Design Thinking to Create a Remote Patient Monitoring Platform for Older Adults' Homes

How might clinicians collect the vitals needed for effective scheduled video visits for older adults? This challenge was presented by AARP to graduate students in a Digital Health course at Tufts University School of Medicine. The design thinking process was used to create a product that would meet this need, keeping the needs and constraints of older adults, especially those with chronic conditions or other barriers to health, central to the solution. The initial steps involved understanding and empathizing with the target audience through interviews and by developing personas and scenarios that identified barriers and opportunities. The later steps were to ideate potential solutions, design a prototype, and define product success. The design thinking process led to the design of Home Health Hub, a remote patient monitoring (RPM) platform designed to meet the unique needs of older adults. Additionally, Home Health Hub can conceivably benefit all users of telehealth, regardless of health status—an important need during the COVID-19 pandemic, and in general due to increased use of virtual visits. Home Health Hub is one example of what can be achieved with the dedicated use of design thinking. The design thinking process can benefit public health practice as a whole by encouraging practitioners to delve into a problem to find the root causes and empathize with the needs and constraints of stakeholders to design innovative, human-centered solutions.     

Transorbital endoscopic approaches to the skull base: a systematic literature review and anatomical description

Neurosurgical Review - Transorbital endoscopic approaches are increasing in popularity as they provide corridors to reach various areas of the ventral skull base through the orbit. They can be used...     

Ilizarov external fixation in the treatment of comminuted leg fractures

Fifty consecutive comminuted leg fractures were treated by Ilizarov external fixation. Eleven were closed fractures, 37 were Grade II, and 2 were Grade III open fractures. Forty-five fractures healed within 6 months. In 5 fractures the Ilizarov device was removed and healing occurred by intramedullary nailing (2 cases) and decortication (3 cases). The causes of failure were: rapid peroneal union or bone fragment necrosis. Subjective tolerance and fracture stability are limited by septic loosening of the wires requiring frame removal after 6 to 8 months. Excellent results may be obtained (no leg length discrepancy, no angulation, no rotation, no joint stiffness), but the time required for union is long and additional surgery is required.     

The functional neuroanatomy of psychiatric treatments

The attraction of this kind of model-building is its rigor. There is an unhealthy indiscipline to psychiatry as long as it remains purely phenomenologic. Clouds are described, then other clouds; then they are related, one to another; then new clouds form, and they too are described. It is a process that could go on forever, but it is too nebulous to win support for very much longer. In contrast, psychiatry that is based on etiopathogenesis, on brain maps, has rigor. It is either true or untrue, like the three models presented above. If it is true, like the frontal lobe hypothesis of dopamine agonists, it will lead somewhere. If it is only a small part of the truth, like the kindling theory of temporal lobe drugs, it will be supplanted, before long, by a more cogent hypothesis. What is more attractive about this kind of thinking, however, is the practical side of it. The KBS hypothesis of autism is not simply an idle exercise. It is a guide to a specific approach to behavioral treatment and a warning to eschew the mindless search for a pharmacologic "bullet." Theories, like every other living thing, have to do something useful before they are ultimately set aside. At least this one lends some common sense to day-to-day events.