Learning from How Doctors Think

When I picked up Jerome’s Groopman’s How Doctors Think, I imagined that it would give me a useful window into the mind of the busy clinician. On medical projects we often find it a bit challenging to get enough research time with physicians. (Aside from maybe lawyers and CEO’s, there are no better exemplars of the “time is money” mentality—American doctors, in particular.)

Dave, Doug and Noah learning how surgeons think.

While I appreciated the informal history of medical education, interesting anecdotes of diagnostic challenges and satisfying dose of medical atmosphere, I learned just as much about design and design research as I did about medicine. (I'm not surprised to discover that I'm not the first to make this connection. In her blog, Elegant Hack, Christina Wodke discusses how she thinks design education should be thought of more like medical education, with a focus on gaining experience over several years in industry, rather than just technical skill in a design program. She'll get no argument out of me there.)

The part of the book that I found most striking is Groopman's discussion of what he calls "classic cognitive errors" in diagnosing and treating medical conditions. I have made and seen each of these errors in understanding people and devising products and services to meet their needs. While explicit knowledge of these categories of flawed thinking isn't a guarantee against them, I do think that by naming them and affirming their reality (often by reference to the work of psychologists), this book can help us remember the kind of mistakes that top-notch professionals make when they're tired, stressed, egotistical, or just lazy.

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Going with the Flow: Interaction Design for Healthcare

Healthcare is a target-rich environment for design. Discussing even the smallest design challenge quickly exposes the hacked-together systems and processes that somehow function to help us stay healthy. Designers must understand the context in which they work, yet confronting the complexity of healthcare can be paralyzing. It seems impossible, for example, to discuss the viability of mobile devices at the point of care without discussing the Byzantine network of roles, regulations, and workflows that the device touches: nurse assistants, the lab, the patient, receptionists, regulatory bodies, HIPAA, hospital and lab information systems, IT departments, point-of-care coordinators, ADT systems, and so on.

While it’s important to understand the knotty context of a healthcare design problem, it’s just as important to know when to reach for the sword of methodology to cut through it. To illustrate this point, I’ll discuss some healthcare design challenges I’ve seen during my research and design work and the methods I’ve used to tame the complexity.

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Interface Design as a Life or Death Proposition

In the mid-1980's, a team of physicians, lawyers, and public health experts conducted a lengthy study of the nature and causes of medical errors. They published their findings, entitled "Incidence of adverse events and negligence in hospitalized patients," in the New England Journal of Medicine in 1991.[1] Their research indicated that "there is a substantial amount of injury to patients from medical management, and many injuries are the result of substandard care." While the industry evaluations and renovations sparked by these findings have taken effect, physicians and clinicians have simultaneously adopted more sophisticated technologies to provide more accurate and efficient care. [2]

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