 Let's jump into it. So for our first speaker, we have JT Tan. He is from Cleveland, Ohio. Shout out to Cleveland, and he is the leader of the Prevent Project, which is looking to reimagine how we can create negative pressure enclosures. So let's take it away, JT. Thanks for coming. How's it going? Thank you so much for that, Matt. Yeah, love the opportunity to run through this journey. And I will say this is a journey. It's been eight weeks. This is the wrap-up of eight weeks. And really, it didn't start here. It's a very interesting kind of journey with, you know, I woke up one day just kind of not wanting to do something. I'm sorry. Wanting to do something about this and not knowing what wondering if my CPAP could actually become a ventilator. Well, day one, that was pretty quickly invalidated. But it started learning about why CPAPs and VIPAPs or other forms of non-invasive ventilation weren't really being used. It was because there weren't enough safe environments for that to be useful. And then we started realizing that there was a bigger problem that we're arms with more PPE and social distance as tools in this fight, but that maybe we can stop, you know, and filter, kind of contain and filter the COVID aerosols that were being formed at the source and prevent the spread of infection with these personal fume loads to create cleaner and safer care environments and also start impacting some of these policies that are going on that are really creating situations like in hospice, we're finding where you are forced if not, you can't be with your family members when you're dying, and other sort of operational impacts that are not allowing them to accept patients or have exacerbated an existing workforce problem because the work work, the frontline workers are so exposed. And so, yeah, you know, it's about really containing this COVID dust that's getting on everything and realizing that we could create, you know, these sort of fit-for-purpose enclosures, right, something bed-based or something mobile that would essentially just contain and filter this and start opening up options, care options, but also be able to enable this level of increased safety and unlock these applications. And we're starting to find these patterns as we're exploring, you know, these different possible applications along with patient journey that, you know, you have the acute care environment such as crowded waiting rooms, patients in hallways, and again, going back to that design thinking that you're talking about, really going and getting conversations with people in the front lines who are experiencing this to identify these different situations and start really wondering, hey, if you take this approach, what sort of Delta can we provide, right? But then realizing there's other situations in post-acute care and senior living prisons, military vessels and cruise ships, the dentists that are starting back up to work, that they work in, you know, these what differs between these, and then go to the extreme of transport, which every environment, is that they have different levels of control and that in these less controlled environments, that's actually where the higher value proposition plays. So here's a little bit of, you know, in that testing phase, that design journey where we're on, where it started out with early partners in radius labs on the San Diego, Cancone, kind of built this as a way to test this filter and a blower set up in a couple of different types of filters, and then started working on a better packaging that's tightened up into where, you know, we can't have a fully no duct tape type of prototype, and as we now start moving on to thinking it's single use, what would a single use enclosure look like, that would still have all of the user requirements and access points. We've got a cool team that we've been able to pull together and are very passionate about this goal, and that are all working together across, you know, both design and technical types of questions, but most importantly at the clinical level, really being able to have that voice heard, you know, through the CUBE care and post to CUBE care and all of these other environments. So with that, I just love to hopefully not gone too over here, fit within what you asked where they might, Matt, but would love for you guys to, if there's anyone interested in helping out, interested in contributing, my contact information is right here. Look forward to connecting. No, totally. Well, that was, thank you. That's awesome. And again, anybody who wants to, like, is working on something similar, wants to collaborate, this is a great place to get together. So I think we should move forward. I think so too. So thanks, Rob, for policing. That's going great. I would love to introduce our next speaker. We have Dr. Alfred Atanda, who is a good friend of the Design Lab. He is a specialist in pediatric orthopedic surgery. And he is also a specialist in telehealth. He's been innovating in the area of telehealth for the past three years and has been doing lots of great work in the time of COVID. So Alfred, we will give it over to you. Thanks, everybody. My palms are literally sweating just thinking about what's going to happen while I'm talking, but I swear if there's anything weird, it's not me. I'm just sitting here in my kid's playroom. So yeah, thanks so much, Morgan and Matt and Rob on and everybody. I'm Dr. Alfred Atanda. I'm a pediatric orthopedic surgeon. I live here in Philadelphia, but I work down at DuPont Children's Hospital in Wilmington, Delaware. A lot of you have heard me rant and rave about telemedicine. I just wanted to be heard here first that I've been talking about telemedicine way before COVID. I'm not just jumping on the COVID bandwagon, but you know, as an orthopedic surgeon, we get a lot of kids and patients basically referred to us from lots of different avenues. And some of you who are this past year's hackathon heard our little pitch about how do we reimagine how patients get into our orthopedic ecosystem. And as a specialist, a lot of folks go to the emergency room, to the urgent care, to their pediatrician prior to coming to see us. And a lot of times the way that they get into our ecosystem, the way they get trioxed to see us, is based on non-clinical means, meaning they're non-clinical schedulers and folks that bring them into the system. Fast forward to March of this year when COVID hit, now nobody basically can come into the system unless you have a serious, serious problem. But we had to figure out how do we keep those kids still coming into our system, right? Just because COVID is here doesn't mean kids aren't breaking bones, they're not getting bone infections, they're not dislocating joints, they're not getting hit by cars and falling off their bikes. So we really had to utilize telemedicine in ways, a little bit more than what most of you are probably used to. So for folks with a regular problem, they get on a telemedicine platform and they usually do like a direct to consumer or provider to patient consultation. And that works well. But for us, like I said, a lot of our patients go elsewhere. So what I had to do being that I had a lot of experience with telemedicine was really figure out how our large practice that sees 40, 50,000 outpatient visits a year can still keep people coming into the door and generate revenue. So really accelerating our provider to provider telemedicine platform and our expertise in that realm was something that had to happen within a month or two. And we've been doing that in the design mode. We've been piloting and prototyping things. Luckily for us, we have surgeons that are available because a lot of our elective surgeries were canceled like the last couple of months. So we were able to do a lot of little small pilots, a lot of trial and error, collecting data, collecting metrics, seeing how we can change people spending time in the ER and decrease lengths of stay in the ER, decrease unnecessary transfers in between hospitals, all the while providing high quality care and maintaining patient satisfaction. And it's been very successful to this point. It's not anything that we've monetized or created a company around it necessarily, but it's definitely helped us reshape and reframe how people come into our healthcare ecosystem in orthopedic surgery. One of the things that I wasn't expecting to find, as in addition to just providing my advice and my knowledge to urgent care and ER docs out there, we've kind of come up with this notion of like a telehealth triage navigator because a lot of the patients that call us, what we've been doing is rather than just having a scheduler talk to them on the phone, we have a nurse practitioner or physician assistant turn that into a telehealth visit where we can see what's going on, see where the problem is, then they can appropriately send them to get the appropriate x-rays or studies and then get that stuff outside and then we can collect all that data interpret it and then we can determine if they actually need to come in for a visit or can they just be managed with rest, physical therapy and other non-operative things. So in the traditional healthcare landscape, it's fee for service and we're always trying to get people into our healthcare system, but what we found is that utilizing some of the barriers that have been removed by CMS and the government for telemedicine, we can keep people exclusively in a virtual way outside of our walls, bill for that, generate revenue, but still keep them safe, minimize exposures for them and for us and then have them come into our system as they need to because we can follow up and check in with them every two to three weeks. And that's something that just kind of came out of this pandemic. I wasn't expecting to stumble upon that. It was more like, okay, we have patients, they can't come here, let's see them and let's bill for it, but now we're figuring out there's all sorts of diagnoses that we may not ever need to see within our walls, especially at a large tertiary care academic hospital. We want to reserve our resources, our complex procedures, second and third opinions, big surgeries, and keep all the ankle sprains and knee bruises and shoulder sprains and things like that outside of our walls because the patients don't want to come and see us anymore than we don't necessarily want them to come for simple problems. They just don't know that there's another way that they can receive care without coming into our system. So that's been the big surprise for us. We don't have a product or anything per se, it is providing a service, that's what telemedicine is, but I think just in the last three months, we've used a lot of trial and error and design thinking principles to help us get to where we are now. That's so cool. I can't help but say that just a few months ago in February, I think it was, we were having this conversation about telemedicine and information about telemedicine, and then I can attest that you were already well into that area before COVID hit, and I think that's just so perfect. I think one of my questions to you, which I'll just have you answer for everybody, is like what you were just saying, these people that we didn't realize before maybe don't need to come in physically. I would have thought a few months ago, or at least before we talked the first time, that orthopedic surgery was the kind of field where people actually do need to come in, but what was the process like finding out that that wasn't really the case? Yeah, it's very interesting because most orthopods, that's what we think, is that we're very tactile with what we do. And a lot of the highly specialized problems that we do treat should come to see us. We should put our hands on them and should examine them. But what we're doing is not necessarily treating a whole lot of folks in their homes. I mean, we do that for people that we know, we've been established relationship with, but for all the brand new patients out there that have issues, we found ways that we can rely on other frontline providers that are out in that patient's community and their medical homes to treat them kind of for us, and like a surrogate treatment for us. All we need is an x-ray and we can have another provider. It doesn't necessarily even have to be a doctor. It can be a nurse practitioner or physician assistant. They can be our eyes and ears. They can range the joint. They can palpate things. And as long as I can see all that, I can talk to the family and counsel them and I can view the imaging studies. That patient in many, many instances doesn't ever need to set foot in our office. And again, as a highly specialized surgeon, I want to see people who need surgery, people who need complex procedures. For every six-year-old I see with an ankle sprain, that's taking up a slot and resources in my clinic for another more complicated, complex case that can't come in. And I think understanding that and realizing that it's not all necessary about fee-for-service and generating revenue and having high volumes. It's about moving knowledge and moving information to the places it needs to go, as opposed to moving people. Because as you all have known, our lives have changed with this pandemic. But I think in many, many instances throughout healthcare and beyond in other industries, it's really opening our eyes to see how much we can get by leveraging the existing technology and information technology that's out there. That's a great message. Thank you so much for joining us. Just remind everybody that please add all your questions, comments to the chat box and let us know who you are, where you're from, what you do. We're excited to hear from everybody here. Yeah, and am I on mute? Can you hear me? I can hear you. Oh, okay. I'm like, no response. I'm curious about the telemedicine thing is such an interesting evolution. And did it really take, why did it take a pandemic for something like telemedicine to become mainstream? And what does that say about the bigger issue of healthcare facilities and doctors being places that just we really have trouble getting to think outside the box and to reimagine things and redesign things? Yeah, I mean, that's a great question. I think first and foremost, it's a cultural thing. As a physician yourself, you understand that things have been done in a way for decades, even centuries for and by physicians. And I think any major large kind of structural shift to the workflow is going to meet a lot of resistance. After culture is financial constraints and reimbursement issues, as you know, telemedicine is reimbursed on a state level. Certain states have very good broad coverage and parity laws for telemedicine, whereas others don't. So you don't, especially in highly sub-specialized specialties, time is money and energy is money. And if you can't provide care in a way that you can get reimbursed appropriately, a lot of people aren't interested. And it is sad. But one thing that I think is that's good about this pandemic is that we do now know that there are a lot of improvements that can be made to our healthcare system. There are a lot of ways that we can streamline and reimagine the care that we provide for our patients and not necessarily have it so kind of provider and hospital centric, as opposed to figuring out how we can make the patient the focus of the care and get our knowledge and expertise and the care they need from us to them. And it's going to be challenging, but I think the last couple of months has at least enabled a lot of folks within healthcare to start embarking on that conversation. Yeah, absolutely. It's almost that this is a unique design moment in healthcare that we haven't experienced before. Well, thank you very much. I think we're going to go ahead and move on to our next two guests. Morgan, Yuna. I would love to. So our next two guests, we have Bon Koo and Ellen Lemton. We're so excited to have you guys on the show today to talk about a new book that you just brought out, Health Design Thinking, and just to talk about Health Design Thinking in general. So Bon Koo is a practicing emergency doctor. He's an assistant dean for health and design at Sydney Kimmel Medical College at Thomas Jefferson University. And he's also the director of the Health Design Lab where Matt and I both worked. That's right. And Ellen Lutton is a senior curator of contemporary design at Cooper Hewitt, Smithsonian Design Museum in New York. And she's the author of many books, including beautiful users, designers trying telling, and the senses design beyond design. But those all sound like great accomplishments. I think maybe like your most noteworthy accomplishment is managing to work with Bon for one, two, or three years or however long it took and actually getting him to complete a task. So if you have any tips on how you did that, I think Morgan and I would want to know. You're a legal thing to take off mine and get your opinion on that because... I'll cash off with you on that. That's great. So thank you guys for joining us. Thanks for all joining. And my heart rate's going at 130. I think Rob managed to get rid of the Zoom bombers. I've never experienced that before. So apologies to... I don't know. All right. So we'll work through this. And I see Yohan. Oh, good to see you, Yohan, from Boston. Raise up your hand. I got a little visualization in the book. I'm going to share my screen here. Pamela Horn is there, our publisher of Health Design. Thank you. Thanks for joining from New York. And let's go here to... I'm going to share my screen. Right. Bob, can I just say something? For all of Verity, who's chiming in on the chat, keep it coming. And after the end of this, we're going to go through. We're going to revisit the chat box. So keep the chats coming. We're not quite revisiting the bombing, but... Yeah, we won't revisit the bombing. Sherry Orr said Rob is a great Zoom bouncer. Yeah, thanks, Rob. As a physician who thinks about the intersection of design and healthcare, my approach is to look at every problem, or try to look at problems in healthcare from a design lens and ask myself this question. And here we go. And a lot of our initial inquiry for solving problems that we see come out of this lab. It's called the Health Design Lab, where a lot of us work. On this call. We use this space as a space where we can create, where we can think outside the box. We give nurses, doctors, medical students the permission to fail. And our inspiration for this space was looking at test kitchens in restaurants. Some of the world's best restaurants have these test kitchens where they can create new recipes. And so we thought we need a place where we could think of new recipes for healthcare, where we can have that permission to fail, where we can think about how we can create a new product service or how we can think about going about creating a new type of space. So we started this test kitchen about five years ago in our hospital in Philadelphia. But what we lack was a cookbook for these new recipes. So that's how I found Ellen Lupton. So yeah, I've written quite a few cookbooks, Bon, you're absolutely right. I have spent my career creating books that invite designers and the general public to engage in doing design. And if you go to the next slide, Bon and I met in 2018. We were on a panel together. And Bon seemed like a nice guy. I kind of liked him. And afterwards he said, I need a cookbook about health design thinking. And for some foolish reason, I said yes. And we started doing this book. You go to the next slide. A few months later, we were there in his test kitchen figuring out the table of contents and the contributors and what we wanted to say and how we were going to organize this book. You go to the next one. And it was a process of determining what are the key ideas in the health design thing. Sorry, am I on the right slide, Ellen? Oh, whatever, you're fine. Whatever you got is great. You'll see, there's Bon's kitchen now turned into a page in our book because we want every medical school to have a test kitchen for design thinking. And so our book is very practical, accessible, beautiful, illustrated, how-to book for getting into design thinking with all the examples come from the healthcare space. So there's a lot of books out there on design thinking, but ours is the only one that is written for you, for this audience. You go to the next slide or whatever slide we got is fine. Am I going the wrong way here? Yeah, just try going forward, buddy. Oh, yeah, here we go. There we go. Yeah, so we came up with our very own diagram of the design process, which is built on the work of many who have gone before us, and we really see this process as starting with observing just the way medicine does with looking at what are the symptoms, what are the problems, what's being presented. So it's empirical, it's patient in the sense of being patient and listening and paying attention. And then there's a wild phase of being imaginative and making lots of prototypes and brainstorming and having blue sky thinking. And then you kind of test that and come back and see what you learn. So it's a nonlinear process. It's collaborative. It involves patients, caregivers. It's open. I love this diagram, Ellen, because so many of us in the medical field were so, we can't tolerate ambiguity. So this provides a nice framework for us to anchor some of our principles and methods. So it's not this loosey-goosey type of thing, but it's a nice visual for us who don't have a design background to anchor to. Yeah, exactly. And we started this book, what, two years ago? Yeah. Go to the next slide. That's some of the inside next. You can keep going backwards. There it goes. So one of the principles in our book is empathy, which is being able to experience the world as much as possible as someone else would. And storytelling helps us do this. Listening, interviews, those help us do this. And this example is from a product that was developed in Bonn's lab by students at Thomas Jefferson, which was a gynecological table that's collapsible and confused in the ER. And the men on the team all had to have the experience of having a pelvic exam. So they had to put it up there, put it out there, spread their legs, and get what that's like, because that's empathy. This is a real product, right? And then our product came out, which is this book, which we got big boxes of it in February, and we were so happy and excited and couldn't believe it. And then what happened, Bonn? Then the pandemic happened here. So we were supposed to go on a book tour, and everything got canceled. So we've been doing a lot of these intros to our book virtually, like we're doing that right now. And I just want to share a few pages that's been particularly relevant during this pandemic. And one of these images comes from Yuhan from Boston. He runs a great group called GoInvo, and it's a great design consultancy that focuses on healthcare. And it's really the importance of data visualization. And in this age of the pandemic, where we were seeing a lot of disinformation and misinformation, that it's important to get good science out there in a way that people can understand easily. As this is probably one of the most famous data visualizations that's come out of this pandemic on flattening their curve and how we can use social distancing to not overwhelm healthcare system capacity. So I think for me, it was really powerful for me to see some of these data visualizations and how some of them captured the public's imagination and really helped with the messaging around good science. Here's another section of our book on the principles type of section. And this was really, you know, what design allows us to do is ask the right questions that we want from our healthcare system. And one way we use this a lot for those of us who have been in design workshops is to form these how might we questions. And it's when I look back at this page of questions for the future of healthcare, this is pre-pandemic. And wow, those questions have changed. So when I think about the future and what questions we should be asking for our healthcare system for public health, these are some that pop into mind because there is no going back to normal. There's no going back to the normal pre-pandemic. And I do believe that healthcare is fundamentally going to change and there's an opportunity for clinicians and designers to get together and start asking these how might we questions of what we want our future healthcare system to look like. And I think that's it. Thank you guys so much for presenting. Ellen, I have to say possibly the worst thing about not having an in-person book tour is that you can find my book. Bond did, but, you know, we'll have to follow up on that in addition to our debrief on Bond in general. But it's so great to have you on and Bond, thank you so much too. We've got a lot of questions and Ellen, we'd love to hear your perspective as a designer and then the doctor's on the call as well, the designers. So a lot of questions that look like they're coming up in the chat box are asking about access to care. You know, it's hard for certain users to access healthcare by telemedicine and things like that. Yeah, I think there's definitely a lot of great theme here going on. It looks like there's some people making connections, which is awesome. Perfect, this is what we want. But specifically, you know, and Dr. Atana, I don't know if you want to comment on this, but you know, what about the issues of access, you know, so I like that Laura Apple says here, you know, 50% of people in Detroit do not have reliable access to the internet, their smartphones, but not data phones. And then also, Kenneth Lam as a geriatrician, you know, brings up the fact that, you know, so many people over the age of 65 have due to disabilities and experience with technology have access, issues with access to telemedicine. So, you know, what do you think about those comments? And I know you're a pediatrician, so I think the geriatrician question isn't fair. Yeah, so thanks. I've actually been reading all the questions because I get these questions a lot. So one thing I just wanted to say is that, you know, telemedicine is a tool, just like anything else in medicine is a tool, whether it be a reflex hammer, a stethoscope, an EKG machine, an x-ray, it's a tool that needs to be used on the right patient in the right clinical scenario by the right provider in the right situation where all stakeholders are comfortable utilizing it. I get a little passionate about telemedicine, but by no means that I suggest that we're going to replace all inpatient and in-person care with virtual stuff. I think it's something just to augment the care that we provide. Now that being said, depending on the particular problem, depending on the particular issue, some people may not want to come in. They may be totally fine with their visit being virtual. And I think offering that option is something that's very, very important. But if people feel the need to come in, if they don't have access to good smartphones and good data plans or good Wi-Fi, or they're not technologically savvy or tech literate, by all means, you need to have a robust, you know, practice that can house them in person in the main hospital in a satellite office or what have you. It's very interesting that you bring that up because we're doing a study now. We're hoping to get it published where we looked at the utilization of the patients in my particular sports medicine practice who are opting to do telemedicine. So I offer it to a lot of my patients, some of them utilize telemedicine and some don't. So we went back and looked to see where these people were coming from, who they were, what socioeconomic backgrounds they came from. And you would imagine, you know, that it would be rural patients that don't have means of traveling and all that sort of stuff that would be utilizing it the most. And that was directly the opposite of what we found. Delaware is a long, skinny state and Wilmington is at the top. And what we found was that the patients who utilized telemedicine actually lived closest to the hospital. They were not rural patients. They tended to be well off in higher education levels. And that was very interesting because you don't want to create inadvertent disparities by offering something that is supposed to increase and broaden access to care. So I think as we're going on this journey, some of the people that did ask such questions about access to care, you have to be mindful of those things. Right now, this first step in our project is just to see who's using it and who's not. Then further subsequent research questions will be, well, why is that? What are some of the causes? What are some of the issues? And then the third level of questioning will be, well, what can we do about that to ensure that everybody has access to telemedicine and everybody has access to the care that they need. But I think realizing that it's just another tool in our tool bag of how we can engage patients and how we can disseminate knowledge and care and advice and information, telemedicine can help that. But for those subsets of patients that for whatever reason doesn't work for them, then by all means, we have the means to treat them and care for them the way that they would like to and they have access to. Yeah, absolutely. And kind of, I was reading some of these comments it's so interesting thinking about access to care, access to a smartphone as being an issue, but it clearly is. And it kind of makes me think of Ellen, actually, when you were in Philadelphia, I remember you speaking about your work with access to museums for disabled. Yeah. Yeah, and I wonder what opportunities might we have here in kind of collaborating on something like this? Do you any thoughts on? Well, I think museums like hospitals have to redesign themselves. And at our museum, we're talking about how are we going to reopen and allow the public to come back in. And also to continue to make our museum accessible. One of the ways that we have always done that is having lots of stuff for people to touch. And that's going to have to change. So we're looking at the Contactless Museum, you know, the museum where you're not touching anything. And yet you can still access information. So for example, we have audio description for people who are visually impaired. How can they access that without touching any kind of device? How can people, you know, really make use of all the types of layers of information that we have worked so hard over the years to provide to all our visitors? So we're right with the hospitals figuring out how to make our great public spaces available to everyone. That's so great. It's so cool to hear about health design from the perspective of a designer, because we talk about it and think about it all the time in our lab from another perspective. But I think that a lot of the questions here have actually kind of gotten at the user experience and what we expected. I think like us doctors, we had always thought that people wanted to come in and they wanted to wait for us in the waiting room. And they wanted to see us in person. And then they wanted to like commute to get there and make an appointment three weeks in advance, which, you know... Three weeks, that's what you're aiming. Well, you know, and there's some questions about bringing users into healthcare. I just wonder about, you know, your experience and Alfred's experience in terms of like user experience in healthcare and what you guys have learned that you could share with everybody. Yeah, you know, it's funny that you bring that up because, you know, as an orthopedic surgeon, you know, I'm a very simple guy, right? You know, you break bone, me fix. And that's what we do. And as a sports medicine surgeon, you know, we get a lot of young athletes that come in and it's a very paternalistic view. But I always assume that I know like what's going on and what they want and what they need, you know. But if you line up 25 kids who come in with knee pain, they may all want different things or they may all need different things. One kid may need a note clearing him to go back to gym class. Another kid may be really, really worried about what's going on in his knee and his mom is trying to talk him off the ledge. So he, they bring him to me so I can talk to him and I can allay his fears. Other kids, they have a big problem with their knee and it just doesn't work anymore. And they can't run, they can't jump, they can't do anything and everybody's scared. But if you approach every single patient experience as oh, this kid has knee pain, I'm going to go through my mental training and spit out what I think they need to hear, you're going to miss the boat because everybody has what they need. Their chief complaint is just that. It's their chief complaint, but it's not who they are. It's not their personal situation at that time. And, you know, another example is we get a lot of kids whose parents aren't together anymore. So we get one child who comes in with mom and we go through everything and then mom goes home and because of the relationship with mom and dad, dad doesn't like what he hears and he wants to come and hear it from me. Well, guess what? I'm not necessarily adding anything to that child's overall care, but that dad and that child of that particular time, they need something. And I have to recognize that. I can't just spew out what I would say to anybody. So you really have to individualize the experience for these patients, kind of like the ads you see on Facebook and Instagram are tailored to you it wouldn't really help if I saw Morgan's ads and she saw my ads. We probably wouldn't buy anything. But I think, you know, as healthcare goes, as we've all been training and all going through kind of the rat race of getting to become an attending, you lose sight of that. If you actually did realize that most of us probably never knew that because we, again, we don't have design thinking and outside of the box thinking in our healthcare curriculums. But that's been the biggest thing for me. It's like, I can't just dictate what people need. I have to really understand what they need, what they want, and meet them at their level in order to appropriately provide care. Because I can tell you everything about your need. But if you're not hearing it in a way that resonates with your particular experience about how your knee is affecting your life at that moment, you're not going to be very satisfied, to be honest with you. Of course. There's been a couple of good comments here by I think Mia and Colleen about co-design. And I know I'm going to put you on the spot. Yuhan, because I know you do a lot of work on building these user interfaces in the digital health space. And do you want to maybe talk a little bit about how you do co-design or your approach to developing some of these interfaces? And be aware, because we would just call on people on this thing and just ask them to speak out. Well, you're scraping the bottom of the barrel if you're asking me for advice. But we, as part of I think any decent engineering or design or policy process, you're figuring out consequences for what the hell you're doing. And you do that through what happens to people when they use this. Why does it happen? What are the ripple effects? And so if we're not testing with patients, with clinicians, with administrators, God forbid, and all the parties and stakeholders involved in some way, then I don't think we're doing a good design process. We're doing an injustice to what's happening. So yes, we pay patients. You don't ask for freebies. Clinicians get the 300, 500 bucks an hour. Lawyers get that. Where are the patients in that routine? So I think you have to pay all the parties and expect to pay them all the same. I know it sounds crass, but money moves people. And you just have to think about how you incorporate that into your practice. So there was a question also along the same lines for Bon and Ellen about emerging healthcare and design and what it's like to collaborate with patients. If you guys have a story that sort of resonated with you while you were writing the book about getting that experience from patients and sort of learning from them. I mean, I think for us, it's just what Yohan was saying, that it's much easier for us just to design something in the box of our lab and then to put it out there. It's, I think, harder from the onset to invite the end users like patients and administrators in. And so I think that's been something that we've tried to do when we do our initial workshops to invite patients in. So I really appreciate designers and design consultancies that do that. It's a lot harder work up front, but I think you can deliver a much better product. And thank you for the folks from UK and South Africa for joining. I know it's late out there. Wow, I appreciate that. I know. I'd like to follow up on that comment, that question that in our book, some of the case studies are designed by patients. So we see patients as designers and as key, just obviously key players in the whole thing. So this is an incredible approach to designing garments for healthcare designed by a patient. We have incredible example of a patient communication system, a way of creating personal visual health histories that was developed by a patient who's a graphic designer and who turned that into a tool. Katie McCurdy, yep. Yeah, so that's a really, it's really important and really key to the philosophy of health design thinking. Absolutely. So interesting to see, just from the perspective of doctors, seeing when a doctor becomes a patient, how much that influences their practice going forward and how much that influences their experience and their idea of what a patient wants. So that's just really interesting to hear about from you. Yeah, I want to call on one person. He's put some comments up here that I've caught my attention. Laura Apple, are you there? I'm here, yeah. Yeah, yeah. Okay, you have a white screen. Yeah, so I'm interested. You're talking a lot about how COVID's changed and been this opportunity to do things that we never did before, but physicians need to reduce the friction. Can you tell me more about what you've said? Well, so I work on behalf of, so my job is, I'm at the Michigan Health and Hospital Association. So I work on behalf of all the hospitals in Michigan. And of course that incorporates a lot of physician work as well. And we've ended up as part of the pandemic, you know, creating a lot of new groups, meeting regularly with chief medical officers and HR directors and trying to think of who else we've had. Oh, our legal counsels. I mean, it's just, it's been nonstop. And one of the things I'm commenting on is, it's something that was totally unexpected. As waivers happened at the federal level and the state level, and barriers to people practicing with supervision or without, etc. The whole thing about telemedicine being able to be done, you know, you could use FaceTime and you could have remote locations could be billed. It didn't matter what the originating site was or the remote site. I thought that as these things changed, there would be this wave of this flexibility would be amazing to people. And it was as though people were, it was as though they had been contained in a in a very rigid like boarding school setting. And then they were all released until to go out into the world and, you know, do whatever you want. And no one, no one could do it. Everybody, the legal counsels would say to us, well, what exactly does this mean? Well, it means that you have flexibility. Yes, but what would the liability be if we do it this way? And we got a, of course, there was an executive order about not doing non-essential procedures, but it said ultimately the decision is the licensed medical professional. Well, then we can't do anything. I was like, well, but they gave you this flexibility. Yes, but what will the sanctions be if we do it wrong? Well, there's no one who's, there's no requirements here. It's like, you get the ultimate decision making. You're like, you're not going to be punished. And I can't tell you how many times I got people, even, you know, the governor gave us a statement, the chief medical executive of the state. So I was just surprised that what I thought would be removing the friction created this uncertainty that was actually not welcome. Yeah, no, absolutely. Absolutely. It's been a very interesting adventure in healthcare. And I, we're, and I to reference our institution, we are probably one of the few institutions that had already rolled out the telemedicine infrastructure. So, but I definitely have friends and colleagues in places that were not ready for that. And it definitely was an interesting way in which people solve this problem. Well, thank you. I think, I think we're kind of running out of time, right? So it's an hour flew by. I apologize that we didn't address the many, many people who identified this on the chat box as their first Zoom bombing experience. I'd like to apologize to anyone that has offended and to those of you who are not offended, you know, on the chat box. Thanks for your support. So next week we've got a great show as well. We've got Erin Peevee who has been named by the American Institute of Architects as one of the top architects for health and the top 40 architects for health. We also have Megan Duong, who is known to Jefferson University. She is part of a company called Fix the Mask who is creating a device that actually turns surgical masks into N95s, which is the kind of mask that we need to protect ourselves against COVID. So that is what a lot of people have been fighting for when they're saying, you know, get me PPE. They don't have that kind of mask because we never really use it very often before. And so she's created a solution for that. So we're excited for this and we will be reaching out to you guys to invite you to that session as well. Yeah. And I want to thanks once again, everybody who came on at JT TAN with the Prevent Project, Alfred Atanda, from Dupont-Namours, and Bon and Ellen. Thanks again. Health Design Thinking, the book somebody wanted to know. All right, guys. Thanks again. Have a good weekend.