The Smartphone Physical team at NeoCon: (L-R) Mike Hoaglin, Shiv Gaglani, Michael Batista, and Griffin Milsap



Posted by Cameron Young on Thursday, July 11, 2013 · Leave a Comment

We partnered with a team from Medgadget during NeoCon to perform mini Smartphone Physicals as an effort to demonstrate how space and technology affects the healthcare experience, centered specifically around EmpathPocket for iPad, and Regard. After the conference, we followed up with them to reflect on their experiences:

What were the highlights of your experience administrating the Smartphone Physicals? How did people at NeoCon react to the apps, accessories, innovations?

Shiv Gaglani: NeoCon was an amazing experience. My colleagues and I are used to medical conferences so it was interesting to attend our first design meeting, let alone one as massive as NeoCon. Even though the audiences were different than our experience at TEDMED or later in June at the American Medical Association (AMA), the people at NeoCon were incredibly receptive to what we were doing. The ECG and blood pressure readings as well as optic disc pictures remained crowd pleasers, and it was clear that some people heard about what we were doing and made their way to our area expressly to get their SPP. We focused on how the Smartphone Physical was augmented by the well-designed and mobile space created by Nurture: from the comfortable Empath to the flexible Pocket (my personal favorite). The need for the space was clear a few days later at the AMA meeting, where we had to rely on underwhelming tables and chairs, which blunted the Smartphone Physical experience compared to what we were used to through our collaborations with Nurture at TEDMED and NeoCon.

How about the showroom/exam area set up? How did Empath, Pocket and Regard interact and affect the SPP?

Michael Batista: The environment designed by Nurture featuring Empath, Pocket and Regard enhanced both our ability to perform the Smartphone Physical and the experience of the attendee/patient receiving the physical examination. Compared to the typically sterile and uninviting exam table, Empath puts the patient and clinician at the same level to promote a comfortable environment to encourage interaction. In terms of capabilities, Empath is excellently designed to allow either the clinician or the patient, who may have a limited range of motion in the clinic, to easily alter the orientation into a number of necessary conformations throughout the course of the physical exam. Be it a comfortable, upright position during blood pressure measurement or a relaxed, reclined position during ultrasound visualization of the carotid arteries, transitions can be made quickly and unobtrusively.

With the maneuverable Pocket on hand, all of our devices are readily available. An iPad mounted to the Pocket provides a centralized platform where physical exam data is  both collected and recorded, promoting easy transitions between each measurement collected during the examination. Patients commented positively on how the visibility of the data being collected on the iPad enhanced their understanding of the data while engendering a more transparent patient-clinician experience.  Together, Empath and Pocket created a very fluid examination process, bringing the patient closer to his or her own health care while eschewing the need for the examiner to break off the conversation with the patient to spend time either recording the data or retrieving another device.

In cases where the patient was accompanied by other attendees who wanted to be included and informed in the examination process, Regard expanded the triangle of interaction between patient, clinician, and data (displayed on Pocket). Regard established a very comfortable, inclusive environment where the onlookers, which in the clinic could be the patient’s family or close friends, had the opportunity to become as informed as the patient during the examination process through data presented by the examiner on the Pocket or mirrored to a television screen. Additionally, Regard allowed attendees to remain connected with convenient outlets and work stations while visiting the Smartphone Physical “clinic.”

What were differences/similarities to your time at TEDMED? Did the different audiences react differently to the SPPs?

Griffin Milsap: There’s no doubt that the audience at TEDMED was a bit more medically inclined and interested in SPP more than the space in which the physicals were performed, but NeoCon attendees were just as interested in SPP, for a different reason.  Many of the attendees were genuinely interested in their vitals, with several even asking for specific tests to be done.  Folks who weren’t feeling well were seeking answers that a SPP was able to provide.  I would say we saw a different population of attendees this time around.  Instead of a more clinical audience, we saw more of the patient audience, and got just as much valuable feedback from a very different point of view.

Given the fact that we did about 300 physicals at TEDMED with five stations spread over three locations, I’d say that our approximately 100 physicals at NeoCon with only two stations in one location indicates a comparable interest level.  The design community seemed to be more focused on the big picture and how SPP could be implemented in a clinical/residential environment with the development of new spaces.

In general, how do space and technology affect each other in doctor-patient interactions? How do the status quo in healthcare and the vision of the future of healthcare that Nurture’s mapped out compare?  

Mike Hoaglin: Healthcare encounters are undeniably ruled by transition. Whether it’s going from waiting room to exam room, or clinic to hospital, every movement counts and is an opportunity to enhance the patience experience. Instead of contributing to the stress of an uncomfortable situation, the best-designed healthcare space should tacitly relieve tension. The doctor-patient interaction has traditionally been somewhat limited by cold, awkward space, but now new connected technologies can make the space more of a tool to better connect with a patient. Time in the waiting room can be amped up with productivity and education given the right set up. Most importantly, thoughtful space sets an empathetic tone for the encounter. The patient should feel at ease to discuss sensitive information and be open to learning from the physician.

The exam room of the future as envisioned by Nurture is a clear leader in this area where the form and function of their products set the foundation for an optimal doctor-patient interaction. Their products go beyond empathy and dignity and emphasize the partnership and engagement themes in wellness: interactions are kept at eye level and actual patient data are integrated into the space such that a personalized feel is maintained even between visits.

Where do you see physical exams going in the future, maybe 5 and 10 years down the road? Drastic differences in doctor-patient relations or similar to today?

Shiv Gaglani: My hope is that the kinds of technologies we showcased in the Smartphone Physical will empower patients to be more attune to their individual health, turning them into their own data collectors. This would allow the already-limited time between a clinician and patient to be spent on understanding the data and coming up with shared treatment plans that they can agree upon. However, it will take time before these changes permeate to all clinical offices. While some hospitals and individual clinicians have already begun competing on quality measures, so many people need health care that those clinicians who are not as committed to improving the patient experience will still have plenty of people to treat. Hopefully even these clinicians will accept that current parts of the physical exam are ineffective at best and could be replaced with better technologies that improve the patient experience.


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