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Six lessons that guided 2016

1. In the 99% of healthcare that happens outside the doctor’s office, care planning is vital to reaching health goals
A team effort, led by Beth Herlin, developed content for a three part series unearthing the history of Care Plans, delving into the current state of care planning, and what all this means for their future development. This past Fall, Beth traveled to the Stanford Medicine X to give a keynote on Care Plans, and the concepts that the team developed continue to saturate our in-house and client based design.
Care Plans: A 3-part series of the landscape, design and future of personalized healthcare

2. Understanding that our health is determined by so much outside of medical care increases our responsibility for our own health
On the 25th of October, Social Determinants of Health visualization by Edwin Choi went live at determinantsofhealth.org. The giant printed posters made their way into Boston Children’s Hospital (Innovation Center), IoraHealth in Chicago, and MITRE, to name a few. They are a striking reminder of how our health is connected to more components than we realize and addressing health problems requires a holistic approach.

3. Bringing fun into care planning can help a new habit stick and open up otherwise difficult health conversations
The new 60-card care planning decks were finalized and shipped. Decks were given to attendees at the Partners Connected Health Symposium and the Partnering For Cures Conference. Care card stickers made it into the iOS Messaging App Store. Since then, the open source cards have popped up in a variety of talks and articles (e.g. Claudia Williams’ talk at Stanford Medicine X). At Health Refactored in Boston, Sugar Kills connected us with Susannah Fox (current HHS.gov CTO) and Alex Drane (co-founder of Engage with Grace and Seduce Health).
Susannah Fox and Alex Drane at Health Refactored, Boston

4. Pursuing radical transparency means promoting open source
Radical transparency has always been a core principle at Invo and has influenced everything from open standard Electronic Health Record design, to a visual primer on the Zika virus, and even our work on visualizing city budgets. We advocated for open source in healthcare through interviews (e.g. Juhan Sonin in the book Developing Citizen Designers by Elizabeth Resnick) and keynotes (e.g. Juhan at NE HIMSS).
Understanding Zika, a visual guide to the virus

5. Growth and development at Invo means cultivating a strong team and working on impactful projects…
2016 brought new faces and backgrounds into the studio, including interns Lilly Fan, from the Rhode Island School of Design, and Kelsey Kittelsen, from Dartmouth. Hrothgar, an Oxford mathematician and world traveling coder, and Sharon Lee, a biomedical engineer and artist from the University of Virginia, joined the team.
Sharon Lee, Biomedical Engineer and Designer from UVA
Hrothgar, Mathematician and Designer from Oxford

We designed the genetic carrier testing experience for clinicians and patients with WuXi NextCODE, future visioning for Walgreens, health IT tools for Imprivata, Electronic Health Record workflow design with eMDs, big data analytics with Crimson Hexagon, design strategy for clinical trial matching based on genomics for Cure Forward.

6. … but it also means learning how to brew hard cider and making new friends
Taking time to try something new refreshes and primes our minds for the work we care so much about. This past year, we partnered with Collective Next to pilot their Graphic Facilitation workshop, and Grove to learn about planting, growing, and farming vegetables in the kitchen. Internally, we held our own tech-talks featuring typography, by Hrothgar, cider brewing, by Sarah Kaiser, and DNA sequencing, by Edwin Choi.
Craig McGinley explaining his graphic thought process

Next up for ’17... 

Evolving care and transition planning (one collaboration is with our studio neighbor, Danny van Leeuwen) and an added focus on precision medicine for all, giving individuals full access, full ownership, and full participation in their health. 

Invo Spring Events

The snow mounds are melting in the Boston area. We can finally get out without a shovel, and we have some big plans for spring. Join us as we explore design, emerging technology and the future of health.

UX Hong Kong: Leadership Brunch
Hong Kong 
March 22, 2015
Involution Studios founder Dirk Knemeyer is traveling to China, Japan, and other parts of Asia, meeting with and presenting to leaders in emerging technologies. 

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HxRefactored
Boston, MA
April 1-2, 2015
Invo will once again join more than 500 cross-disciplinary thinkers and practitioners for an inspired mix of thought-provoking talks, workshops and discussions at HxRefactored 2015 in Boston. Visit our booth to meet Jeff Belden, MD, Founding Chair of the HIMSS EHR Usability Task Force and lead author of Inspired EHRs: Designing for Clinicians.


Service_Design
Service Design Salon
Tokyo, Japan
April 3, 2015
UX and Emerging Technologies
Dirk Knemeyer will present UX and Emerging Technologies. User experience (UX) as a discipline started in computer hardware and software, was co-opted and accelerated by Web site design, and is returning to roost in the exploding digital products of today and tomorrow. To remain relevant, we will need to learn, adapt, and grow in ways we never would have imagined when learning about research, interaction design, and javascript.


University of Shizuoka Game Lab 

Shizuoka, Japan 
April 4, 2015
Open Q&A with Dirk Knemeyer

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O'Reilly Media Webcast
April 16, 2015
From Bathroom to Healthroom: How Magical Technology will Revolutionize Human Health
Juhan Sonin discusses the future of health. It's time to design products to capture life and physiologic signs invisibly … usually through non-invasive sensors that don't require a single drop of blood, but just whiffs and sniffs. And when it is visible, it must be designed to feel wonderful. From Bathroom to Healthroom introduces participants to the macro factors shaping these realities, along with an in-depth exploration of the various impacts of and opportunities for design.

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HFES 2015
Baltimore, MD
April 26-29, 2015
From Bathroom to Healthroom: How Magical Technology will Revolutionize Human Health
Juhan Sonin presents From Bathroom to Healthroom: How Magical Technology will Revolutionize Human Health at the HFES 2015 International Symposium on Human Factors and Ergonomics in Health Care.

 

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O'Reilly Media Webcast 
April 30, 2015
UX Design for Emerging Technologies
Jon Follett takes a look at the role of the UX designer, as new technologies begin to blur the boundaries between design and engineering for software, hardware, and biotech. He will also discuss core competencies and case studies in practices areas like the Internet of Things, genomics, and robotics.

 

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TechSandbox
Hopkinton, MA
April 30, 2015 

IT, IoT, Mobile & Software SIG and Medical Devices & Life Sciences SIG
Juhan Sonin discusses the future of health. We are headed to “stage zero” detection and treatment which has the potential to double or better the lifespan of every first-world citizen. The power of the data and tools is impressive. The implications are daunting to the same degree. Designers and engineers will need to deliver products that are functional and invisible, but also make designs that are inviting not intimidating, reassuring and not anxiety-producing. We want to improve humanity, not put it under house arrest.

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UXPA Boston
Boston, MA
May 15, 2015
Involution sponsors this annual gathering of the UX community, with 30 speakers and over 1,000 attendees, one of the largest of its kind in the US.

Self-care, care planning, and prevention are essential to staying healthy

so we always looking for the latest resources. Here are two that piqued our interest this week.

Self-care: Digital Therapeutics

prevent-homescreen

Omada Health offers a number of programs like Prevent, which provides online support  and health/careplan kits with the tools an individual needs to manage serious chronic health conditions such as heart disease and type II diabetes.

Health Month

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This little app promises to help you improve your health habits in a “fun and sustainable way” using social games. You can try it for free. If you do, let us know what you think.

Healthcare as an "alternate economic universe"

hacking_affordable_care

Give yourself an hour and listen to this podcast: Hacking Affordable Care on Radio Open Source. Christopher Lydon talks with Steve Brill about how we got to where we are right now and who really benefits from the Affordable Care Act legislation. It’s worth your time.

New this week:

Don’t miss The Digital Life: The Super Bowl, Emerging Tech, and Health! Jon and Dirk explore the training, techniques, and technology for professional football and how the advances the NFL is making toward a complete view of health metrics and performance in real time is inspired by the quantified self movement. 

Wednesday brought the final article in our series looking at design for the patient experience, Software in Action, which looks at current software solutions including PatientsLikeMe®, Involution’s hGraph, and the Change Healthcare™ platform.

And on Monday we shared a unique look into the design process for a new Health Axioms card in How a Health Axiom Card is Made. Perhaps you will be inspired to share your own ideas!

As the news has spread in all directions we have discovered that the 2014 Ebola outbreak represents not only a healthcare crisis with global impact, but also an information crisis. Even highly respected news outlets can have conflicting information on a single event, so that the stories are confusing and hard to trust. Hours spent poring over the NIH and CDC and WHO sites revealed the common threads of truth, but the details were scattered. There was no straightforward way to get a complete picture.

So, we decided to create a single source of graphical information that could become an international resource. Something that could compliment the Wikipedia page. Clean lines, a classic readable font, with unambiguous colors and icons. Headers in black and white, red for critical information, gray text to let pictures do the talking. Easy to scan and locate the topics before reading closely for details.

For designer Xinyu Liu, sifting through and digesting the massive information set was a great challenge, as was creating the graphics based on what she learned. It took time as well to select and refine icons for readability and simplicity. A fully articulated timeline had to be scrapped because it simply didn't show all of the information. Then came distilling the language for brevity and clarity, fact-checking to make sure we had the country names correct, as African politics have shifted since the virus was first identified, and researching to ensure clinical accuracy. 

We worked quickly to get the graphic out into public view. Waiting to get it perfect was not the plan. It is an image for now—it’s not yet searchable nor dynamic. We need lots of eyes on it, the eyes of people who are far more aware of what is currently happening and how it all began: doctors, healthcare workers, policy makers, scientists, and others in the field. We are continually gathering feedback, updating, and reposting. The scientific method at its best: ideate, model, test, repeat.

The first draft of this document was put together in under two weeks. Here is a peek at how that happened.

red-ebola

A single page from Xinyu's sketchbook contains the challenge in a nutshell: overwhelming data in a broad range of topics, from geopolitical divisions to chronology, the nature of the virus, rates of incidence and deaths, and more. Color codes and graphs are beginning to take shape even while information is still coming in.

death-rate

A detail of the timeline that now clearly tells the story of each outbreak since 1976 with geographical locations, rates of cases and deaths, and a summary of how the infection began and spread in each case. The timeline also indicates points at which new strains of the virus were identified.

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Gathering epidemiological data, developing the context for the narrative of the current outbreak.

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Working with feedback to improve visual consistency, and, later, understanding the concept of viral load to add new information from an external reviewer.

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Here we see the finely tuned visualization of the information in the previous two sketches, used to convey the dramatic differences in viral load among several devastating diseases.

Involution Studios is a tiny company. We are not an NGO nor a non-profit. We are, however, deeply committed to designing great healthcare and changing people’s behavior for better health (hence, the Health Axioms). We want to understand what is happening with Ebola, and we want to make it easier to share that knowledge. So we created Understanding Ebola: A Visual Guide as an open-source project that we are distributing as widely as possible. We invite feedback and we will continue to update and improve it as healthcare professionals send us better information.

details

Recently on The Digital Life podcast, Involution's Jon Follett sat down with Creative Director Juhan Sonin to discuss the Health Axioms card deck and designing for behavior change.

The Health Axioms are 32 recommendations that put you in touch with habits to improve your health, life, and well-being. The sometimes surprising, always practical axioms nudge you toward the healthiest life possible. These are one small part of a global movement to shift the health care system to one of: non-invasive personal diagnostics, highly specialized clinicians that work closely with patients and their families, and self-monitoring, self-empowered patients. Getting there is equal parts smart technology, healthcare reform, and everyday common sense.

Sonin describes how personal experience launched his involvement in healthcare design and technology, when he realized that his health was not as perfect as he'd thought. Despite his own fascination with the latest gadget, however, he reminds us that simple behavior change still plays a vital part in our health. The Health Axioms "help people cut through the BS and focus on clear actionable advice that will hopefully have impact on how we interact with the healthcare system and our bodies. ... Each card has a single idea on it. One specific behavior that we should concentrate on like 'Move more,' or 'Get more sleep,' 'Take baby steps,' 'Exercise is medicine,' 'Food is medicine.'"

Juhan has distributed hundreds of decks nationally (and internationally) over the past few months and shares some of the feedback and ideas coming in, along with plans for the future (and a sneak peek at a few of the new card topics).

So, blend up that green smoothie, tie on your walking shoes, and listen while you move!

Dirk Knemeyer has a few questions about Apple's ideas for a mobile medical solution.

This coming June, Apple is expected to announce their “Healthbook” app. In a bold expansion on the concepts of Involution’s hGraph app, Apple is attempting not only to federate all of a user’s important, top-level health and wellness data but also to synchronize with hardware devices that do everything from analyze blood to count steps to monitor heart rate.

Healthbook mockup

Mockup of Healthbook screen published to Behance this past February.

hGraph, your health in one picture

hGraph, the only open source visualization for your complete health, developed by Involution Studios.

There is an enormous need for this kind of software. Right now hundreds of companies are shipping devices that collect or track health and wellness information, but locking that data into proprietary interfaces that they are trying to monetize in order to sustain a business. This bottom-up approach worked in validating the market, but it is not at all consumer-friendly in the aggregate. It is too hard for a user who knows how all of his or her different services work to get a good picture, let alone a doctor or emergency healthcare professional. Having one software interface where all of your data is tracked and displayed is clearly the correct solution. Someone certainly needs to do it. The question is, is Apple the right company to be doing it?

Emphatically: No, for three reasons.

  1. Apple is terrible at software. Can you name one piece of software that Apple makes which is really excellent? From iTunes to Mail to Pages to iCloud, one is worse than the other. OS X? Used to be the best, largely thanks to engineering, not design, but as they try to unify their desktop and mobile operating systems and user experience, it gets worse every day. Keynote? OK, I will grant you Keynote. But Apple has a long track record of being astonishingly good at hardware and cover-your-eyes-bad at software. Maybe they get it right here—I hope they do—but as my Mail app continues to misbehave and iCloud remains unusable after more than a decade of trying, I can’t fathom that they will.
  2. Health information access needs to be universal and consistent, not specific to mobile OS providers. Apple, Google, and Microsoft are locked in a battle for digital supremacy. Rather than search for solutions that are complementary they are each trying to create their own OS, their own devices, and their own mapping programs. If they are now also providing their own Healthbook equivalents, it could present a serious challenge. Do we expect healthcare professionals to train up on three different software environments? What happens to your Apple data if you change to Microsoft, will it be lost or just offline and not integrated? Do these shortsighted competitors have the vision to cooperate?
  3. Apple’s parochial interests will stifle innovation. The totality of this picture is a complex one. Apple, correctly, is trying to bring together a tremendous amount of health data and information from potentially very different sources and devices. Meanwhile, they are rapidly patenting various hardware, software, and input and output mechanisms aimed at the rapidly expanding mobile medical device market. Each success brings Apple closer to developing a Healthbook that is more proprietary, less universal, and infinitely less useful in the long-term and/or outside of the Apple bubble.

Ideally this sort of software would be created by an international non-profit focused solely on health and wellness as part of a blueprint for healthful humanity. Among their initiatives they would make this sort of top-order software as accessible and transferable and standardized as possible. Of course, there is no such organization. It seems like an obvious thing to be funded by the Bill & Melinda Gates Foundation, but how much Microsoft stock does the Family Gates still hold? Around and around we go.

About Involution’s Health Design Practice
For almost 10 years, Involution has been building software for health companies of every shape and size, from household names like AstraZeneca and Walgreens, to research leaders like the Personal Genome Project and Partners HealthCare. We also work with the most exciting and progressive health startups. We’ve made digital healthcare our top focus.

Stanford MedicineX logo
Stanford Medicine X 2014
Stanford University
September 5-7, 2014
Register

Remember doctor's visits when you were growing up? The wooden tongue depressor. The well-worn stethoscope. That weird thing they jammed in your ears. And now, my young children are getting about that same treatment. But that is going to change.

Involution Creative Director Juhan Sonin has been invited to present "Design For Life" at Stanford Medicine X in September. Along with other innovators in patient-centered design, Sonin will talk about design-for-health possibilities and responsibilities.

As design harnesses digital, materials and networking technologies, a very new health experience is just over the horizon. Proactive, lifestyle design. Tracking real-time health data. Non-invasive tools. Custom "just for you" treatments based on your actual genome. These are all real technologies, being used by ordinary people. Together they are leading us to "stage zero" detection and treatment which has the potential to double or better the lifespan of every first-world citizen. It's not science fiction—the children of the 2020s will only know this reality. Tongue depressors will be limited to school craft projects and popsicles. And it is all the product of technology and design.

"Design For Life" will introduces the macro factors shaping these realities, along with an in-depth exploration of the various impacts of and opportunities for design.

About Medicine X
Medicine X is a catalyst for new ideas about the future of medicine and health care. The Medicine X initiative is designed to explore the potential of social media and information technology to advance the practice of medicine, improve health, and empower patients to be active participants in their own care. The “X” is meant to evoke a move beyond numbers and trends—it represents the infinite possibilities for current and future information technologies to improve health. Under the direction of Dr. Larry Chu, Associate Professor of Anesthesia, Medicine X is a project of the Stanford AIM Lab.

About Juhan Sonin
Juhan is the Creative Director of Involution Studios, and has been the creative leader of four different organizations, producing work recognized by the BBC, the New York Times, Ars Electronica, National Public Radio, and Billboard Magazine. Prior to joining Involution, Juhan spent time at Apple, the National Center for Supercomputing Applications (NCSA), a few startups, and MITRE. He is also a lecturer on design and rapid prototyping at MIT.

OSCON2014 logo
O'Reilly OSCON

Open Source Convention
July 20-24, 2014
Portland, OR
Register

Remember doctor’s visits when you were growing up?
The wooden tongue depressor. The well-worn stethoscope. That weird thing they jammed in your ears.

As design harnesses digital, materials, and networking technologies, a very new health experience is just over the horizon. Proactive, lifestyle design. Tracking real-time health data. Non-invasive tools. Custom “just for you” treatments based on your actual genome. These are all real technologies, being used by ordinary people. Together they are leading us to “stage zero” detection and treatment which has the potential to double or better the lifespan of every first-world citizen. Not science fiction, the children of the 2020s will only know this reality. Tongue depressors will be limited to school craft projects and popsicles. And it is all the product of technology and design.

Join Involution Studios Creative Director Juhan Sonin in Portland this July as he introduces participants to the macro factors shaping these realities, along with an in-depth exploration of the various impacts of and opportunities for design.

About OSCON
Once considered a radical upstart, open source has moved from disruption to default. Its methods and culture commoditized the technologies that drove the Internet revolution, and transformed the practice of software development. Collaborative and transparent, open source has become modus operandi, powering the next wave of innovation in cloud, data, and mobile technologies.

Now in its 16th year, OSCON is a unique gathering of all things open source, where participants find inspiration, confront new challenges, share their expertise, renew bonds to community, make significant connections, and find ways to give back to the open source movement. The event has also become one of the most important venues to unveil ground-breaking open source projects and products.

About Juhan Sonin
Juhan is the Creative Director of Involution Studios, and has been the creative leader of four different organizations, producing work recognized by the BBC, the New York Times, Ars Electronica, National Public Radio, and Billboard Magazine. Prior to joining Involution, Juhan spent time at Apple, the National Center for Supercomputing Applications (NCSA), a few startups, and MITRE. He is also a lecturer on design and rapid prototyping at MIT.

NPR Health Axioms Story

Involution's Health Axioms are grabbing the attention of the health innovation community.

NPR Health Blogger Nancy Shute posted her impressions of the Health Axioms recently in If A Picture's Worth 1,000 Words, Could It Help You Floss?

After getting her own Health Axioms in the mail — with a personal note — Shute called Involution's Juhan Sonin, one of the creative minds behind the deck. She had spread the cards on her desk at work and watched her co-workers' reactions, which ranged from "Health tarot cards!" to "But who are they for?" Not surprisingly, Sonin was frank in saying that the decks reflect a first-release "primordial ooze stage" and that he hopes to get feedback and ideas from a broad audience. Given the number of responses already posted to this one article it's clear that people want to talk about health and want to be heard.

Shute lets the cards speak for themselves by including several images from the deck, summing them up as not Crazy Eights but having their own "geeky charm," even with Manga-style illustrations reminiscent of "Soviet propaganda posters (but in a nice way)"(!) She let colleagues bring them home, reporting both delight (from a 10-year-old) and shrugs of indifference (from teens). She was puzzled by two of the axioms ("Know Your Numbers," "Who Is Your Wingman?") and demonstrates how quickly these two became worth the small effort of reading the card backs.

Read Shute's blog post. Check out the Health Axioms. Let us know your thoughts.

Learn more about/order Health Axioms.

About Involution’s Health Design Practice
For almost 10 years, Involution has been building software for health companies of every shape and size, from household names like AstraZeneca and Walgreens, to research leaders like the Personal Genome Project and Partners HealthCare. We also work with the most exciting and progressive health startups. We’ve made digital healthcare our top focus.

GET Conference Logo

GET Conference
April 30, 2014
8:30 AM to 5:30 PM (EDT)

Ballroom at the Hotel Marlowe
25 Edwin H Land Blvd
Cambridge, MA 02141
Register

Involution Studios is a sponsor of this year’s GET Conference in Cambridge, Massachusetts next month. Organized by PersonalGenomes.org, the Conference is planned each year to coincide with World DNA Day, which celebrates the completion of the Human Genome Project in 2003, as well as Watson and Crick’s 1953 conclusion that DNA molecules have a 3-D double helix structure.

Topics covered by GET Conferences have included:
• Omics such as personal genomes, microbiomes, immunomes, and metabolomes
• Sensors, including health and environmental sensor technologies and self-tracking
• Policies covering access, sharing, governance, privacy, IP, and so forth
• Data and IT platforms, visualization, modeling, applications, and tools
• Traits and measurement, interpretation, and new products and practices
• Medicine: preventive, predictive, personalized, and participatory

In its fifth year, the GET Conference will bring together leading thinkers to discuss how we measure and understand people and their traits. This event explores the frontiers of understanding about human biology and serves as an annual forum to debate the technical, commercial, and societal impacts.

About PersonalGenomes.org
PersonalGenomes.org is a 501(c)(3) charitable organization whose mission is to make a wide spectrum of human biological information accessible and actionable to increase biological literacy and improve human health. We support the Personal Genome Project and produce the GET Conference.

About Involution’s Health Design Practice
For almost 10 years, Involution has been building software for health companies of every shape and size, from household names like AstraZeneca and Walgreens, to research leaders like the Personal Genome Project and Partners HealthCare. We also work with the most exciting and progressive health startups. We’ve made digital healthcare our top focus.

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