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Design for Life

JUHAN SONIN

Bloodletting to Bloodless

Technological and societal trends are converging and pushing design to the forefront of health.

Health, as an experience and idea, is undergoing an epic shift. For millennia, humans have treated health as the rare spike that requires intervention. At a very basic level, when it comes to health, we humans experience our physical condition today much as our more furry ancestors did. We roam around. We eat mostly green stuff with the occasional indulgence in a tasty snack of fresh-killed meat. We drink water — well, some of us “hydrate” — and have sex and procreate. We stick with our tribe and try to steer clear of hostile marauders. And as long as we’re feeling OK, we think we’re OK.

Generally, that’s true.

Then, health happens, usually when we least want or expect it. We stumble on the trail or travel far from home and come back with dysentery. One of these health events prompts a visit, so you go to a tribal elder who sets bones, or you seek out the town doc to ease your intestinal disturbance, or, after catching your son flying off the living room couch, you get an MRI to reveal a bicep tendon rupture.

What we call health is made up of these episodic issues and interventions. Even periodic exams are events that we bathe and dress up for. In fact, we are most conscious of our health during these moments. For the average person — one without chronic pain or illness — health is conceived of and managed as an exception.

Few would deny that health is the single most important factor for any human, at any age, living anywhere on Spaceship Earth. The potential impact of a health setback on our lives can reach into all other areas of our lives — work, finances, love, and hobbies — and even affect the community. The stakes of dealing with health are significantly high. For example, a high school math teacher with a kidney stone calls in sick, the principal hires a per diem substitute teacher, and the learning of 20 high school kids dwindles. In our era, the complexity of health has surged dramatically. Remarkable things have transpired over the past 100 years, the past 40 years, and the past 5. In 1909, for example, hospitals treated third-degree burn patients with opiates, frequent application of moist antiseptic dressings, and sometimes baths;[] today, clinics spray-paint on new skin, based on the burn victim’s cells.[] The jump in technology and our understanding of biology and the health sciences is startling, which has ratcheted up both the system complexity and awareness of it. What’s good for one patient might not be quite right for the patient in the next bed over.

Yet, same as 1,000 years ago, humans don’t want to think about health until health happens — or more accurately, a health event happens. This state of denial is evidenced by the declining health rankings of the United States compared to 33 other wealthy nations. From 1990 to 2010, although Americans’ life expectancy increased, our health rank decreased notably across six key measures.[] Although there might be social and cultural forces at play in these disheartening statistics, the continued decline of the health of the population in the United States suggests that we’re still stuck in the land of episodic medical care, not only with respect to treatment, but also thinking, engineering, and designing for health.

There is a way out of this, and the remedy is not just a pill, diet, or implant. To illustrate the possibilities available to us right now, take a moment to consider the following thought experiment.

Suppose that all of your data is simply and automatically collected — every number related to your existence, from the financial (which we’re nearly doing today), to travel (again, captured today), to habits, to eating, to exercise, to examining your daily biome. It’s captured. It just happens, unobtrusively in the background.

Now suppose that your captured data is visible: you can see the data points, see the trends, and even see the data of your close friends and family, such as is depicted in Figure 12-1 and Figure 12-2. This visualization would effectively convey important data at sizes both large and small, and enable you to recognize patterns in yourself and others so that you can make positive decisions and affect beneficial change (see also Figure 12-3).

The hGraph

Figure 12-1. The hGraph: your health in one picturean open source, standardized visual representation of a

patient’s health status

hGraph users can easily identify which metrics exist in a normal range versus those that might be too

Figure 12-2. hGraph users can easily identify which metrics exist in a normal range versus those that might be too

high or low

The foundations of this new paradigm are in place. The structure is ours to make.

Our thought experiment provides a stark contrast to the current state of design thinking on life, on health, and on data. We have minimal transparency into key health metrics. For the data we do have, the overhead required to collect it is enormous. People have a hard enough time changing their Facebook privacy settings or figuring out mortgage refinancing. The systems we deal with are increasingly complex, and the user interfaces are more like puzzles than designs. As decision makers, we are swamped with conflicting data.

As designers and engineers, our work is increasingly multidimensional (not a flat-decision space), and linear-thinking human beings are not good at nonlinear thinking. Seeing every variable and doing the mental calculus to orchestrate better decision making is not our species’ forte. We fly by the seat of our pants until we get tired and land — thump — not always in the right or best place. One major variable in the everyday behavior change game is sensors. Invisible sensors.

Learn more about hGraph at http://www.hgraph.org

Figure 12-3. Learn more about hGraph at http://www.hgraph.org

 
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