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OCTOBER 9, 2006 
Inside the Volcano Carnegie Mellon graduate Maggie Breslin brings her innovative thinking to the Mayo Clinic At Carnegie Mellon, I took a first year seminar with Dick Buchanan. He used to liken [design thinking] to climbing into a volcano: It's messy and it's risky and it's dangerous. To tap into unique insights, you have to follow tangents and lose yourself in them. The trick was to learn when and how to climb out of the volcano. People from all disciplines want to tackle complex problems. Designers can make something that allows a much richer conversation about the problem you want to solve. 
At Mayo Clinic's SPARC Innovation Program, our program space is right in the middle of the clinical space. There are patients across the hallway. The conversation that happens in the doctors' offices is so loaded with history that allowing [patients] to have an equal conversation is incredibly hard. Our challenge was, can we change that conversation that patients and physicians are having? Our director of research is an endocrinologist and does work with people with type 2 diabetes. We decided to investigate: How do we help them make better decisions about their medications? When we first started, I didn't know anything about diabetes. He explained it, and I made a card up for each of the five medications, like baseball cards. We gave them out to patients. They were intrigued, but it didn't really change the conversation at all.  People wanted to be able to make comparisons. So we divided issues into categories -- side effects, weight issues, daily routine. We cut them up and created a matrix: medication across the top and across the left side, different issues. We tried this. We gave patients the issues and asked them to order them. We attached them with Velcro. As they would talk about each medication, the physician would lay out categories. In this version, we noticed the patient would talk more. The form of this prototype we tried was all wrong. There was too much text. It would be hard to work in the exam room. We went back to the card idea, but now the cards were about the issues. The physician would say, "Which is more important to you?" As the patient and doctor spoke, the patient would take more and more of the cards. You would hear patients begin to make their own plans. That was what we wanted.  By Maggie Breslin, as told to Jessi Hempel
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