Meet the Doctor Who's Teaching Med Students to Think Like Designers
Emergency physician Dr. Bon Ku, head of an innovative research lab at Thomas Jefferson University, is creating design-minded solutions to improve patient health and confront COVID-19
By Tiffany Jow
Photo courtesy Brainstorm Design Conference, 2019
Two weeks ago, a website called Rescue Ventilation went live. Its aim—in light of an alarming shortage of ventilators, the life-saving apparatus that enables the most severe COVID-19 patients to breathe—is to offer health care facilities an effective alternative: a double-filtered manual ventilator (also known as an Ambu bag) that can be hand-pumped by clinicians in shifts, possibly for days at a time. Since Ambu bags aren't made for infectious patients, Rescue Ventilation designed a pair of adapters, which can be 3D-printed from a downloadable file, for connecting HEPA filters to the device's outflow tubes. A video shows Dr. Bon Ku, an emergency physician, demonstrating how to assemble the parts. Another doctor, dressed in protective equipment, administers the ventilator to a medical simulation mannequin, whose lungs expand as he squeezes the bag. Ku gives him two thumbs up: It works. "Great," he says, his voice cracking with emotion.
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In addition to treating patients at Thomas Jefferson University Hospital in Philadelphia, Ku serves as cofounder and director of the Health Design Lab at the college, where he works with students to develop new design concepts for the health care sector. Rescue Ventilation, a joint effort with local architecture firm FKB and Stanford University's Anesthesia Informatics and Media Lab, is just one of its many projects. Established in 2014 as the first of its kind for a medical school, the lab teaches doctors how to think like designers. Students, nurses, doctors, and other Thomas Jefferson University Hospital personnel go through rapid cycles of design thinking—a human-centered process that involves asking questions, making visualizations, prototyping, and storytelling—to tackle real-life situations. Like a test kitchen, the Health Design Lab empowers members to experiment and fail; its recipes may or may not end up on the dinner menu.
Now, as a global pandemic exposes our health care system's design flaws, the need for initiatives like the Health Design Lab is painfully stark. "The superpower of doctors of the future will be to be able to think creatively and problem solve," Ku said in a particularly prescient TEDx talk in 2016. "Having this skill will not only allow us to fix our health care system, but make our communities healthier."
Ku details the lab's work and ethos in the book Health Design Thinking (MIT Press/Cooper Hewitt, Smithsonian Design Museum), out last month. He wrote it with Ellen Lupton, senior curator of contemporary design at the Cooper Hewitt, Smithsonian Design Museum, who he met on a panel in New York. Presented in practical, approachable prose, it offers context, methods, and case studies sourced from the medical community, such as a hand-held device for detecting breast cancer or a clothing line with functional openings that people with chronic illnesses can wear during medical procedures. Graphics by Lupton's longtime collaborator Jennifer Tobias bring the ideas to life. "Bon and his colleagues are opening up the way health care professionals think about their work," Lupton says. "It's so important at this moment in history to build capacity for [design thinking]. When patient needs and health care challenges start to feel like abstractions and numbers, our whole society suffers."
Ku, a son of Korean immigrants who has no background in design, got the idea for the Health Design Lab in college. "In medical training, you don't have the freedom to exercise creativity," he says, noting that the formula for training doctors, where students passively receive information from a master educator, hasn't changed in 100 years. "Why isn't medicine looked at as a creative industry?" he continues. "Spaces in health care aren't designed for healing. When you have to go to them, you're sick, you're tired, and it's probably the worst day of your life. [Hospitals] reflect that. It's a missed opportunity. Why can't we bring design intent to places where humans suffer?"
In order to fix the health care system, Ku decided he needed to redesign medical school. So he started cold-calling and visiting design studios, from Ideo and the architecture firm KieranTimberlake to Stanford's Hasso Plattner Institute of Design, to understand how they operate. He incorporated what he saw—flexible office spaces with white boards, breakout areas, and model-making rooms—into the Health Design Lab, located in the vault of the former Second Federal Reserve Bank of Philadelphia.
Part maker-space, part think tank, the facility holds a clinical 3D printing and bio-printing lab that allows students to get ideas out of their heads and into the world. Its innovations include the Care Cube, a pediatric pain scoring system developed after the university realized that a toy-like object could be more effective for younger patients. The cube has a different facial expression on each side that represents a different level of comfort; to describe a pain level, a child simply points to a face. In 2017, Ku and his colleagues introduced a course that paired medical students with architecture students. Together, they created a digital mapping tool that tracks how doctors, nurses, and patients traverse the university hospital's emergency room. The data was used to suggest improvements for communication and decreasing wait times.
Other projects include CoLab, a converted Airstream trailer that connects communities with health services. Last month, the Lab transformed it into a base camp filled with testing supplies and computer stations for workers at an outdoor COVID-19 testing site in downtown Philadelphia. The lab is also creating a system that will allow university doctors to order a CT scan, MRI, and a personalized 3D print of a patient's organ for physicians to use in patient education, like explaining what's going to happen in a forthcoming operation. Ku intends for all these concepts to eventually become part of the health care system at large.
Every concept that emerges from the lab has patients at its core—a model that transcends design strategy and lays at the heart of the lab's work. Such nimble, human-centric thinking will be key to addressing the current COVID-19 crisis and ones to come.
"Modern medicine is based on the relationship a patient has with his physician," Ku says. "If I'm able to build a relationship, based on trust, with a patient, I can get the full story and understand what's making him sick. If we violate that with bad design—anything from a policy to a spatial design—that relationship is eroded and the patient is going to get worse care. Preserving that relationship is critical."
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