In overcrowded waiting rooms of emergency departments across the country, every chair tells a story. In one seat, a man suffers heart palpitations because he missed a ride to his dialysis appointment. In another, a little girl wheezes from an asthma flare-up caused by mold in her family's apartment. Countless stories reveal seemingly trivial factors that later ballooned into costly emergency medical interventions.
Patients’ health trajectories, particularly at hospitals serving low-income populations, hinge on myriad social and economic factors that could be addressed with out-of-the-box solutions. Yet patients and others who could offer first-hand insights about their challenges aren’t generally integrated in the solution design process, often making the pursuit of innovation less effective and more time consuming to get right.
Looking through his lens as a former biomedical engineer, Sina Mostaghimi, MD, now an emergency medicine resident at Boston Medical Center (BMC), is eager to accelerate innovation in medicine by applying the principles of design thinking — a hands-on process of creative problem solving through experimentation, iteration, and a focus on the user of the resulting product. This approach eschews silos in favor of a hyper-collaborative process involving a diverse range of stakeholders.
Mostaghimi shares this vision with fellow emergency medicine resident Zaid Altawil. Together, they aim to establish design thinking as the norm during next month’s Hack/ED event, a medical hackathon in Boston that takes a page out of Silicon Valley’s book to generate effective solutions to some of emergency medicine’s greatest challenges, all in a 24-hour period.
Hack/ED will bring together multidisciplinary students from across the country — with backgrounds in engineering, computer science, design and beyond — to collaborate with hospital staff and patients. During the event, teams will prototype solutions to submitted challenges in the event’s three tracks: product design, social determinants of health, and quality improvement in emergent care. While the solutions could likely be new apps to connect patients to care, new uses for existing technologies, or new workflows within the hospital, by nature, it’s almost impossible to predict the outcomes of a hackathon. And that’s a good thing, says Mostaghimi.
Mostaghimi recently sat down with HealthCity to talk about the impetus behind Hack/ED, the event’s capacity to address social determinants of health, and the potential of hackathons to bring medical culture into the twenty-first century.
Hack/ED prioritizes the involvement of students and community members. What’s the value in bringing in participants who don’t have the same subject matter expertise as medical professionals?
When there’s a complex problem, people tend to focus on their own experiences. They rely on that type of pattern recognition and have trouble looking at the problem from a different lens. I think the biggest issue in medicine is that we focus so much on pattern recognition in our clinical daily activities — which is fine, but the problem is when you try to translate that into innovation in medicine rather than just caring for patients. You’re always looking through one specific lens.
By bringing students with diverse backgrounds and no prior experience into a project like this, we get a completely different lens through which to look at a problem. They don't have that kind of recognition yet because they haven't necessarily worked in industry for 20 years. They can make their own solution from the ground up. We want students to think differently, and we want to foster the next generation of medical innovators through healthcare hackathons. This is the beginning of filling the idea of design thinking in their brains.
How have you come to view collaborative design thinking as an integral part of medical innovation?
When I was a biomedical engineer, my frustration was that I never got access to the end user. Every time we met with the ophthalmologist about the new device we were creating, we’d bring several iterations. But she’d take one look and immediately say, "Oh, none of these will work." If we had had that person right there while we were building it from the ground up, we would have had a much faster solution, and a much more impactful solution.
In emergency care, we collaborate with multiple different specialities because we realize that it is imporssible to master all aspects in medicine. This spirit of collaboration allows for more effective care. Without it, emergency care wouldn't work.
What is the biggest takeaway from an event like Hack/ED?
I hope healthcare solutions will be an end result, but they aren’t necessarily the point. What matters most is the process. Really, we hope to spur innovation and collaboration among a younger generation so that they understand that this is the way that the world is going — we need interdisciplinary collaboration to solve tough problems. It's about communication. Especially in medicine, where you have these complex problems, you have to attack it in a multifaceted approach. You have to realize that you have limitations in your knowledge that other people might be able to fill.
You have to realize that you have limitations in your knowledge that other people might be able to fill.
How does a hackathon foster that type of collaborative problem solving?
The beauty of hackathons in general is that they target a preferred audience. When you say “I want to have a medical design workshop,” you're only going to get biomedical engineers. If you were to throw a weekend workshop on “innovation in medicine,” no end user would want to come. But when you put the word “hackathon” in there, and you're focusing on problems in patient experience, product design, and social determinants of health — then that's where you start to get that breadth of backgrounds that are interested. Because everybody thinks they have a little bit of skin in the game, you get computer science, business, nursing, pharmacists — everybody.
Medical hackathons get everyone in one room to just innovate. You have all the materials ready for you, all the minds, all of the end users, so you can come up with several iterations in the short term.
The social determinants of health don’t generally come up as a focus of other hackathons, is that right?
With Hack/ED, we realized that there's a lot more use to this format. It’s exciting as a way to use your skills toward something that's fun and competitive, but also to have some sort of social impact. The end user doesn't always necessarily have to be the doctor, and the problem doesn't always have to be a medical device. In fact, the biggest problems may be in the social determinant side of things.
Boston Medical Center has an incredible, unique patient population that often is not the target of anything, let alone hackathons. That’s probably because our patients don't have a lot of money — they don't have a voice that echoes some of the other populations that are targeted by these hackathons. I think that's where the opportunity is — just because we're targeting our patient population doesn't mean the solutions that come to bear won't have a wide reach.
Do you think there are any limitations to the way we can apply design thinking in medicine?
No, I honestly don't. I think where design thinking can have the biggest impact is in coming up with innovative solutions to streamline patient experience, improve care quality, and enhance patient safety. I don't think we've really begun to understand what design thinking means in medicine yet, so I wouldn't put any limitations on it just yet.
This interview has been edited and condensed.