Fifty years ago, on the 29th of December, 1965, shooting of 2001: A Space Odyssey began. Stanley Kubrick’s masterpiece was to become the best sci-fi movie of all times, according to both the American Film Institute and The Rolling Stone magazine. Part of its success – along with an eye-opening story, a brave script and breathtakingly beautiful scenes – was how utterly futuristic it looked. When production on 2001: A Space Odyssey began, the Apollo program was still in its infancy, and manned missions have not yet reached the Moon. But the movie’s spaceships, cryopreservation capsules and digital screens still seem modern and believable. They could easily be placed in contemporary films like Interstellar or The Martian and without looking anachronistic. He used methods every hospital manager in the world should consider using when the job is to design the future of care.
Genius director Stanley Kubrick was not impressed by the settings of other sci-fi films of the time. He decided against following Hollywood tradition. He didn’t rely on Hollywood designers and visual artists as every other director did. Instead, he based the movie on the ideas and predictions of experts, engineers and scientists from trailblazing organizations like NASA and IBM.
The ivory tower of today’s medicine is very much like the Hollywood traditions Kubrick violated. Physicians, care delivery experts and regulators all believe they know what’s best for patients, and most everything, from hospital processes to new healthcare technologies is designed based on input solely from people inside the healthcare industry. As Kubrick’s example shows, truly visionary solutions can only be designed by the right mix of industry insiders and outside experts.
Why raze the ivory tower?
Initially the bravest predictions about future technologies came from Arthur C. Clarke, visionary science fiction writer. Inspired by digital guidance systems in development for NASA, he proposed that while the astronauts sleep, an on-board computer could take care of them. But computers back then were rare commodities only big companies could afford.
So Kubrick and Clarke approached IBM, a pioneer in the field of personal computers to find out how to make this computer plausible. IBM actually brought in their celebrated industrial-design consultant, Eliot Noyes, to create designs for the computer system. In the summer of 1965, Kubrick received a letter about the concern that “a computer of the complexity required for Discovery spacecraft would be a computer into which men went, rather than a computer around which men walked”. Finally, he used Clarke’s inspiration and the suggestions from IBM in designing the finalized form of HAL 9000, a computer that became a legacy.
Healthcare faces similar challenges. We need a strong vision of the future and innovation to take us there. But these cannot be achieved from the ivory tower of medicine, by regulatory agencies like the FDA and boards of physician experts. Physicians can’t see the problems of care delivery without patient input. And decision makers might not even realize there are innovative technologies available to solve these problems.
We need people with intimate knowledge of both the actual health problems we seek to treat, and the technologies disrupting our industry. We need to bring in the ideas of patients and disruptive startups. We need to raze the ivory tower, or we’ll keep running in circles while we waste trillions of dollars on ineffective care and patients continue to suffer.
What healthcare can learn from Stanley Kubrick
From spaceship interiors to the Moon base, from videophones to digital advertisements, Kubrick relied on experts not only from Hollywood, but also from scientific fields from computer science to the space industry. This is why he created something that stood the test of time. Changing an old system is not possible without putting the primary stakeholders in the driver’s seat. And this is why today’s healthcare, designed without contributions from patients and innovators, cannot meet the demands of neither patients nor politicians.
There are signs that this is changing. The Food and Drug Administration launched a Patient Engagement Advisory Committee in September of 2015. The Society for Participatory Medicine and the Blue Button movement in the US aim to provide patients with their own data and medical records. The prestigious British Medical Journal seeks more patients to be reviewers on articles about their conditions.
The HealthDesignBy.Us movement brings together patients, caregivers, healthcare providers, engineers, artists and researchers who are passionate about patient-centered participatory design. They develop smartphone games for kids with diabetes; social media campaigns, and hold workshops to redesign care delivery processes. This is a true bottom-up initiative, focusing on patients and letting them shape their care.
Still, these are just the first steps. Patients should play a pivotal role in designing the future of care. They should have their voices heard when the interior of a clinic is designed or the delivery of health services is structured.
Innovative startups that are built around patients could also help change the status quo. TrialReach connects patients to open clinical trials. Smart Patients provide a platform to share experience and advice. The Heal application connects patients to physicians the same way Uber connects passengers to drivers.
When 2001: A Space Odyssey was released in 1968, the first critical reactions were utterly negative. Well-known critics thought the film offered “pretentious music and weird effects”; or was “in summary, a most unsatisfying movie”. Viewers did not like it, and left during screening. But this audience consisted of people over 50, with no interest in science fiction. When people started spreading the word about how unique the movie is, a younger generation took notice, and cinemas started to get crowded.
We see the same in healthcare today, with physicians and regulators pushing back against empowered patients and innovators asking for a bigger say in shaping the future of care. The “old guard” may judge your contributions harshly, but that doesn’t mean you shouldn’t forge ahead anyways.
Designing the future of healthcare with Kubrick’s method
There are several great ways to put Kubrick’s design process to use in healthcare:
- Every hospital should have a patient advisory board including patients who have been treated at that facility. Only with their help would it become possible to create a healthcare system that is futuristic even decades after the first plans were drawn.
- Hospital managers and administrators should organize healthcare hacking events. Far from just inviting experts to tell him how to do his job, Kubrick planned and organized experts from outside his industry to get the most out of their knowledge and expertise. The Radboudumc REshape Center in the Netherlands has been doing this for years.
- Healthcare event organizers should include patients in the planning of their conferences. More and more healthcare conferences get the “Patients Included” badge which means patients either speak at the event or are in the organizing committee.
- Startup incubators should connect engineers and developers to patients who can tell them their needs. This would establish a relationship between the technologists and those who will actually use their innovations, and make sure that patient needs and concerns are resolved. Currently, this is a missing link.
It’s up to us to decide – should healthcare remain a paternalistic hierarchy with obsolete technologies, or should it be built on a foundation of innovation, serving patients effectively and at a manageable cost?
Read more about the future of healthcare and learn how to start upgrading your own health in the new book, My Health: Upgraded.