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Alan Rheault, Nurture’s Director of Industrial Design, has many sources for inspiration. But an annual source of renewal comes from the TEDMED conference where he can immerse himself to learn from the best and brightest in the medical community who come together to discuss problems and potential solutions.

Alan Rheault, Nurture’s Director of Industrial Design

“TEDMED offers a renewed sense of optimism. Everyone talks about how broken the healthcare system is, but TEDMED also talks about the breakthroughs,” said Rheault. Learning from those within the healthcare industry is also affirming: “Nurture is a healthcare company. It’s critical to our foundation that we learn and know about the healthcare world from those who are in it.”

Dr. Zubin Damania, “ZDogg MD,” was Rheault’s favorite speaker, a medical satirist and educator from Las Vegas. The focus of his presentation was about burning out in general practice and rethinking this particular healthcare model.

Nurture is dedicated to the future of healthcare, which is a perfect pairing with TEDMED.  As a TEDMED sponsor for the past three years, Nurture has lent support to the conference and provided simulcast sites for webcasts. The purpose: not to increase sales, but to provide an opportunity for those in the medical field and those who support it to come together to learn, exchange ideas, collaborate, and have a mind meld for potential solutions. “For us, TEDMED participation is more than just a gathering of our customers, designers, and dealers. It provides a view into the future of healthcare and offers an opportunity for new insights,” explained Rheault.

Rheault highlighted two themes from TEDMED 2013 he believes will be critical to the future of healthcare:

• Small Data
• The belief that healthcare is broken, but is fixable

Small Data is defined as personal data that can be captured by individuals independently. The opportunity arises with how will we use all of the self-monitoring and continuous monitoring devices (Fitbit, Nike Fuel Bands, etc.) to inform our health, and how will the data find its way into our personal health records and EHRs. The other question is how will the Small Data impact Big Data over time? Larry Smarr added thoughts about Big Data from understanding and diagnosis to customized care. Ultimately by combing Small Data and Big Data, the opportunity exists to create the “super knowledgeable patient.”

Will capturing the Small Data, the day-to-day information from people, provide much needed insights to influence the way we treat certain conditions or diseases? More than likely, if Small Data and Big Data such as genomes — understanding an individual’s personal DNA sequencing – are put together, patients will benefit significantly from the insights derived.

Rheault was glued to all the presentations throughout the conference, taking it all in and feeding off the inspiration. Another theme that resonated from several speakers is that the healthcare system may be broken, but it is fixable. There is great hope for the future. While all presentations provided great insights, Rheault found the following notable:

America Bracho -  working with Latino communities. Key points: To treat patient communities you have to understand the patient community. To understand the patient community you have to use people from the community. She talked about this higher level of empathy and how to hire a community leader.  ”You have to hire the heart, the brain can be trained,” said Bracho.

Peter Attia – what if we have it wrong?  What if we are thinking of our problems of obesity and diabetes the opposite of what’s true?  What if resistance to insulin is making us fat instead of fat making us resistant?  He talked about realizing his lack of empathy with a patient because of his closed mindedness… until he had his own issues.

Andrew Solomon – powerful story about the accepting those that are different, and how changing them (like an autistic child) would mean wishing them away. He talked a lot about unconditional love between a parent and a child – when do you try to “normalize” and when do you try to find those that are alike in a special group, ie. the deaf community, gay, downs, dwarfs, etc.

John Kheir – after losing a premature baby patient because in a code situation, because they had no way to easily put more oxygen in her blood, he is working on a way to inject oxygen into an IV through micro particles – this clear problem is driving his quest for innovation.

Laura Deming – 18 years old, working on extending life. “It was just unreal to think that this is an 18 year old.  She will probably be somebody well know in the future, so I wanted to note her name!” said Rheault.

Inspired? We hope so.

Share this story, connect with some of these innovative thinkers, including Alan, or simply take what was shared and apply it. After all, none of us believes healthcare is unfixable, we believe in the vision of how much better it can be.

We bend our bodies in strange ways to accommodate the technologies of today. Taking note of our poor posture, understanding the benefits of improving it, and finding ways to do so can create positive health benefits. A recent study on changing postures in the workplace, done by Steelcase, revealed how new technologies have led to nine new postures.

9 new postures by Steelcase

While the Steelcase research regarding postures takes into account the influence of new technologies in the workplace, Fast Company recently featured an article with illustrations and a downloadable PDF about 15 weird postures related to the use of personal technology devices, emphasizing life outside the workplace. The article features postures such as the cell trance (walking and using your technology device without noticing your surroundings) and the conversation generator (using your technology as part of your conversation with others).

In general, poor posture can lead to neck, shoulder, and back pain, not to mention poor abdominal muscles and the undesirable pot belly.

When it comes to technology use in healthcare, there’s no doubt that the rapid adoption of the latest innovations have had an impact on postures. Injuries to care providers due to poor postures while charting or conducting a patient transfer are significant. Nurture understands these challenges and has developed solutions to lessen the strain. Solutions such as Pocket, a highly mobile worksurface, provides caregivers opportunities to connect with patients easily without compromising their posture to do so.

Pocket supports the use of tablet technology.

Different postures such as knee-to-knee, where a provider is sitting directly in front of the patient or family member, facilitates direct eye-to-eye contact and fosters an ease of conversation and personal connection. In times of transition, the in-between times on a patient’s journey, there are opportunities to create spaces that enable patients and their loved ones to continue being productive while doing such things as waiting. Regard creates spaces that support technology, private conversations, and the opportunity to hold multiple personal belongings. The configurations seem almost endless, but the purpose is critical, meeting patients, caregivers, and care providers where they are on their healthcare journeys and providing the much needed support to foster healthy connections.

Regard supports the patient’s journey and technology needs.

As James Ludwig, vice president of global design for Steelcase, states: “We love our technology – it’s become a ubiquitous extension of ourselves.” Nurture doesn’t want us to ignore how technology is impacting our bodies in the healthcare environment either. After all, if healthcare environments aren’t healthy enough to support the people who work within them, how can care providers help the people they serve become healthy? It’s a bit like practicing what you preach.

So what impact has technology had on your posture? What have you done to support your posture while integrating your personal technologies? We’d like to hear- and if you agree with this post, please share it!

According to the Johns Hopkins Bloomberg School of Public Health, systematic communication between healthcare providers, patients and their families results in better patient care and shorter hospital stays, and may also improve family outcomes. This finding was based on a review of previously published research examining the impact of interventions to improve communication for those with advanced or serious illness.

There’s no doubt that technology is expanding healthcare communication in doctor-patient relationships, offering an opportunity to enhance communication as well as the depth of information that can be tracked and communicated. Technology is:

Empath enables caregivers to communicate with patients at eye-level.

• providing patients with personal health management tools
• empowering patients to conduct their own research, seeking answers and medical information online
• utilizing telehealth as a forum for healthcare delivery

A video taken at the 2012 Health Care Summit explores how “Technology is Changing Healthcare.” Interesting highlights from the video include:

• Doctor-patient relationships are here – it’s not just hype
• Managing chronic illnesses
• Predicting catastrophic illnesses
• Living comfortably the last couple of days of our lives
• Doctor may become the second opinion vs. the first opinion
• Telehealth in India
• Patient/Doctor…who should have the final opinion?
• Should doctors empower/encourage patients to discuss the information they’ve found on the internet?

Regard helps families, patients, and caregivers communicate and utilize technology and collaborate in a comfortable yet semi-private setting.

In a day and age where technology often serves as an additional appendage, it only seems appropriate that it be used to enhance the patient experience. There are so many opportunities and apps to help enhance communication and the quality of care. Even a quick online app review reveals multiple options, not to mention those that your healthcare provider may suggest.

Are you using technology to enhance your experience with your care provider(s)?  Have you found that technology enhances your overall medical communication experience? Do you like the direction that technology is moving patient-doctor communication?

Have you read our recent posts on the uses of smartphones and other forms of technology in healthcare? Check them out here. 

Going into TEDMED, our goal for the Nurture space in the Hive was to facilitate experiences and conversations during the Smartphone Physicals that amplified the personal connection between clinicians, patients, and the technology they were using. Based on the feedback we’ve received, from media sources like NPR, ABC, USA Today, BusinessWeek, and the Huffington Post, it’s clear we succeeded. TEDMED went so far as to dub our set up as the “Exam Room of the Future”. They wrote:

Three major pieces of furniture, the patient chair, pocket desk and a physician stool – all on the same level as the patient chair to facilitate communication – are on rollers so they can be easily reshuffled. The entire space is ideally as uncluttered as possible, for a calming effect.

Margaret Alrutz, Director of Strategic Marketing & Experience Design at Nurture, says the room takes cues from cultural changes at large. “Healthcare changes as people’s experience of the world starts to change, and one area that’s driving things now is retail. For example, a consumer may think, ‘I can get movies and meals at home anytime I want, but I get to have a physical maybe once a year. It takes a long time and it’s uncomfortable,” she says.

With the glut of on-demand consumer technology, though, including health apps like those in the Smartphone Physical, the new expectation is, “I can participate in healthcare and not be told what to do,” Alrutz says. However, she added, “We may not yet have the social clues to navigate this scenario. So can we take these cues that are already familiar, like sitting in an easy chair, as ways to signal how to interact? “When a patient walks into a room and sees an easy chair and a TV screen, they may think, ‘I know how to do this,’ ” Alrutz says.

We also received feedback on the effect our space has on the clinician – patient connection from Leanne West, the director of the Landmarc Research Institute at Georgia Tech. Leanne said:

I felt more relaxed being at eye-level with the physician thanks to the Empath recliner, rather than perched up on the awkward exam table. It was more conducive to having an actual conversation.

I could easily see images on the smartphone as the tests were being conducted. The physician also didn’t have to constantly be turning his back to me to type notes into the computer, he could do it all there on his phone. The design of the space made this all possible.

Roz Cama, after experiencing a Smartphone Physical in the Nurture space, delivered an insight into the future of the health exam that bears repeating:

The physical was chair-centric, not exam table centric, like you’ve seen in the past.  You almost don’t feel like a patient, you’re just having an intelligent conversation with a colleague about something very important – your health. This brand of personalized, customizable medicine, liberated by this kind of technology, is very exciting.

Shiv posing with one of the aforementioned smartphones.

We spoke with Shiv Gaglani, a medical student and editor at Medgadget who set up and ran the Smartphone Physicals in the Hive at TEDMED last month, to reflect on his experience. This is what he said.

1) What did you learn at TEDMED that will affect your work/life going forward?

Shiv Gaglani: Outside of the few talks I did see, the true highlight of TEDMED for me was meeting the delegation. Fortunately the Smartphone Physical was the perfect excuse: I literally had the ear of dozens of participants (as I took a picture of their ear drums using the smartphone otoscope). These ranged from company executives and hospital administrators, who had interesting and positive thoughts about the Smartphone Physical, to medical and even high school students who were inspired by what technology has already made possible. Some of these conversations will stick with me moving forward and in some cases some of the connections will last much longer than the four extremely busy, yet gratifying, days that are TEDMED.

2) What did you think of the Smartphone Physical? What were the highlights of your experience administrating the physicals? How did people react to the apps, accessories, innovations?

Shiv: The experience and reception to the Smartphone Physical surpassed my expectations. We knew what we were doing would be popular, but the attendees almost ubiquitously gave positive feedback, as depicted in the word cloud comparing the traditional physical to the Smartphone Physical. It was interesting to see which devices really lit up the imaginations of the participants. Some were excited by the easy-to-use blood pressure monitor and pulse oximeter and understood immediately the implications for turning patients into accurate data collectors. Others’ eyes lit up, both literally and figuratively, when we were able to show them for the first time a picture of their optic discs. Parents understood how the smartphone otoscope would help them allay their fears when their children had ear infections. The smartphone ECG captured the imagination of many because of the cool underlying technology as well as the fact that during TEDMED we actually found a few potential cases of undiagnosed arrhythmias and hypertrophy. And finally the smartphone ultrasound showed people how easy it may become to peek inside their own bodies; in two instances we even were able to see the youngest TEDMED participants, enjoying the experience from within their mother’s abdomens.

3) How about the exam room set up? How did Empath, Pocket and Regard affect the Smartphone Physical?

Shiv: Definitely! My team was really impressed with the overall space that Nurture set up, and specifically the equipment. Since we are all medical students or professional we are used to dealing with exam room beds, chairs, and desks that are hard to operate and interfere with the clinician-patient interaction.

Empath was really easy to adjust, allowing us to go easily from a seated position to a slightly reclined position. This allowed us to use the smartphone ultrasound to visualize the “patient’s” carotid arteries, which is important for blood pressure measurements. Many of the patients were pleasantly surprised by the Empath as well because of the heating and massage elements (at certain break points, we TEDMED ‘docs’ snuck a quick sit on the Empath as well).

The Pocket enabled us to mount our iPads and conveniently enter data throughout the Smartphone Physical experience. Rather than sitting behind a desk on a computer, we formed a triangle where the vertices were the clinician, the patient on the Empath, and the device/tablet on the Pocket. It also helped that it was mobile and vertically adjustable – given the large demand for Smartphone Physicals, we were able to set up mobile screening stations outside of the exam room.

Finally, Regard as a whole took into account the 21st century patient. It ranged from the comfortable seating to the multiple outlets and work stations that enable patients to stay connected and engaged rather than uncomfortably isolated while waiting to see their clinician. My whole team was pleasantly surprised by how enabling Nurture’s space was for the Smartphone Physical.

4) What was your reaction to the Hive?

Shiv: Having attended TEDMED 2012, I thought this year’s Hive was even better! It was such an enjoyable area to be in that many attendees didn’t mind missing the talks in the main auditorium. Of course we think that the Smartphone Physical was a top feature of the Hive, but there was a lot of other activity, ranging from up-and-coming health start-ups to the Great Challenges area and the Emotiv brain-monitoring area. It also was conveniently stocked with drinks and food so many in my team were glad to do 4 or 5 hour shifts to keep up with the demand for Smartphone Physicals (now, if only they could get a restroom closer to The Hive…)

5) Where do you see physical exams going in the future?

Shiv: One of the motivations behind The Smartphone Physical was to address some of the problems with the current physical exam. Many of us have witnessed or undergone exams in which the clinician hastily “went through the motions” and generated inconclusive or, worse, unreliable data. For example, I’ve seen very few clinicians actually measure blood pressure using the two-step procedure and after waiting for their patient to be seated (with both feet flat on the floor) for 5 minutes. Part of this is because the average patient visit duration has decreased, leading to cursory physicals, and another part is that, in the age of blood tests and CT Scans/MRIs, the physical has lost value. However, it is still a very meaningful part of the clinician-patient relationship and combined with proper knowledge of patient history can lead to the correct diagnosis more often than not. The Smartphone Physical is meant to show that not only can we make the physical more accurate through technology, but we can also engage the patient so he or she is able to see and understand what the clinician is seeing. For the first time the patient can see his own ear drum or retina, and thus is more likely to understand what the clinician means when she says, “you need to control your diabetes because it’s damaging the vessels in your eye.” In summary, I think the physical exam is here to stay…it’s just undergoing a 21st century makeover with the aid of technology and education.