Provenance—Lauren’s Update Nov 2020

Some of you know I crafted a suite of software applications to “rebuild the hospital from the inside-out” a few years ago.  The starting place for the design was how to meaningfully address patient satisfaction by improving two key features of the illness experience that tend to be aggravated by the processes and priorities of hospitals.  This was my antidote to hospitality industry strategies being employed in corporate medicine.  The two conditions I set out to improve were 1) loss of autonomy and 2) loss of identity.  In its most basic sense, when people feel ill mentally or physically (or both), we say, “I don’t feel like myself.”  It was shocking to me, when I considered these 2 states, that they mirrored what presumedly the most empowered group of people in the hospital also feel: physicians.  The ground rules for the design were that anything created to improve the patient experience could not entail any work at all for clinical providers.  After making a complex map of areas for improvement, things fell into categories of build-out. Many of the technical stumbling blocks of the design have already been overcome by developments in the few intervening years, but nothing like what I designed exists. I had started work on the patent and submitted a grant application to the NIH SBIR/STTR program for phase 1 funding.  A former patient helped me with this.  The timing of this unfortunately coincided with the opening of The Seed House, a brief mini-fellowship in Philadelphia, and the first of what would become serial, undermining breakdowns of trust in my life partner relationship.  I also was troubled by suggestions that the value of my design would lie in data mining, something I barely comprehended at the time but felt morally conflicted about because it meant introducing technology that would help make patients’s care better but use their information in ways that profited Provenance asymmetrically.  I felt daunted by how to retain the essence and inspiration of a project that I could see would require me to resist business pressures—in other words, it put me in exactly the position that caused me to consider how to remake hospitals.  I couldn’t quite see the balance, and the scope of marketing this project was huge for me.