Episode 1: Julian Bleecker - Design Fiction and how an imagination can help us see the future of healthcare
The future of Rx bottles, Kubrick on details and the fortune-telling court jester of the hospital
It’s with great excitement that I announce the inaugural episode of the North of Patient podcast. You can check out the podcast at the following:
As a reminder, I wrote here briefly about why I am starting this podcast and what I hope to accomplish through this project. Put briefly, I hope to promote longer term thinking about the directionality of healthcare. In addition, I will aim to summarize what I felt were the most pertinent ideas that came from these conversations via this blog.
Julian Bleecker
It’s hard to imagine a better guest to kick off North of Patient with, and to set a tone about future thinking, than Julian Bleecker. Julian works with companies and organizations to visualize and understand the future by building representative artifacts from an imagined future. He is a serial entrepreneur who founded Near Future Laboratory and OMATA, and is the originator of the concept of Design Fiction. He is also written extensively on the topics of design, technology and the future, and his book "The Manual of Design Fiction" is widely recognized as a pioneering work on the subject.
In our conversation, we discuss a breadth of topics ranging from what can be learned from the film industry on imagining the future, thought experiments on future healthcare artifacts (such as the evolution of the waiting room and prescription bottle), and how imaginative thinking could fit into healthcare organizations and the merits it may bring to healthcare provider wellbeing.
I found him both inspiring and refreshing to speak with, and I appreciated his optimism about the future in general.
Top 3 Takeaways on thinking about the Future of Healthcare
Start with something relatable:
Julian underscores the importance of grounding futuristic thought in the familiar. "If we're going to think about something that we can't possibly imagine… let's start by grounding it in something that is relatable that you can like identify with."So when asked, how does one start thinking about the future of AI, he responds with “I wonder would would be for breakfast in a future in which AI was a normal part of everyday.”
How can this be applied to healthcare? If we make the effort to peer deeper into the future than the immediate few years, then it’s crucial to remain grounded in concepts that we feel are central to care today. It’s fair to imagine that medications will still exist in the mid term future - so what would the pill bottle look like? What elements might be new and what might persist? Could it take on a different shape or form, or perhaps colouring, for different practical reasons in the future? How might the augmented reality change how we see the pill bottle and it’s contents? These are all opportunities for our imagination to do some work.Make the language accessible to all:
Julian points out that “the future is not a privileged domain for people with advanced degrees”, though we often tend to think that it is a complex and inaccessible space that can only be accessed by a few with bespoke knowledge. Thus we need to use language that includes, rather than excludes, so that more minds can participate in the creative process.
As an example and source of inspiration, Julian talks about how film and directing inspired him in his youth. As a Stanley Kubrick fan, he talked about the breakthroughs in design of the infamous space station in “2001: A Space Odyssey”. Having been intrigued by Kubrick’s technique, Julian learned that in order to inspire thinking on the team, he had the movie crew create an instruction manual for how a toilet would work in zero gravity in complete detail, in order to envision something believable for the movie. Importantly, this needed to be done in a way that anyone could read and understand it.
Instructions for the Zero Gravity Toilet from “2001: A Space Odessey” Healthcare has a notorious reputation for its complex and inaccessible nature, and it is often language and jargon that keeps patients and others outside of the walls of the healthcare system abstracted from it’s conversation and advancement. Julian's methodology breaks down these barriers by insisting that we all have “every capacity because of this incredible vascularized piece of meat in our head called a brain to imagine”. By simplifying complex ideas, the future of healthcare becomes an inclusive conversation that invites diverse contributions and innovations.
Design fiction has a role in healthcare organizations and may positively impact healthcare worker wellbeing
“Imagination precedes inspiration, inspiration precedes innovation"
Imagination, or design fiction as Julian puts it, is the necessary substrate required to create inspired teams, who then go on to innovate within organizations. While innovation lies on the utility side of the spectrum (and thus allows for objective and measurable impacts), imagination is less well-defined and more of a visceral experience.
So when it comes to assessing the early stages of promoting imagination, Julian asks, “Are people smiling when you engage them in this?
Analogous to the role the jester played in medieval courts and comedians play functionally in society, organizations need the equivalent license for someone to not only call out inadequacies or double standards within individual organizations, but also to have the freedom to experiment with fresh thinking and to inject novel ideas and solutions to leadership.
"Futurist is kind of a loaded term… something maybe less assuming. It could also be a small, 2-3 person little studio..” - that brings novel ideas on a routine basis. Advanced technology need not always be the answer either - it could be creative, practical solutions that push forward the experience for the patient and the work environment for the team.“Imagination is our evolutionary advantage. It doesn't happen unless you're willing to have the audacity to imagine that change could happen.”
In other words, it fuels hope, which at the present moment many would argue is in very short supply within healthcare, especially in primary care. Hope could come in the functional form of a few less clicks to complete a form on an EMR or reducing the need to document using an ambient scribe. It could however also come in the form of people feeling acknowledged, both those working in healthcare delivery, and of course, the patient. An acknowledgement can be as benign or seemingly mundane as something that makes their experience more colourful, something that brings a smile to people’s faces.
For more information about Julian’s work, feel free to check out his website, the Near Future Laboratory and his podcast.
I wanted to take a moment to say thanks to Julian for not only willing to be the guinea pig and be first to come onto my podcast, but for going out of his way to help give advice on the technical setup for the podcast. You’re a busy guy, and it meant a lot to have you give a lending hand.
In addition, I wanted to give a special thank you to Jonas and Nikolaj from Svaneborg Kardyb, for their kind support and willingness to let me sample one of their magical tracks, “Orbit”, for the podcast.
You guys all make the world a brighter place.