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Tag: Design

You are Solving the Wrong Problem

There is some problem you are trying to solve.

In your life, at work, in a design. You are probably solving the wrong problem.

Paul MacCready, considered to be one of the best mechanical engineers of the 20th century, said it best: “The problem is we don’t understand the problem.”

Story time.

It’s 1959, a time of change. Disney releases their seminal film Sleeping Beauty, Fidel Castro becomes the premier of Cuba, and Eisenhower makes Hawaii an official state. That year, a British industry magnate by the name of Henry Kremer has a vision that leaves a haunting question: Can an airplane fly powered only by the pilot’s body power? Like Da Vinci, Kremer believed it was possible and decided to push his dream into reality. He offered the staggering sum of £50,000 for the first person to build a plane that could fly a figure eight around two markers one half-mile apart. Further, he offered £100,000 for the first person to fly across the channel. In modern US dollars, that’s the equivalent of $1.3 million and $2.5 million. It was the X-Prize of its day.

A decade went by. Dozens of teams tried and failed to build an airplane that could meet the requirements. It looked impossible. Another decade threatened to go by before our hero, MacCready, decided to get involved. He looked at the problem, how the existing solutions failed, and how people iterated their airplanes. He came to the startling realization that people were solving the wrong problem. “The problem is,” he said, “that we don’t understand the problem.”

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The Neverending Story

We’re hearing a lot about the use of electronic medical records (EMR) in medicine. The government is all for it—providing financial incentives for those with EMRs and disincentives for those still relying on paper charts to make their way through the world. Most health professionals, especially new physicians in training, simply can’t imagine a world without an EMR at their fingertips.

The ability to electronically capture discrete bits of data on each patient allows us to categorize, tally, and build unbelievably beautiful charts and graphs.

These systems also uncover deficiencies in patient care; with the push of a button, we know whose blood pressure or blood sugar is out of control, or how many patients weigh too much for their height. Clinicians click-through as many templates as possible in order for the system to capture these professional nuggets of information. Nuggets worth their weight in gold to researchers and pharmaceutical companies, eager to market their next blockbuster drug to physicians whose patients just happen to fit their marketing profile.

The trouble is when you’ve seen one template–built patient medical record, you’ve seen them all. These systems do such a great job of capturing discrete bits of data that patients become just that—only discrete bits of data.The essence of who they are, their story, becomes lost in attempts at efficiency.

What interests me about each patient is their story: what’s happening in their life that brings them stress or joy. Are they wanting medication for their cough, or really just needing assurance they don’t have lung cancer. Each visit brings a new chapter, a peeling of the onion allowing me to see the various layers of their personality over time. This is more important than almost any other discrete piece of data we could fit into a template. It takes time and effort to build an electronic medical record that speaks for the patient; time that is often in short supply for busy clinicians.Continue reading…