Why should you care about EHR?

Having worked in several hospitals over the past 10 years, only twice have I used electronic health records (EHR) for documentation. 


Seem crazy? It is. Especially being from a generation that grew up with computers. It is archaic and unfathomable to my peers, (who work outside of health care) that institutions as important as hospitals would still use paper records. 

A recent article from Bloomberg provides more background on the issue.

(*this article was published before the Patient Protection and Affordable Care Act was upheld.  previously, the HITECH Act addressed the necessity of EHR)

I wish I could photograph some of the hospital charts I work with and post them on this blog... to share with others the hieroglyphic-like handwriting of doctors that I'm somehow expected to decipher. Not only is it unreasonable and ridiculous, its unsafe. If I miss a 'Hold tx' order for a test to rule out diagnoses like neuro-vascular accidents, I could potentially jeopardize patient safety through my intervention. 


Speaking from experience as a clinician familiar with EHR, it significantly improves your ability to provide quality care. Having immediate access to legible notes from every medical team involved in the patient's care (*typically there are several specialties involved in a patient's plan of care) allows you to quickly develop an informed clinical picture that guides your rationale for treatment. It also increases productivity, allowing you to digest twice, if not thrice as much information in one sitting.


In addition, your records are always more in depth because you're able to type so much quicker than you write (shocking!). Thorough documentation is helpful to everyone else who interacts with the patient throughout the day, and paints a much more detailed picture of their status from hour to hour. 


Conversion to EHR is an ongoing evolution that will require a lot of patience, effort (read: money) and time. However, its estimated that under new legislation which incentivizes computerized documentation, 50% of private practices and hospitals will be functioning on EHR by the end of this year.


For my designer friends out there, think about the possibilities of creating a system that adheres to HIPAA standards, allows doctors from various health systems to exchange information, and offers a simple interface that is sexy and easy to learn (two elusive terms in health care vernacular). Surprisingly enough, this magical system doesn't yet exist, and several of the largest software companies in the world are still trying to resolve the issue. In an attempt to dominate the market, each company has created their own system which doesn't communicate with other systems (sounds familiar). So what are you waiting for, designers? 

Stretching the boundaries of Design

Recently, I wrote an article in collaboration with Omhu, to emphasize the influence of perception on individual choices and behavior. Read the article which ran in both Advance for Physical Therapy & Rehab Medicine, and Advance for Occupational Therapy !




The take home message reinforces the need for design language that acknowledges object relevance in a variety of contexts. As designers, the ability to focus our energy on meeting anticipated needs that may develop over time, requires an understanding of our functional trajectory throughout the lifespan. We also need to be aware that the onset of mature age does not automatically mean we all of a sudden like surrounding ourselves with depressing artifacts!


It also brings up an interesting point on patient compliance. Might people be more accepting of an assistive device (ie. cane, walker) if the form was generally accepted to be beautiful or luxurious? I find this compelling, since patient compliance is typically a major safety risk and accounts for needless falls, injuries & subsequent medical care.


Seems like an interesting area of research, no?


Hopefully this article motivates Therapists to gain greater awareness of objects and services which are relevant to their clients' needs, without the negative stigma that has been present in assistive devices for far too long. As for Designers, hopefully it encourages them to push the limits of their concepts to satisfy the needs of today and tomorrow.

Words That Inspire Design

My ongoing film tangent

This movie has been out for quite a while, but I rediscovered it again this week, recalling how much I loved it the first time I saw it. Bill Cunningham New York is a lovely film about Bill, a long time photographer of everything fashion. We've all seen his spreads in the Times, and perhaps at times even been influenced by his observations. It is an inspiring story about a remarkable person, still doing what he loves well into his 80's. Since living in New York, I've always secretly hoped someday I'd wear something brilliant enough to catch his eye...someday Bill, someday!

Reelabilities Film Festival in NYC

Starting next week on February 9th, the Reelabilities Film Festival will feature a series of works
which portray various disabilities, increasing awareness through artful & beautiful story telling.

From Reelabilities.org :

"ReelAbilities: NY Disabilities Film Festival is the largest festival in the country dedicated to promoting awareness and appreciation of the lives, stories and artistic expressions of people with different disabilities. Initiated in NY in 2007, the festival presents award winning films by and about people with disabilities in multiple locations throughout each hosting city. Post-screening discussions and other engaging programs bring together the community to explore, discuss, embrace, and celebrate the diversity of our shared human experience."

Personally, I have my eye on Aphasia, and Girlfriend.

Check out the list of featured films here.

If you're annoyed, chances are others may be too

Great article in the Times featuring Marc Newson today. A person who's earned respect for his successful approach to design in various applications, Newson demonstrates the benefits of infusing actual Design in universal design.

In the article, Newson states that '99% of door handles bug him'. His design response is lauded by design enthusiasts, and perhaps more importantly addresses accessibility without sacrificing a design language consistent with his usual touch of simplicity and sophistication.


Perhaps the best part about the design is the fact that Newson was compelled to re-design the handle because it annoyed him. Nothing is more motivating than designing something you know can be done better. Plus, if it annoys you, there's a good chance that it annoys someone else out there, too.  What could be a more effective way to channel negative emotions (i.e. being annoyed) than to respond with a productive solution? Being annoyed with the frustratingly bad design of hospital environments is what initiated my pursuit of a career in design. Being annoyed brought people to Zuccotti Park for the OWS protests. It seems that 'being annoyed' can compel people to do powerful things, when channeled effectively.


So the next time you find yourself cursing some inefficient banal object, environment, or situation, harness your annoyed state (and creativity) and make something happen...or consult a designer.

Scale project updates & progress

As I continue to develop my scale concept, I've started to make some progress in the way of finding a technology that is low profile and will provide the desired response. Check out the latest and greatest little load sensor!

Now that the technical part is resolved, I can focus on making it something you could comfortably live with in your home. I did a quick comparison study between the wheelchair 'footprint' and the natural stance (feet shoulder width apart). See results below...

(top left: wheel chair point of contact // top right: feet in natural stance within the footprint left from the wheelchair // bottom left: wheelchair footprint // bottom right: anatomical vs. natural stance)

 Its seems like a low profile platform of ample dimensions could be a comfortable solution for everyone given that not many of us stand "at attention" in anatomical position, especially not as we age and often require a larger base of support to maintain our balance.

Earlier today, I can across a scale that was featured on the website Spinalistips. I was in awe of the work that went into crafting this adapted model, but also felt that it illustrates quite strongly the relevance of my project, as there are not many options for consumers in wheelchairs.