Art in an Unlikely Environment

Untitled 2012
NYC

Would you buy this piece? I would.
Would you believe its actually a series of drawings produced by a bored hospital patient on paper napkins? You should, because this is exactly what I encountered this past weekend while working. Even though I was wearing my therapist hat that day, the quality of this effort was not lost on me.

It immediately caught my eye upon walking into the room. The artist was humble about the work, unwilling to admit that their wall treatment had added significant value to an otherwise 'artistically-bankrupt' room.

This seemingly simple statement was a way for the patient to exert some influence and possibly even minor control over their environment. This is understandable, in a place where your sleeping, bathing, socializing, eating and elimination are controlled and monitored at all times. When I asked the patient about the work, they confessed that they are an artist by trade and that they found doodling to be an enjoyable way to pass the time. The more I probed, I found out that the patient also found this practice comforting.

The infusion of individual influence on the immediate environment has a therapeutic value, and is an inherent psychological response. Whether adding artwork, arranging items in space, or changing the color of a wall, its evident that we all have preferences that resonate in our personal space, even if that space is only temporarily personal. In the case of my patient/artist, there was something calming and enjoyable about being surrounded by visually interesting stimuli. For others, it could be a certain type of music, or quality of light.

Promoting and encouraging this phenomenon in healthcare settings is entirely feasible and seems like a worthwhile venture, especially in a place like NYC where artists are possibly our best natural resource. In addition, allowing personal influence over space would likely impact quality indicators such as patient satisfaction scores. 

Pinking & Shrinking: Design For Women Gone Wrong

Many of you undoubtedly read about Honda's newest woman-focused car "She's". Honda replaced the apostrophe in the name "She's" with a heart, because they realized that secretly all women would prefer that their vehicles were designed by Lisa Frank.

Honda Fit 'She's'

After getting past the name, which was a bit of a struggle, I took the time to learn more about it before passing judgement too early. Then I read about the features that made She's a truly feminine vehicle according to Honda:
"available colors: pink and eyeliner brown"
"UV protective windshield to prevent wrinkles"
No mention of She's performance, fuel efficiency, engine power, or safety features (beyond the ones that maintain facial beauty).

Judgement passed.

Its been a tough couple of months for us women, between all of the 'legitimate rape' rhetoric of late, 'women in binders', and now a car geared towards women that touts superficiality over actual performance and reliability. Its become exceedingly difficult not to become frustrated as a woman who was raised to expect so much more from society and herself.

Honda is not releasing She's in the US, because they're familiar enough with the market to know it may not go over so well in a country where female subservience is less acceptable.
Maybe that's a small victory in disguise, but the fact that they've still manufactured a vehicle under the assumption that She's (with all of its cosmetic treatments and superfluous features) is what women would prefer is disturbing on many levels.

Not to say that automotive design shouldn't consider the needs and interests of female consumers, because there are differences between men and women...but also between women, and between men. Human factors including height, weight, reach, grip strength, reflexes, and reaction rates, apply to every human that operates a car. Also, why is UV protection only touted as a feature in the She's? Don't men like protection against skin cancer too? And are gender roles still really so separate that the color of a car defines whether a man or woman drives it?

When "pinking & shrinking" effects the quality or performance of a product, its not only often poorly done, its bad business. 

Honda isn't the only company guilty of pink washing products in an attempt to woo women. Maybe some women do feel more feminine and beautiful when holding a pink rifle, and that's fine. Just don't insult that woman by selling her a rifle designed to double as a handbag, that improves her ability to attract men,
when all she's really trying to do is shoot with accuracy.

The Power of 'Perceived Benefit': Kinesio Tape and Other Curiosities

Kinesio Tape was mentioned in NPR's health blog, Shots, and as a therapist it caught my attention. The article, entitled "Kinesio Tape Plasters Olympians, But Not All The Science Sticks", discusses the increased use of the product and questions the validity of its claims.

As a clinician, I would venture to say that most therapists see Kinesio tape not as curative, but as a treatment modality. It is one of many methods used to treat a patient depending on various factors, including the diagnosis and patient compliance. Some patients do experience benefits from the support taping provides, which allows them to return to peak performance more quickly, and some do not.

Whenever I see ads in trade publications for Kinesio Tape training clinics, I think about what a big business this product is, between profits from clinics, to the fees for their intensive training seminars, to the unpaid endorsement provided by professional and olympic athletes seen wrapped in Kinesio Tape during competition.

All of this is fascinating, especially when you get to the last few paragraphs of the article...

Even Good [international director of the Kinesio Holding Corporation]admits that the science hasn't caught up with the anecdotal evidence and the results that athletes have seen with Kinesio tape. But Powell [associate professor of sports medicine at the University of Utah School of Medicine] says that in the athletic community, a lack of hard evidence may not even matter.

"Anything that [athletes] perceive as an edge, they'll try, whether it's scientific or not. And the athletes are convinced that [Kinesio tape] is really helpful," she says. "It wouldn't be the worst placebo in the world; it's not doing any harm."

Of course one could argue that the actual harm lies in the false sense of security provided by a modality that hasn't been clinically proven to benefit the user in the way in which it claims. 

Still we look to find a reason to believe.

We subscribe to certain diets, embrace the latest exercise crazes (shake weights?), take the newest 'miracle' supplements, and believe in the healing powers of countless non-evidenced based treatments.

Here is where my design thinking starts to kick in. Caution, worlds are colliding.

Do things sometimes work better because we want them to? Does wishful thinking play a role in a product's success? Clearly to some degree, the answer is yes. Clever marketing, branding, and even packaging all help in shaping our perceptions of products and services. However, the real driver in the case of products like Kinesio Tape is the power of innate human motivation, and perhaps psychosomatic influence resulting from the placebo effect.

So why is Kinesio Tape such a successful concept? What lends to such a strong perceived benefit? Here are my observations...

1. Some evidence of legitimate science

In the case of Kinesio Tape, the method of tape application is based on the anatomy of our joints, tendons, muscles and ligaments. It mimics lines of pull, agonistic and antagonistic movements, and range of motion. I don't doubt that there is some scientific foundation behind the development of Kinesio Tape, given the anatomical rationale behind the product's clinical application. 

2. Engages the senses

It resonates on a sensory level, giving us immediate feedback during our every movement. One can feel the pull of the tape on the skin, and the pressure it applies to the body. It seems that if nothing else, the tape increases body awareness as it draws attention to movement patterns and anatomy. The bright colors grab your attention, almost showcasing your battle wounds with pride and flair. 

3. Minimally invasive

It doesn't require a prescription, or a medical procedure. Being an over the counter product makes it much less intimidating.

4. Positive associations

We see it on professional athletes and olympians in radiant neon colors. Its a lot less bulky and restrictive than a brace, splint or sling, and not associated with severe injuries. 

5. Expertise required

Kinesio Tape is applied by a trained professional, giving the patient a much greater sense of security and thus significantly adding both real and perceived benefit.

Obviously, understanding the different aspects of motivation, perception, and actual benefit, can inform design strategy. Ideally, it would be nice to see 'actual benefit' be the priority.

Design in Clinical Environments

Here is a recent article from McKnight's Assisted Living discussing design considerations in clinical spaces. Too bad the author got my credentials wrong, but at least she didn't spell my last name 'Jasper'.
http://tinyurl.com/bul9fbg

Featured in Metropolis

The Mainframe, an object which adapts to serve three different functional purposes depending on user needs, was featured in Metropolis!

 

A recent read on Fast Company

I came across an interesting article on Fast Company regarding an observation on the structure and function of US pharmacies

www.fastcodesign.com

Upon reading the article, I started thinking about my personal experiences at the pharmacy, and how I would access a pharmacist if I needed consultation. You can read my comments posted below the article itself.


Would it be possible to apply a system modeled after a 'doctor-patient' relationship, in which the patient (or pharmacy customer) has consistent interaction with a specific pharmacist who understands their medication regimen? 


Most drug store pharmacies operate sort of like an emergency room, with the first available clinician tending to patient needs as they arrive. While this is necessary when dealing with high patient volumes (a definite similarity in both instances), might the consistency of return customers in the case of the pharmacy be an opportunity for clinical familiarity over time? Especially if the customer is known to the pharmacist through both direct contact, as well as contact with their prescribing physician. 


Similar to an ER, a pharmacy could also benefit from a person to handle triage, determining which patient questions demand a pharmacist's attention and which could be addressed by anyone else on staff.


Consistency seems to be of interest, due to the opportunity for increased familiarity between pharmacist and patient, and ultimately improved service. 

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?