Thought-Experiments for the Future of Health Designs
Clinic in a box, ice cream truck and tech-first health operations
I just spent the day in an Ugandan emergency room. It was a scary amount of ambiguity. A frustrating experience, but all the more reminder on why I want to elevate the human health experience.
I’ve been crafting a way of organising health innovations; basically, thought-experiments to aid the design of the future-of-health. I enjoy them as a guiding force because they’re creative while straightforward.
Here are the 3 I’m using lately:
In a Box:
A concentrated toolkit for different goals. For example,
- Diagnosis and treatment for tuberculosis in a box
- Supporting pregnancy antenatal care in a box
- Prevent preventable diseases for children <5 in a box
It seems like such a simple phrasing but the simplicity is deceiving. It’s hard to boil these things down. It’s much easier to write a comprehensive 100 page guideline. Placing them “in a box” forces me to prioritize, reduce redundancy and question the essential components within the goal.
Especially for diseases that burden the world’s poor, it’s important to prioritize simplicity. These environments have a lot of constraints and visualising the best-case-scenario for treatment is often a long shout away from what we can actually do.
Instead of thinking about the magical end-goal when we have unlimited $$$, this box model gives a realistic and utilitarian starting point.
Specifically, box-thinking prompts the question: what are the lowest-burden, highest-impact interventions that support a healthcare goal?
Later on we can incorporate the higher-burden and lower-impact interventions. The box is about the most essential services.
Ice Cream Truck
In the next level we can think about treating a health outcome in an ice cream truck. A to-go model.
In general, we need more mobilised health services to access more people. Not just for rural environments. For busy cities too! High traffic periods can make accessing health services challenging. Mobilising and outsourcing health services through portable clinics can increase accessibility and reduce the burden on the ‘main’ health centre (since the people who can get treated quickly do not take up capacity in a health centre where higher risk patients go).
The ice cream truck gives us a chance to expand the box and to think about machines, medications, electricity, and so forth. I have enjoyed this thought-exercise for women’s health: what machines, medications and devices do we need to serve a majority (80%) of women’s health services?
Focusing in on a truck makes the ‘collection’ of innovations more tangible. Too often we think about women’s healthcare in the context of a big health institution and no one can define the essential medical ingredients to the service. It’s helpful to have this granularity figured out! Not only could we design an epic mobile health clinic, but we would have a blueprint still relevant for stationary health centres. And checklists are useful!
Integrated Health Network
The last level to my thought-experiments is the most complicated and most reliant on technology (specifically AI, information management and sensors). This is where we will reduce redundancy in services, reduce inefficiencies and bureaucracies to increase the leverage of health staff.
Basically: what are the processes that define health services and how can we outsource them?
There’s been a physician and nurse shortage for ages all around the world. Especially in booming developing markets. To dream of the future of healthcare without considering the real human labour deficit is irresponsible and ignorant, in my opinion.
The integrated health network is a system that deeply considers how things work together from a scientific sense (for example, antibiotics and prebiotics; the gut microbiome and hormone deficits) and from a logistical sense (do we have duplicate paperwork? What kind of screening can we do in advance? Etc).
This type of model contains a lot of connecting lines. It will look a lot more complicated than sectioning off the “Cardio” department and “Emergency” department, but it will be a whole lot more comprehensive.
If we combine it with the first two levels, the boxes will provide the ultimate Pareto’s principle simple building blocks and the ice cream trucks will mobilise many health services… which will leave us with more capacity to build integrated health networks at facilities.
This is a technology-driven layer otogetherf healthcare that gives human providers room to shine!
That’s my current 3 buckets of thought-framing for health. I’m sure it’ll change in years, but these have been great for my gymnastics training thinking about how to design health architecture in the future.