There are 315 million "patients" in America, and only 1 million physicians. Keeping track of their histories is a gargantuan task, and many doctors have turned to the Electronic Medical Record, a computerized list of everything from allergies to addresses, to keep up. But despite being a huge improvement from paper records, the EMR is in desperate need of a graphic and technological overhaul. Doctors often don’t have time to sift through dozens of printouts before they see a patient, and even if they do, the record might not be comprehensive or up to date.
These are, essentially, design problems—at least according to Ben Blumenfeld, the force behind the Health Design Challenge, a design competition to overhaul the EMR. As the son of a doctor and the director of Designer Fund, an "angel fund of designers" that helps fledgling tech startups, Blumenfeld saw an opportunity to use design to improve the quality of patient care. "Medicine is ripe for a design revolution," he wrote last fall. "Just look at what currently passes for someone’s medical record and your brain races with all the improvements that would make this 100 times more usable and beautiful."
Working with a White House Presidential Innovation Fellow named Ryan Panchadsaram and a group of high-profile designers and doctors, Blumenfeld launched the Health Design Challenge last November. When the competition wrapped up at the end of the year, more than 230 designs had been submitted. This week, the White House and the Designer Fund unveiled the winning proposals.
So what does the future of the patient record look like? The winning design, Nightingale, was devised by Amy Guterman, Stephen Menton, Defne Civelekoglu, Kunal Bhat, Amy Seng, and Justin Rheinfrank, a team of designers and strategists who work together at Chicago consultancy gravitytank. Their scheme imagines a responsive record that can act like a dashboard, letting doctors view patients holistically and track results and prescriptions in real-time. Patients can use Nightingale as a mobile or web app, a kind of "guardian" that lets them keep track of the day’s medications or updates them with symptoms to look out for. The idea is to leverage the EMR as a tool to actually improve the quality of care, not just the clarity or visual beauty of the information. "Nightingale stood out because they defined the problem with the current medical record really well," Blumenfeld says. "It’s not just that it’s poor visual design but basically that these records have data in them that could allow us to improve our health if used correctly."
Another interesting proposal came from Studio TACK, a group of Brooklyn-based architects. Their second-place solution focused on preventing what doctors call "bounce back" patients, those regulars who keep returning to the hospital with the same problems. They proposed reorganizing the EMR by problem, rather than by chronology. This way, doctors would see the full history of Joe’s diabetes, rather than just his past two ER visits for complications. "Our health history is nonlinear," the TACK team explains. "A medical history organized solely by chronology does little to help a patient understand where they are and where they need to be." It’s a holistic approach, and historically, it’s led to some of the most major advancements in modern medicine—for example, the 19th-century anatomist Thomas Hodgkin accidentally discovered Hodgkin’s lymphoma when he began grouping specimens by type rather than chronology.
Remarkably, the Health Design Challenge’s winning proposals will soon migrate into the real world. Over the course of the next few months, a team of designers and developers led by Panchadsaram will combine aspects of the winning designs into a viable platform that will be implemented for over 6 million patients in VA hospitals. According to Blumenfeld, it may even become the standard. "This platform will then be open sourced," he added, "so that any electronic medical record company will be able to use it in their systems."
Check out the rest of the proposals here.
[Image: Medical Equipment via Shutterstock]