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In Health Design, Silence Is Golden

Recently, users of my diabetes remote patient monitoring app, SweetSpot, have been flooding my inbox with messages about a highly-anticipated feature that has been in development for the past few months. Like a kid in the back seat of a car repeatedly asking their parents, "are we there yet?", my users were constantly emailing me with subject lines, "Is It Here Yet!?" With each ping I'd respond, "almost," as I refreshed my Slack channel repeatedly to check for any new updates from the dev team. This feature was particularly important because it would cure a major pain point faced by our users and fill the only real hole in our MVP (Minimal Viable Product) that is keeping it from being a self-sufficient platform that solves the issue (accessing diabetes data, easily) that it was designed to solve. Finally, after months of rising anticipation, multiple rounds of QA testing, and a healthy scraping of bugs, the day everyone had been waiting for had arrived: Launch Day. I couldn't wait to ease everybody's troubles away.

Some might expect such a highly-anticipated day to be met with roaring applause, smiling faces, and positive feedback - but I knew better. I sought a much different response from my users on that day - silence.

SweetSpot was designed for endocrinologists to help them better care for their patients living with diabetes. It was never designed to reinvent any wheels. It was meant to be a tool that could seamlessly integrate into their current workflows. Through every step of SweetSpot's design, the words "not another click" bounced through my head. "Not another click" is a common phrase heard around the hospital, often in response to Electronic Health Records (EHRs) and how cumbersome they can be to use (many studies have already demonstrated doctors' dislike for EHRs, including this one which showed that 75% of doctors attributed burnout to the EHR). But really, "not another click" and the complimentary eye roll that accompanies it, is a representation of how doctors feel about technology and its integration into the hospital. A barrier and inconvenience.

With SweetSpot, the goal was to design a platform that gave a doctor's superior lateral rectus eye muscle (the muscle involved in rolling ones eye) a break. The goal has always been silence - the natural response to everything just working the way you'd expect it to. The sound that is so rarely heard in a busy hospital.

Since releasing the highly-anticipated SweetSpot feature, I've been tracking its usage and seeing that it is being used just about as frequently as it was once demanded. But the best part is that since its release, I haven't heard a word about it. It's working just as intended - naturally, without a second thought.

I imagine it's a similar feeling a parent feels when they first send their kid away to sleep-away camp - when at first, they get letters and calls every day, but as the summer goes on, the communication slows perhaps even to a stop. It might be hard for the parent to not hear about their baby, but as often said, "no news is good news."

I went to sleep-away camp for one summer and called home crying every single day. My parents even still have a letter I sent home with a single tear-drop on it circled in blue pen. But that's a story to unpack for another day.


Amiad Fredman, MD

The Health Design Blog invites you to meet the newest specialty of medicine: the health designers - and learn from their backgrounds, experiences, and stories. We hope that our stories will inspire others who feel the pull to move against the grain, to light the spark inside of them, and unleash it onto the world. To keep up to date with these stories, make sure to follow this blog and sign up for the health design newsletter here.

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