People's Choice Winning Idea: NephroZip
It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately, one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors and had the courage to tackle the problem head-on. Three years ago, Avik Som organized “Problem Day” at his medical school (Washington University School of Medicine in St. Louis, MO) and invited his professors to an unrestricted “open mic” venting session.
Representatives from the departments of surgery, medicine, pediatrics and neurology attended. They described their frustrations and day-to-day struggles with the students for 3 hours straight. After decades of service to suffering patients, it was the first time that anyone had asked them to share their own stories.
And borne out of this collective catharsis was IDEA Labs (a 501c3 ) – a student-driven movement to tackle clinician problems with fresh ideas and the energy of youth. I attended the third annual “DemoDay” (also known as “Solution Day”) presentations in St. Louis this week and was amazed by the breadth and depth of the student solutions to specific clinical problems. From plastic ties to hasten renal surgical procedures to energy efficiency units for hospital HVAC systems – the ideas spanned many technical knowledge domains, and investors in the audience paid rapt attention.
This year’s first-place winning idea was the Cystoview adaptor. Bladder scopes (or cystoscopes) represent a surprising 0.5% of Medicare’s total annual expenditures. Yet they still rely on old analogue technology and their images are difficult to share and transfer. The Cystoview device converts any cystocscope from analogue to digital, and images can be uploaded anywhere – from a desktop computer to a smart phone. Once collected, digital images can be mapped and reconstructed into a 3-D bladder scan so that surgeons can plan to more effective tumor resections. In addition, having the cystoscopes go wireless reduces the risk of infection associated with cords dragging across surgical fields.
IDEA Labs is unusual for several reasons. First, it was designed as a joint venture between professional schools at Washington University – Avik Som wanted to draw talent from Engineering, Business, Law, and Sciences to create multi-disciplinary student teams. The cross-pollination of student ideas can lead to some especially creative solutions.
Second, students retain 100% of the intellectual property associated with their solutions. So whether they design a specialized lumbar puncture chair, digital cystoscopy device, wheelchair storage mechanism, or new blood test for cancer, they are responsible for pitching their idea to angel investors and creating a business plan that will bring their ideas to market.
Third, IDEA Labs is student-driven, and therefore agile and independent from the administrative and political hurdles that can slow down innovation at academic medical centers.
Last year IDEA Labs students raised $300K in venture capital funding for their ideas. This year, they raised $1.5M. They are also actively franchising their student innovation model to other schools across the country.
Ramin Lalezari is a second year medical student and Director of Recruitment for IDEA Labs’ Executive Board. He is also an American Resident Project fellow (an organization that seeks out promising young medical students and residents and supports their writing talent – they also sponsored DemoDay this year). I got the chance to catch up with him at DemoDay. He described how he got involved with the project as a first year student, and worked with a team of engineers to design a system that detected pre-syncope in hospitalized patients, reducing the risk of possible falls.
“When I heard that medicine lags 50 years behind technology, I was horrified. Why do we still have pagers and fax machines?” huffed Lalezari. “We must do better. Students themselves will drive technology and innovation. We are going to build a network of incubators across the U.S., using telemedicine when appropriate. If a student in Los Angeles is passionate about solving a urology problem with engineers in St. Louis, then we will facilitate it. The student project manager pitches his idea, and students nationwide can sign up to help. Some of these design ideas are going to change the face of medicine. That’s our end game.”
I asked Lalezari if IDEA Labs would draw students away from practicing clinical medicine.
“There is no doubt that these projects require a time commitment. A few teams have disbanded due to the overwhelming burden of studying for exams. So some are quitting IDEA Labs. On the other hand, I’ve heard of some students who become so invested in their ideas that they talk about making a career out of it.”
“Are other medical schools developing their own IDEA Labs model for entrepreneurship?” I asked.
“There are 24-hr ‘hackathon’ models out there, and senior design projects that are formalized courses. IDEA Labs projects are 9 months long, with mentor-guided progress reports every 2 months. Most schools foster entrepreneurship from the top down – administrators and professors drive the ideas and the schools retain the intellectual property. I think that the bottom up approach resonates much more strongly with students.”
IDEA Labs may have turned the long-entrenched apprenticeship model of healthcare innovation on its head. No longer are students vying for the honor of supporting the design ideas of senior physicians in unpaid or underpaid internships. They are identifying problems and solving them in teams of peers without the hierarchy imposed by academic-driven projects. They have leveled the playing field and stand to gain a lot more from their hard work than ever before.
Although medicine may still be a dinosaur when it comes to technology adoption and innovation, the IDEA Labs students are replacing the soloist T. Rexes with team-working Raptors. And that represents a true leap forward in the evolution of healthcare.
***Demo Day was sponsored by The American Resident Project and J&J Innovation. For more information about how to get your school involved with IDEA Labs, please contact email@example.com.
I have been an outspoken, and often times exasperated, patient advocate and student of healthcare reform. There is no doubt that the U.S. healthcare system is operating far below its potential in terms of efficiency, effectiveness, and affordability. In fact, an entire industry of policy wonks and consultants have sprung up in both the public and private sectors – all with recommendations about how to “fix” our system. In my opinion, the most insightful suggestions will come from those who are currently doing the work of healthcare (i.e. clinicians) and change will be adopted and promoted most fervently by the young and freshly minted among them.
Medical students, residents, and physicians newly in practice now have a place to voice their opinions – The American Resident Project is an ambitious movement to promote fresh thinking from tomorrow’s physician-leaders. I am pleased to be supporting this effort here on my blog and in face-to-face meetings with fellows at medical centers across the country. I hope you’ll bookmark the website and join in the community conversation about how to innovate in the midst of a broken system. This is more than a think-tank for change – the ideas and opinions of young doctors may be our best hope for a brighter tomorrow.
Stay tuned for some fresh ideas in the setting of some healthy talk therapy!
Dr. Pauline Chen recently wrote an interesting, if not slightly sterile, article about the prevalence of bullying in medical school. A survey published by JAMA in 1990 suggested that 85% of medical students had experienced some kind of mistreatment during their third year of training, and a quarter of the respondents said that they would have chosen a different profession had they known in advance about the extent of mistreatment they would experience.
One medical school (UCLA) took these sobering statistics to heart and implemented an anti-bullying program of sorts. Thirteen years after it was initiated, more than half of all medical students still said that they had been intimidated or physically or verbally harassed.
I recently wrote a fairly tongue-in-cheek blog post about why doctors are jerks. But I didn’t really delve into the more sinister side of the bullying culture. Some of my experiences in medical training were soul-suckingly bad, and just to add some flavor to Dr. Chen’s analysis, let me share some real-life anecdotes.
My worst experiences in medical training occurred during Ob/Gyn rotations. I don’t know if this has been the experience of other medical students, or if my gender had anything to do with it, but I spent time with a group of female residents who were so toxic to med students that the department chairman actually warned us about them ahead of time in a private meeting. He let us know that these residents had a history of “hazing” medical students, particularly females. I had always been a very conscientious and hard working student, so I presumed that they wouldn’t have much to criticize. My plan was to work hard, keep my head down, and get out unscathed. Unfortunately, nothing went as planned.
The tone was set for me the first day when I witnessed a female, Asian anesthesia resident slap a pregnant Hispanic woman who was in labor. The woman was frightened and spoke no English and was beginning to hyperventilate from pain. The resident was trying to put in an epidural anesthetic and the woman was moving around too much for her to get the needle safely into position. So instead of calling for a translator, the resident started raising her voice, eventually screaming at the woman to calm down. The woman was crying uncontrollably, so the resident slapped her, and told her that she was “going to lose her baby” if she didn’t shut up. The husband was also terrified and could understand some English. He translated to his wife that she was going to lose the baby and started begging her to be calm. I stood in the doorway with my mouth open. The resident told me to get the f-out of there as she threw her gloves at me.
I suppose the humiliation of being caught abusing a patient was enough to channel her hate towards me, so she told the Ob/Gyn residents that I was an incompetent medical student. For the rest of the month I was targeted by the hazing team, and like a pack of wolves they descended, bound to make my every moment a living hell. During the delivery of my first baby (a touching experience that moved me to tears), the new mom experienced a small tear during the birthing process. The residents blamed it on me, and convinced me that I had personally caused her harm by not “supporting her perineum” correctly. I was mortified and fell for the lie – hook, line, and sinker.
When a woman went into labor it was customary for the residents to page the medical student on call and have him or her assist with the vaginal birth or c-section. My peers were paged in a timely manner, while I was either paged at random times or paged to the wrong parts of the hospital so that I appeared to be late to several deliveries (especially when a senior physician evaluator was present to witness it). Once I caught on to this I had to remain awake 24/7 at the nursing station (rather than the more secluded med student lounge) so that I could follow visual cues regarding where and when to assist. After several shifts without sleep the residents began locking the chairs in their lounge so that I would have no where to sit or rest, but would be forced to remain standing “on guard” all night.
One page was particularly painful at the time (but almost laughable in retrospect). A resident took it upon herself to page me just to tell me some important news: I was the worst medical student in the history of the program.
Of course, my final resident evaluation was dripping with venom. I recall statements such as, “Valerie suffers from narcolepsy,” and “she is uniformly late and is never prepared… she doesn’t answers her emergency pages… she occupies valuable space at the nursing station instead of remaining in the medical student on-call room… her performance in deliveries borders on dangerous.” And on it went. I wish I had the maturity to take all of that in stride at the time and see that these women were nuts, and it had nothing to do with me personally. But I was too close to it then, and I bore the pain with a stiff upper lip.
I still think about that poor patient who was slapped, and I kick myself for not standing up to the resident who hit her. I guess I was in such shock that I didn’t know what to do. But living through this abuse helped me to become a stronger patient advocate during my residency years. Just two years after my brush with the Ob/Gyn residents, I gained a reputation for being the intern you never f-with. I know I saved the lives of some who were slipping through the cracks of the system, and I was willing to call in the hospital ethics committee if I had to. Yes, that pregnant woman’s suffering was not totally in vain – because she helped me to find my own cojones. And for that, I will always be grateful.
For the last 4 years, I’ve been teaching medical and public health students about the use of social media and generally digital technologies in medicine and healthcare and I got a good picture of what kind of medical professionals they would become soon. They represent the new generation of physicians.
Here are my points and observations:
- They are technophile. I remember the time when there was no internet, I remember the first website I first saw online. They were born into the technology and internet-based world. For them, websites, Facebook, Twitter and blogs represent the basics. They love gadgets and devices.
- They are fast. They use smartphones, read news online, follow blogs and know what RSS is, they are familiar with multi-tasking. They are much faster than the previous generations, therefore they need different tools and solutions in their work.
- But they use the technology for Read more »
*This blog post was originally published at ScienceRoll*
Just wanted to get some initial thoughts down following the Family Medicine Summit organized by the California Academy of Family Physicians. I’ll have some more developed thoughts in a later post. These initial thoughts were from the plane going from that meeting to the Mayo Clinic Social Media Summit – the meeting I’m at right now.
First of all, thanks again to the California Academy of Family Physicians for the invitation to speak. The audience was mainly Family Medicine Residents and medical students. From my understanding, the registration numbers exceeded expectations (I take full credit for that – Hehe). It’s always energizing to me to present to residents & students.
The opening keynote was from CAFP President Dr. Carol Havens. She asked the audience for words that they think of when you hear “Family Physician.” And, as you can see from this twitpic, the audience came up with a huge list of Family Physician qualities. My favorites are “comprehensive care,” “revolution,” and, of course, “Love.”
My leadership & advocacy sessions Read more »
*This blog post was originally published at Family Medicine Rocks Blog*