Building healthcare solutions that work for all users
“For many patients, time spent in an intensive care unit is a deeply disturbing experience, and not just because they are suffering from a serious illness. They are often heavily sedated, encircled by beeping equipment, unable to talk or even think clearly. Doctors and nurses prod their bodies as scores of trainees watch.”
– The Boston Globe, 14 March 2016
The Boston Globe article, Hospitals working to make intensive care less terrifying, highlighted the challenges of delivering “humane, respectful care” in today’s increasingly complex healthcare environment. It describes the novel approach Beth Israel Deaconess Medical Center (BIDMC) took with MyICU, an app we helped them develop to improve the flow of information and care experience amongst patients, families and their clinical teams.
Here’s one poignant example from The Globe:
“Deeply-sedating drugs can cut pain and allow healing, but they also contribute to patients’ confusion and delirium….While [Paul] Daigneault was in the ICU at Beth Israel Deaconess in 2011, his dreams and hallucinations were vivid. Some were funny. He was convinced the ICU turned into a brothel at night. Others were scary. Friends tried to hold him under water. Daigneault’s cancer is now in remission and he credits hospital staff with saving his life.”
Certainly this scenario isn’t unique to BIDMC – it occurs in hospitals nationwide. But BIDMC’s approach with MyICU is instructive: how a solution in the form of an app could help patients rebuild their memories, reconstruct the real from the imagined, and fill in the gaps of what they didn’t know or understand about their care.
For Aptima, helping the BIDMC team bring MyICU to life has been a fascinating and gratifying project. The challenge was to devise a solution that would not only improve the patient experience, but that would also work in a high intensity care setting where staff act fast, deliberately, and with attention to life threatening conditions. In fact, these are challenges very similar to those encountered in our work with the military. And just like in the defense industry, taking a scientific approach is essential: These projects involve more than just software development; they require understanding problems at their core so we can build a human-centered solution that works for all the users.
For MyICU, we needed to reconcile the dual needs of very different stakeholders. For patients and families, the app would have to be user-centered, tailored to their experience, addressing their cognitive gaps, their emotions and pain points. It needed to resolve their needs, filling in what they needed to know about their care with the right information, engagement, and support.
For the clinical team, it was all about process, the issues in their workflow, their tasks, their constraints, and the framework of how staff members operate with each other and patients. We investigated how they could, without additional technological burden, input relevant patient care information and respond to family questions. And importantly, we researched how they could access the information to treat and understand better the patient as a person with a life, hobbies, work, and family—and not merely an accident or illness.
Like the physician’s Hippocratic Oath of “do no harm,” MyICU couldn’t trigger other problems, create more workload for staff, or instigate new privacy issues for patients. It couldn’t interfere with what was currently working. And, ultimately, MyICU is meant to support and improve the human face-to-face interactions amongst patients, families and their care team, not replace them.
Update: After a successful pilot in two ICUs, we are working on additional projects with BIDMC and will be back shortly with updates!