the most compelling.
______________________________________________________
Pete Celano is an mHealth advocate, expert and productizer.  On twitter: @petecelano

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

In this video Dr. Christakis discusses some of his findings related directly to health and wellness.

“If your friends are obese, your risk of obesity is 45 percent higher. … If your friend’s friends are obese, your risk of obesity is 25 percent higher. … If your friend’s friend’s friend, someone you probably don’t even know, is obese, your risk of obesity is 10 percent higher. It’s only when you get to your friend’s friend’s friend’s friends that there’s no longer a relationship between that person’s body size and your own body size.” – Nicholas Christakis

How might our face-to-face social networks within the workplace (within clinical healthcare) impact our work? Our productivity? Our bedside manner? Our perception of policies and procedures? Our leadership styles?

Might we be able to leverage our professional social connections to improve healthcare delivery? We think so. Be on the lookout for more information on the MedStar Institute for Innovation’s enterprise social collaboration tool, MI2 Sense. (If you would like to learn more, contact Ed Tori, MI2′s Director of Presence at ed.tori [at] medstar.net)

I think we form social networks because the benefits of a connected life outweigh the costs. If I was always violent towards you or gave you misinformation or made you sad or infected you with deadly germs, you would cut the ties to me, and the network would disintegrate. So the spread of good and valuable things is required to sustain and nourish social networks. Similarly, social networks are required for the spread of good and valuable things, like love and kindness and happiness and altruism and ideas. I think, in fact, that if we realized how valuable social networks are, we’d spend a lot more time nourishing them and sustaining them, because I think social networks are fundamentally related to goodness. And what I think the world needs now is more connections. – Nicholas Christakis

Learn More About:

• TED
• Nicholas Christakis
• Connected: The Surprising Power of Our Social Networks and How They Shape Our Lives — How Your Friends’ Friends’ Friends Affect Everything You Feel, Think, and Do
• MI2 Sense – (pronounced “my two cents”) MI2′s enterprise social collaboration platform and its use in the clinical healthcare space, crowdsourcing, and health innovation.

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

This is a question that, if answered honestly, might transform the way we look at health, healthcare reform, healthcare regulation, the committees we sit on, our patients, and ourselves.

Learn More About:

• TED
• Dan Ariely
• Predictably Irrational

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.

On June 28-29, 2012, the Center for Health Design’s Pebble Project, in conjunction with The MedStar Institute for Innovation (MI2) held a one and a half day immersion to inform strategies for an effective, efficient and safe new Emergency Department.

Strategic Design:

Strategic design integrates the vision of future demand, market, healthcare finance and technology into an operationally efficient and successful emergency department. It is not simply designing the “ED of the Future”—nor the most efficient ED of today—but is a measured design response the meets the programmatic and operational needs of today while looking outward towards the future with new delivery concepts, technology and anticipation of demand.

What Took Place:

Attendees engaged in interactive design methods and models workshops, visited an internationally acclaimed emergency department, were exposed to a mixture of peer-vetted world class benchmark ED design case-studies, learned from thought provoking keynote speakers, and networked with like-minded professionals. Faculty authorities offered their real-life “lessons learned” to express the “how and why” that underscore proposed strategies. In this small workshop setting, experts interacted directly with participants to address key challenges their respective departments were facing.

The program included an advanced, intensive curriculum that included:

• Essential elements and strategies to use design methodology to improve ED operations.
• Design process solutions for a broad spectrum of ED operational issues.
• ED facility models that work for some, but not for others
• Emergency preparedness and other adjacency considerations

Leadership and Faculty:

• Michael P. Pietrzak, MD, Director Strategic Initiatives, MedStar Institute for Innovation
• Vicki R. Lewis, PhD, Scientific Director, National Center for Human Factors Engineering in Healthcare, MedStar Institute for Innovation
• Frank Zilm, D.Arch., FAIA, FACHA, President, Frank Zilm & Associates
• James Lennon, AIA, ACHA, President, Lennon Associates
• Marysol Imler, Strategic and Operations Planner, HKS
• David B. Duthu, PE, Board Principal, ccrd
• Richard L. Rome, PE, Board Principal, ccrd
• Susan G. Lorenz RN, DrNP, NEA-BC, EDAC, Vice President, Patient Care Services and Chief Nursing Officer, Princeton HealthCare System
• Craig A. Gronczewski, MD, MBA, Chairman of the Department of Emergency Medicine, Vice President of Medical Staff
• David Clark, BSN, RN, LSSGB, Emergency Department Nurse Manager
• Shannon Kraus, AIA, ACHA, MBA, LEED AP, Senior Vice President/Managing Director, HKS
• Barbara Huelat, AAHID, FASID, IIDA, Principal, HUELAT PARIMUCHA HEALING DESIGN
• Ella Franklin, RN, CRC, EDAC, Director of Research: ER One Center for Building Sciences, MedStar Institute for Innovation
• Whitney Austin Gray, PhD, LEED AP, Director of Building Science Services, MedStar Institute for Innovation
• William J. Frohna, MD, FACEP, chair, Department of Emergency Medicine at Washington Hospital Center, and is vice-chair of MedStar Emergency Physicians
• Kendall K. Hall, MD, MS, FACEP, Medical Officer, Patient Safety Portfolio, Center for Quality, Improvement and Patient Safety, Agency for Healthcare Research and Quality

What if that money barrier could be removed by a bunch of people who like your idea or your mission? Well it can, through crowdfunding sites such as Kickstarter.

What if the time and money barriers could be removed through progressive employers? Well it can. MedStar Health is one such employer with much more than just a generous intellectual property policy. MedStar Inventor Services actually provides support for its associates’ ideas all the way from concept to market.

See the YouTube video below to learn more about how crowdfunding sites work (and if you’re a MedStar associate, the end of the video tells you what MedStar can do for you and how to get started). If your organization blocks video sharing sites, watch it here: [QuickTime version] [Flash version]

(This, of course, does not constitute financial or legal advice. Before posting any projects on crowdfunding sites such as Kickstarter, consult an intellectual property attorney and other appropriate professionals. Also, be sure to check your employment contract.)

Weigh in on crowdfunding for health innovation projects by posting in the comments below.

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.