July 1, 2016

Week 11 & 12 – Our Attempt at Prototype #2

By mary

The last two weeks for the Mayo Clinic Education Shield’s innovation team were a roller coaster. Within the span of those two weeks we chose an idea, ramped up to test it, and then promptly killed it. It was a shock to the system for some, but the right thing to do.

Back into the Fray

Towards the end of November, we held our open house in Rochester and then needed to immediately pick a second prototype. We do not advise jumping so quickly into a new idea without more research and exploration, but the budget constraints for this trial program gave us a limited time frame. Our goal was to make the most of it.

There were a number of missions that rose to the top of the list:

  1. Bringing more Real Life Experiences to Learning
  2. Overcoming cultural bias (and the impact that bias has on medical treatment)
  3. Team-based problem solving for patients with multiple conditions (inspired by Dr. Victor Montori)

At first, the team was very interested in #3. Mayo Clinic has a global reputation for excellent team-based care. Could it better teach this to the world? The implications were interesting, but after a day of analysis and talking to experts, we decided the complexities, dependencies, and blockers were too great for the 4 weeks we had for the prototype.

Bringing more Real Life Experiences to Learning

We shifted our attention to #1, the problem of bringing more real life learning experience opportunities. We had repeatedly heard that people loved the simulation experience. Sim center learning is well planned and highly interactive.  Teams felt that those experiences, although not available regularly, were the best experiences they’d ever had.  

Was there a chance to bridge the huge experiential gap between the immersion of physical simulation centers and the detachment of traditional online learning? Could we create something new that would deeply engage people in a scalable and affordable way?

12_warnerThe questions seemed worthwhile both from a “user need” and corporate cost savings perspective (and not just within Mayo Clinic). But how to solve? We viewed augmented reality as the most promising technology, but still several years away. Virtual reality had too many drawbacks in terms of creation costs and the quality of realism in the experience.
360 degree video, on the other hand, was a recently commercialized technology that seemed relatively inexpensive. In theory, practitioners could access an immersive 360 degree experience with a $5 Google cardboard viewer and a smartphone. The content itself could be created with relatively inexpensive GoPro cameras and off-the-shelf editing software.

We thus had a problem to chase, and a potential solution. We then split the team to tackle certain tasks and questions:

  • We designed a detailed experiment that would let us A/B test 360 degree video against traditional video
  • We reached out to doctors and NP/PAs who could help us try out the technology with some custom content
  • We researched the state of the technology, the viewers, cameras, editing tools, players, etc.
  • We turned to a virtual reality production company in San Francisco for advice
  • We sketched out the business model for the idea

To be honest, the team was fairly split between the optimists and skeptics on this technology. The real question was whether 360 degree video was a gimmick, or if it really would offer a more immersive experience.

The good news is that we had a ton of interest from medical educators who wanted to work with us to test the new technology (thank you all!). But we also quickly hit some bad news:

  • The level of interactivity was extremely limited. In theory, one could do eye tracking and even eye-triggered interactions. Unfortunately, the state of the technology implied an expensive custom software project.
  • The initial 360 video tests we did of a patient interactions were, let’s be honest, really banal. Without the ability to walk or zoom, or interact, the tech felt useless. Quite the opposite of what we were going for.
  • The 360 video players for the iPhone were really buggy, which might have restricted us to Android phones.
  • The cost estimates for producing a really good 360 degree experience, with multiple points of view and with interactivity, could be quite high - maybe as much as $75K per 8-10 minute video. Added to the custom software costs, the business model was looking like a non-starter.

Last Thursday morning, we held our weekly decision meeting where we recommend a “persevere, pivot, or kill” decision. In the first week, we had a number of worries and/or objections to 360 video, but we decided to continue investigation. By week two, however, we recommended a “kill” decision.

Silver Linings?

While it was frustrating to stop work on the idea and start over, that is exactly what an innovation team has to do — at least if they want to be capital efficient. We did discover two interesting things:

Dr. Farley’s Magical Surgery Session

While some of our experiments with 360 video were boring, there was one experiment that was quite the opposite: Dr. Farley doing a pre-surgery session with his students. In his session, there is a lot happening around the room. What would already be exciting in a normal video becomes more so when you have the power to swing your attention around at will to Dr. Farley, the chest x-rays, the students working around the patient, etc.

Take a look for yourself, using YouTube’s viewer controls in the top-left corner of the video to pan around.


Hulu of Medical Education

We never viewed 360 video as an end, but rather a possible stepping stone in a wave of technologies that should make remote simulation increasingly compelling. However, creation of content is only the first step. We need an effective way to distribute and monetize it. Right now, it feels like the top teaching hospitals are competing against each other. What if we created a medical education “Hulu.” Imagine having a single storefront where a healthcare team could find and buy great content on any topic from Mayo Clinic, Johns Hopkins, Mass General, etc. It’s an intriguing concept. We haven’t had time to investigate whether it has been tried already.

Did We Make a Mistake?

Two weeks of work down… the disappointment of killing an idea… a looming deadline to get a working prototype done and no idea what we were going to do instead… not a great feeling.

So, did we make a mistake?

Giff Constable, the lead on the project from our innovation partner Neo, argues no. We went after a real problem. We explored a new technology with a mix of optimism and skepticism, and went into it with our eyes wide open. We put less than two weeks of work into it. We probably could have run a couple of small experiments faster, but that would have saved us only a few days.

This is the roller coaster of innovation work. If you are trying to push the envelope (and have a business model at the same time), you have to expect that 10% to 15% of things will work. The failures hurt, but it is better to face them.

We’re trying to remember that the purpose of this trial is to help Mayo Clinic make a decision on whether to fund a real innovation studio. The expectation was not that we would come up with a product win on our first few shots at goal. Of course, that is the rational view. The reality is that everyone really wants a win now! And that means we have to dust ourselves off and keep trying.

360 video was not going to be it, so we pulled the plug. We don’t have much time left, but we do think there is enough time to try one more thing.

Stay tuned!

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