Rich Strangers

healthcorp feet small

United we stand. Alexandria, Virginia, May 2017

By Lynne Driscoll, Director – Intellectual Property, IBM

Bringing together several people from 5 different countries and cultures has certainly been an experiment worthy of a ‘Big Brother’ like television show environment. Myself along with others from the U.S., South Africa, Singapore, Mexico and Cameroon have been living in a shared rental house for the last three weeks in the beautiful and convenient ‘burb of Alexandria, Virginia area, just 10 miles south of Washington, DC.  A few of my housemates had never left their country before.

All of us were strangers, for the most part. Some prep phone calls and web conferences occurred prior to the start of the project, people jockeying to understand their role on the team, the project, and to simply understand the accents & to connect the voices we heard to the pictures we saw of our colleagues online and on the messaging application called WHATSAPP.  If you don’t know what is WHATSAPP, it’s more popular than a standard texting application worldwide because it uses internet and not cell data for message transmission therefore much more cost effective than what we blindly expect from our gluttonous US-based mobile data plans.  And it’s more fun.

Speaking of gluttony. While we were together in DC, one of our global team members wanted to get a ‘chalupa’ at Taco Bell. I groaned in agony over his request. Another wanted to visit this store they heard of called ‘Walmart’. I grimaced in disbelief. The rental house itself, where we were domiciled, was nearly 11,000 square feet with 8 bedrooms and 3 kitchens (crazy, I know, but good story to share in person over a margarita).  Is this what we want to share about America with our global colleagues? The infamous American excesses?

At the end of our three weeks together, what we really shared was an excess, or a plethora you would say, of true team work. We each brought our own wealth of skills and experience to take a loosely defined project, create a roadmap and turn it into a working system in record time.  We created (along with our NGO Partners) a working cancer treatment advisor tool, based upon IBM’s kick-ass Watson technology, that can rapidly help oncologists in select Sub-Saharan African countries find the right treatment based upon what is available in that country. Staying up late on most nights, we laughed, we coded, we negotiated, we argued, we ate, we drank and we focused. We used our riches to enrich each other…and more importantly… enrich the health and lives of those we will never meet.

At the start of this journey we were sequestered together as strangers to work on an IBM Health Corps community service project. It seemed like the start of a bad joke. 4 Americans, 1 Cameroonian, 2 South Africans, 1 Mexican and 1 Indian walk into a house….

We walk out tomorrow as rich friends. God bless everyone and my deepest appreciation to our employer IBM who exhibits support and leadership in making the world a better place.

 

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The War & the Moon

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Iwo Jima Memorial Washington, DC – Memorial Weekend 2017

By Lynne Driscoll, Director – Intellectual Property, IBM

As an American, there is not much more moving than visiting our Nation’s Capitol on Memorial weekend.  This U.S. holiday is informally known as the ‘start of summer’, however it is formally known to honor those who have served in both life & death in the protection of our country, values and freedom.  The energy of the visiting crowds, food trucks, street vendors along with the monuments and their stories reminds us how fortunate we are as a society.  Speaking of fortune, we were provided a delightful, local private guide for an evening, moon-lit tour of the Capitol complete with historical insights unknown to many and sights unseen by our IBM Health Corps team.

Infused in our friendly banter among ourselves and our guide, we wandered through the monuments and through the topics of the political parties differences between our respective countries, the puzzling (to even us Americans) electoral college and just exactly how much could you pay for a home in the trendy Georgetown section of D.C.? (according to realtor.com….a LOT is what I would say).

And yet in this celebration of those who lost their lives and loved ones due to wars on soils near & far –  on behalf of the United States and our allies – it hit home. It’s clear that our small team, 7 of us from IBM, is fighting a war in itself.  The war called Cancer.  With many in support, we are building a tool that oncologists on the ‘front-lines’ in low-resource countries in Sub-Saharan African (far away soils from America) can use to effectively treat and battle one of nature’s most destructive forces in the human body that is more insidious than bombs, more prevalent than AK-47s, more underhanded than an IED.

As an example, cervical cancer is one of the leading causes of death of African women.  Preventable with a vaccine, treatable if caught in time. And too many women are senselessly losing the struggle in this part of the world. Let’s stop the advancement of this cancer and the others we are working on.

This team is part of the Moonshot that our CEO declared on this disease. A century-old technology company, that has survived through 8+(?) times-of-war over our existence, seeking to eradicate an enemy.  This team will never get a monument raised in our honor. We aren’t seeking one. But it’s been my honor and pleasure, however small a contribution, to serve my country and my fellow human beings.  I am proud to be an IBMer.

To pursue the mission, add the humans

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Health Corps team at the American Cancer Society Hope Lodge, Baltimore, Maryland

By Lynne Driscoll, Director – Intellectual Property, IBM

We get distracted and buried in our own problems of traffic jams when running low on gas, missing an important email from your boss, batteries dying on our mobile devices at the inopportune time, frantically running kids to soccer/band/scouts, or Amazon not getting your order to your door in the two days PROMISED under Prime.  Sacre bleu!

And then…

And then…

…you get your internal compass reset.

While doing some out-bound community service as part of our IBM Health Corps special project to build a cancer care tool to help the oncologists in low resource Sub-Saharan African countries, my internal needle was spun around this week.

Hope Lodge is a place that cancer patients and their families, who may travel from far away to get treatment at local Baltimore medical facilities, can stay for free of charge.  Beautiful facility, well organized, well staffed, and… as well…emotionally moving. The IBM Health Corps team provided and served dinner to over 40+ people who were using the facility.

Following the strict instructions of the events organizer Jacki (seen above), we donned our hairnets, put on the sterile gloves, avoided the bone marrow transplant tables, made note of the disinfectant location and served dinner.  Then when our guests were sufficiently served and fed, we joined them.  My dinner companions included a man who is a 10-yr survivor of prostate cancer and traveled around the country ‘volunteering’ for the experimental treatments; a young, pretty mother of  8yr old and 10 yr old children getting a newer proton treatment for her breast cancer (who’s husband could only come up 1x a week because of the child care strain); a lovely gentleman with esophageal cancer who was not fairing well with his treatment (and interestingly, his wife worked at IBM in the 1960’s as an admin).  And finally, a young man, not much older than 30, who traveled from Japan for his second occurrence of brain cancer.

Our dinner conversations were insightful at times, uncomfortable at other times, and surprisingly cheerful with some laughs.  They were so so keen on what we were doing.  They all told me that they had to be their biggest advocate to find their treatments (not the physicians), and could this tool be made available to people like them who have to sort through volumes of internet research to push for the latest and strong hope for the best available treatments? I took all their comments and stories to heart.  I was in awe of their strength.

I left the event emotionally drained yet intellectually uplifted.  While this specific project for IBM Health Corps is focused on Africa and what are ‘Third World’ problems with the lack or resources or consistent drug availability, its time for all of us to properly gauge the importance of our ‘First World’ problems because we are all humans just trying to survive.  Be it in Baltimore at the Hope Lodge, be it in Ghana at a doctor’s office.

Remember these people I will.  To think about the impact of what we are doing on this project —  and  —  remind myself of what is really important when my specially packaged southern corn grits are shipped ‘late’ from a warehouse.

Population Health Improvement: Why women engagement and leadership matters

By Christine O’Sullivan, IBM Executive Architect at IBM Client Center Montpellier, Member of IBM Academy of Technology

Writing this article on March 8th (International Women’s Day) and as the IBM Women in Technology leader for France, working in an industry where women are underrepresented in the fields of science, technology (17% of women at my workplace), I’d like to highlight women’s engagement and the role models I met in the Durham-IBM Health Corps project. Michelle, Gina and Pam are three very talented women, and each of them is bringing incredible value to the mission of improving community and population health in Durham.

My first interaction with the Durham stakeholders took place at the kick off event, where I had the chance to talk during roundtable discussions with a group of 6 motivated and mission-driven women from the Durham Department of Health, Duke School of Nursing, NPCC Medicaid, Duke Center for Community and Population Health Improvement and Diaper Bank of North Carolina. They provided me with key insights on the current situation and existing challenges in population health improvement. Michelle Old, Executive Director and Founder of the Diaper Bank of North Carolina, was one of them. The Diaper Bank aims to ensure that families receive hygiene products they need by working with established family-support organizations to distribute diapers to low-income families and those in greatest need.

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Michelle decided to start the bank following a personal experience when her child was hospitalized and when going through 15-20 diapers a day, she realized how terrible the situation of parents could be when they can’t afford to pay for diapers. Making the decision to create the diaper bank had a big impact on their job and on her family life as she decided to quit her job to dedicate her time to this new mission.

Michelle offered us the opportunity to visit the Diaper Bank site and I want to testify how key, impressive and successful the work of Michelle and the Diaper Bank team are to ensure that families can cover essential needs that impact their health.

Among the impressive list of interviews and visits we had in the first two weeks of our project, I had the true privilege to meet with Gina Upchurch, RPh, MPH, founder and executive director of Senior PharmAssist (founded in 1994) at the Durham Center for Senior Life. Senior PharmAssist helps seniors with limited incomes improve the quality of their lives via medication payment and connecting them to the services needed to remain independent. Health insurance literacy is critical and the organization helps Medicare beneficiaries understand and maximize their medical and prescription coverage. Listening to Gina, it’s apparent that organizations such as Senior PharmAssist have a very critical and outstanding role in population health improvement. Gina and the Senior PharmAssist team help seniors in taking their medication, maintaining their ability to perform tasks and to stay independent with concrete outcomes like a decline in the rate of any hospitalizations.

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If you are making a stop at the Center for Senior Life you will be met by all the senior smiley faces in this very lively place! (And you can watch Gina’s remarks at the closing event for IBM Health Corps here.)

Third, I’ll talk about Pam Maxson, PhD, Director of Operations for the Duke Center for Community and Population Health Improvement. We were very fortunate to have Pam as our sponsor and focal point in the Duke team. Pam is an impressive and very knowledgeable person on population health. In addition to bringing value and insights to our work, her authentic community engagement and experience were a true asset to this project and a door opener to working with the key organizations in Durham. Her kindness, generosity and openness made the difference in integrating the IBM Health Corps team in the Durham ecosystem, in embarking and fostering collaboration between all the organizations.

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Technology and tools are an important foundation, as the Durham community needs a platform to share data, to improve connectivity among stakeholders, to provide key functions (such as a global catalog of resources, referral and analytics capabilities and new population-level care management), and deepen impact for the community.

But the success of the on-going work and the possible evolution also clearly rely on the quality and capacity of everyone in these organizations to deliver services to community members, and to connect and coordinate to achieve better outcomes.

Above all, this Health Corps project is about people, with people and for people:

  • About people who are not only patients but also individuals whose health are affected by social and environmental conditions
  • With people who belong to many organizations representing the healthcare system, social services and the communities’ members, engaged to improve population health in Durham, pointing their efforts in the direction of creating a collaborative system that creates health as opposed to dealing reactively to sickness
  • For people, requiring assistance to improve their living conditions, health and well-being

We interacted with many people committed to the mission of community and population health improvement: interviewing, listening to the different organizations, and visiting community sites (including the Diaper Bank, Lincoln Community Health Center, Senior PharmAssist, Department of Health, Alliance Behavioral Health) to understand the requirements, the on-going effort and the challenges. We also organized workshops, using design thinking methods to facilitate the interaction and collaboration between the different organizations, acting as a catalyst to leverage all the great on-going work and to continue building trust. It has been a great opportunity to work with awesome women (Dr. Ebony Boulware, Michelle Lyn, Joanne Pierce, Gayle Harris…) and awesome men (Dr. Eugene Washington, Dr. Angeloe Burch, Jeff Quinn, Fred Johnson…) mobilized to improve population health.

It is the passion and drive of those working in health that leads to disruption and innovation.

Meeting with amazing and brilliant people from the communities based organizations and Durham health stakeholders has been a gift for me. I believe it is also the cornerstone for the success of the population improvement project.

Thanks to the entire team who let us join their journey, to the exceptional women and men who are making a difference in community and population health improvement!

——

Christine O’Sullivan was a part of the IBM Health Corps team, a philanthropic program, which worked with the Duke Center for Community and Population Health Improvement, city and county of Durham, and many community based organizations for 3 weeks in February 2017 to help improve population health. The focus was to develop a framework to map community health and health equity improvement efforts across Durham County (and within Duke), and to measure the collective impact of efforts on health across the geographic region. Read more here.

Only Child Time

Musings about living in a house with 6 teammates

By Caroline Lu, Advisory Designer, IBM Design/Watson Customer Engagement

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Our home away from home

Growing up as an only child, I’ve never lived in a house with so many people. During our project, our 7-person team lived in a 7-bedroom house. There were three floors, a professional kitchen complete with two sinks and a massive Sub-Zero refrigerator. We had a “waiting room” with a grand piano. The basement was equipped with an elliptical and treadmill. Outside, was a sitting area to take in the lake-side view.

This house was built for nonstop activity…And people say New York is the city that never sleeps.

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Our first dinner together making pizza for dinner

Constant movement

There seemed to be constant movement in our house. Something was always cooking, toasting, nuking, draining, boiling. Feet kept moving across the hard wood floors. Laundry was always running, followed by the sing-song beeping of the dryer completing loads that were damp to completely dry. The dishwasher did not stop. In the dining room— which doubled as our work room— both the chatter of collaboration and blaring silence of stress was always heard: the clicking of keyboards, ripping-off of flip chart paper, and scrunching of Post-It’s. Even when I, the night owl, while awake in the stillness of night, could hear my teammates in my head.

But this home was a treat. It was adult camp. It was about immersing ourselves into each other’s lives and quickly getting to know each other. It was about being immersed in a 3-week assignment outside of our regular day jobs to dedicate ourselves to reducing health disparities— a common mission we all decided to leave home for.

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The dining room that dubbed as our team work room

Gifts and Hooks

Once we all arrived in our new home that Saturday afternoon, Natalie Dawe, our program manager (and my bathroom-mate), took us a through a series of team building exercises. With Post-It’s in hand, Gifts and Hooks was about writing down the gifts we each think we bring to the team, and the hooks we needed to remain fully engaged and active as our project progressed. Huddled around the living room coffee table, we shared our thoughts, got to know each other as real people and completed our first team activity.

This reminded me of another activity I did during another project kick-off called Hopes and Fears. (See page 26 of the IBM Design Thinking field guide.) There, we expressed our aspirations and concerns for the project—like Gifts and Hooks where we shared a small bit of what makes us human.

Code of Conduct

To be honest, being accountable to each other at every moment was sometimes amiss, especially when it’s 8pm and we still had 5 interviews to debrief, plan for tomorrow’s interviews, and a 7-person co-creation workshop to prep. This was a high pressure, think quickly, act quickly, pivot, adjust, re-adjust situation. All the while, trying to make 7 different styles of working work.

We were a team of 7 with different expertise: engineer, architecture, data science, client relations, program management, design. We also had 7 distinct personalities. Some might call this a social experiment, or something like MTV’s Real World. See Jason Gilder’s blog called, “The Real World: Durham, NC. IBM Health Corps Edition.

As our 3-week project came close and tensions built, we each, unfortunately, had inadvertently violated our Code of Conduct. This Code was something Natalie had us co-draft and agree upon soon after doing Gifts and Hooks. At that point, we needed a way to discipline our very opinionated, exhausted and cranky selves. Imagine: 7 grown adults needing a green ladle to remind us of good behavior— whoever held the ladle could speak and nobody else. Not our strongest moment.

However, I believe having had a team Code of Conduct in the first place gave us a way to articulate and express desires we wanted for each other and for our project. Each of our intentions were pure. So, for me, when things got heated, I reminded myself of that and tried to calm down.

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Working in the enclosed porch

No man left behind                 

One night, we all agreed to regroup in the work (dining) room at 8:15pm. Ten minutes passed and one teammate hadn’t shown. This was unlike him to be late. We checked his bedroom and bathroom in case he passed out. We were about to take the car and scour the neighborhood since he said he was going for a run. At 8:29 he shows up sweaty and thinking we were meeting at 8:30. He is the brother I never had.

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Only child time doing work on a loveseat at the top of the stairs overlooking the foyer

Only child time

There were moments when I needed “only child time”, my way of saying I wanted to be alone. Whether it was alone time to work, or, alone time to detach from my team, I needed that time to recharge. Admittedly, there were times when I really wanted only child time, but knew in my head that I should socialize. Those times ended up being fond memories.

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On a rare night-off a few of us went to see illuminated outdoor art installations

Back home in New York City

It’s quiet in my 1-bedroom, 1 floor, and 1 sink kitchen in New York City. Outside, a truck just ran over a manhole. Some cars are driving through the gusty night. I hear the hum of my humble GE refrigerator.

I use these words to describe the past 3-weeks of my life:

Intense.

Incredible.

Meaningful.

Life-evaluating.

At the beginning, I thought it was a bit nuts to be living in a house. Now, looking back, it couldn’t have been any other way. Private hotel rooms would not have cultivated and nurtured a team. Even the very nature of our project being about improving community health seemed to be asking the same of us. We, too, as a team, had to understand and empathize with each other: To commune, to collaborate and co-create, to build our little community in our home away from home. To make sure that no man is left behind, or hurt and lost in the woods.

IBM Health Corps – Duke Health: A New Yorker’s Personal Perspective

By Michelle Medina, Client Executive, Health and Human Services

Being a Native New Yorker and braving a rigorous weekly commute into the melting pot metropolis that never sleeps, I figured, for sure I am up to the task of joining the IBM Health Corps philanthropic project for Duke Health.  This entailed leaving my family (including two teens) and work life behind for 21 consecutive days and living, eating and working around the clock with six people I would meet for the first time in Durham, North Carolina. At that point, our only common thread was that we worked for IBM and each of us had a keen desire to contribute our talents toward having an impact on the health outcomes for Durham County. The mission, to immerse ourselves completely with our sponsor, Duke Health and key community stakeholders in order to emerge with a recommended framework that would enable Duke Health and the community at large to harness their most valued assets: People, Resources and Information to improve health outcomes for the community of Durham.  The expectations were high, as the goals to decrease healthcare disparities and promote health equity across the community were a vision shared by all.  This was not just about getting it right in Durham, it was about establishing a model that could be replicated across the country.  

That expression of “being in the boat together” was never more pronounced as it was on the day we all arrived to Durham, Saturday, January 28th, as we sat around in a circle and began to share why we were there and what we each hoped to accomplish.  It was through those daily team interactions; morning coffee, team brainstorming, endless analysis and synthesis, honesty, rawness, rubbing eyes tiredness, occasional fits, break through ideas and nightly check ins, that I came to realize, being selected for this project, was by no means an accident.  I came to see we formed a tapestry of skills, experiences and talents in areas such as healthcare IT, social services, clinical, design, architecture, software engineering, cloud, emerging technologies, marketing and client relations.  We were diverse in culture; Hispanic, Asian, American, Irish, British, 50% men, 50% woman ranging from millennials to those who braved the Y2K era!  Honestly, it was a beautiful thing and it set the stage for 3 intense weeks of hard work on our part and massive commitment from Duke Health and the community at large.

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Our first team lunch with the Duke Center for Community and Population Health Improvement

There is something about Mondays; kick offs, the start of a new diet, a new workweek, list of things to get accomplished and so on that set the stage.  The IBM Health Corps project kicked off on Monday, January 30th in the center of Durham; it was truly all the buzz.  We were greeted with warm hello’s, real southern hugs, a line up of carafes brimming with coffee and tea, pastries, happy people with name tags, Duke Coordinators tending to every last detail in a large, open airy forum with great lighting, high ceilings and brick walls.  You knew you were in a building that had rich history and pride.  It was great energy with over 80 people set up in tables of 10 with a giant white board surrounding nearly half the room.  There was chatter as to whether the Mayor would be in attendance or not.  First it was on, then it was off, staff were scurrying, the coordinators were unsure and then shortly after the first presenter began, Mayor Bell quietly slipped into the back signaling to all, this was a pivotal moment for Durham.

Our key sponsors, Chancellor Washington and Dr. Ebony Boulware addressed the audience.  Dr. Boulware did a great job through visual aid and discussion to set the stage for how academic health systems, such as Duke Health, are evolving to a more population health oriented model.  She characterized this transition as the 3rd curve which considers a much wider health improvement approach that places a better lens on the biomedical, contextual and behavioral factors across populations and enhanced collaboration across a wider set of partners within the community.

Each member of the IBM Health Corps team took the podium and introduced themselves and you could literally hear a pin drop as all eyes and ears were upon us.  Participants from all parts of Duke Health and the community talked enthusiastically about what was working and what could be improved as many were shaking hands and introducing themselves to each other for the very first time.  Many business cards were exchanged and people were excited to learn about each other’s work.  We learned of their mission to strengthen the well being of individuals and families through prevention and education.  They re-affirmed the value of partnering across their ecosystem to create greater access to health and wellness services.

On the first Wednesday, it was then time for design thinking and suddenly a sea of people stood up and were ushered to the white boards with multi-colored post notes and guided through a design thinking workshop.  It was like a massive jam, so well orchestrated as we moved in teams looking at what each team had to say and being guided through a process that helped us to harness these brilliant inputs.   Everyone loved being heard, seeing what others were saying, sharing their bold ideas and watching a collaborative human centered process unfold before their eyes.  Little did I know, that session would spark a desire from the community to adopt design thinking as their new mode of operating.  Early observations were oriented around the need for greater trust, communication, collaboration and engagement across the community and with Duke Health.  There was a desire for smarter use of tools and technologies, access to critical information and data on a more timely basis and ability to know of and access resources and programs to aide clients or collaborate more effectively on mutual areas of interest.   It became clear early on that in Durham, there was no lack of hard work, commitment or talent from those with missions around the health and well being of individuals and the community.  Yet, even so, there was something standing in the way of full or perhaps faster realization of progress in health outcomes in a more system-wide way.  Something would need to be different.  Something would need to change or be activated in order to have that broader, more visible and measurable impact on population health improvement that is beckoned by the 3rd curve.

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At our design thinking workshop

So, what is the problem when Durham County has so much going for it?  Duke University Hospital is ranked nationally in 13 adult specialties.  There is also a plethora of community based organizations, programs, health services, call centers, faith based organization, volunteers and mission driven staff all looking to fulfill every possible health need in the highest quality way.  The Partnership for a Healthy Durham is a shining example of collaboration at its best, which has leveraged the 2014 Durham County Health Assessment and resulting 6 priorities organized into 6 active committees on Access to Healthcare, Education, HIV/STIs, Mental Health / Substance Use, Obesity and Chronic Illness and Poverty.  Over time, it became clear and with our good understanding for what was working and where the challenges still existed, I grew excited about what was possible largely because of great work already underway in Durham, but also because we had an engaged community, committed sponsor and motivated IBM Health Corps team.  

I’ll admit, while 3 weeks goes by in a flash, you still miss your family and there were days I longed for the hug from my child and just when I thought homesickness would overtake me, someone in the community offered a warm smile, a big hug, a cup of coffee and recommendations on where to eat or what to do.  I marveled at how cars would randomly stop at a place that was not a typical cross walk, just to let us cross the street.  That’s certainly a stark comparison as to what you might experience in the Big Apple!  Everyone made us feel welcomed, not only the project sponsors and key community stakeholders, but everyone; from the building security guard, parking attendants, pedestrians, shop owners, neighbors, Uber car service and many more.  While the project goal felt large and the time frame compressed, with long days spilling into evenings and weekends, the IBM team comradery and community at large, made it doable.

I still look back and say I can’t believe how much we accomplished in such a short time; 32 interviews, 60 person round table, 25 person Design Thinking workshop, 3 Partnership For a Healthy Durham committee meetings and a 7 person co-creation workshop, not to mention our own team meetings and breakouts among ourselves!  It was a fascinating process to take part in, that resulted in a representation of what our sponsor and key community stakeholders told us they needed.  The mantra, “If It’s With Us, About Us then It’s For Us”, was our guiding principle in our design efforts.  The result was a recommended framework that would activate the strengths of a coordinated and connected community through the implementation and adoption of a new platform.  The platform takes advantage of the robust tools and systems that exist today which house clinical, claims, social determinants, public and other data sources in a manner that is secure, aggregated and governed.  Fundamentally the platform provides a shared resource catalogue, communications channel and set of tools that together, empowers Duke Health and Durham community stakeholders to take the right set of actions aimed at improving health outcomes.

The day of the final presentation was as energetic as day one.  I’ll admit, you can’t help but wonder, will they like our recommendation?  Will they believe in it?  Will they adopt it?  Now, looking back two weeks post project, and reflecting on that last day, the enthusiasm, the commitments, the feedback and subsequent press releases, I can honestly say, together, IBM, Duke Health and all members within the community, made this happen.  Certainly moving the needle on health outcomes or reducing health inequity will not happen by the flick of a switch, but it will happen because it’s already happening.  We reaffirmed they can do this, we provided the critical success factors to build on their momentum, we assembled a rational and doable analytics framework and more than that, we activated a community!  What a great day, a great moment and a mark in IBM and Durham history. I am proud to say, I was an integral part of with an esteemed IBM team.  I look forward to staying connected to the project and continuing to offer my support.

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From Dublin to Durham

By Eoin Carroll

I’ve just returned from an IBM Health Corps assignment working with several very dedicated community based organizations and health agencies in Durham, North Carolina on how to help improve community health in the region. The IBM Health Corps is a relatively new IBM Philanthropic Program – a close cousin to the IBM Corporate Services Corps and IBM Smarter Cities Challenge philanthropic programs. The program has a very specific focus on tackling health disparities around the world. It involves sending small teams of IBMers to health organizations around the world for three weeks in order to improve health access, health services, and health outcomes.

I first heard of the new program in mid 2016, and its focus on assisting communities to improve health outcomes very much appealed to me. In particular, I am interested in how health outcomes can be improved through tackling some of the broader health determinants such as social and environmental factors. These are widely acknowledged to be some of the most significant influences on population health. So, I applied to join the program, and was delighted to be offered the opportunity to be part of the team traveling to Durham, where we would work closely with community stakeholders on how to address some of the health challenges experienced by the city’s communities.

Our project sponsor, the Duke Center for Community and Population Health Improvement, asked us to work closely with the community in Durham in order to come up with a framework and roadmap for a Population and Community Health Improvement Information Sharing and Mapping platform. The aim of this platform is to facilitate communication and collaboration between the various organizations and agencies working to improve health outcomes in Durham. Quite a challenge for a three week assignment! But we hit the ground running.

Even before arriving in Durham, we had several calls with both our sponsor and with a few community based organizations – all organized by our energetic Program Manager, Natalie, from IBM Corporate Citizenship. So, we were well appraised on several of the challenges in advance. Members of the team gradually arrived over the course of a cold Friday evening and Saturday morning at the end of January, and, as this was the first time we had met, we started by going on a Saturday afternoon “getting to know you” team walk on a woodland trail near our house. During the walk, one of the team members spotted a large owl flying overhead. It settled high up in a nearby tree, and we all rushed over to see it. It sat quite calmly on a branch, looking down at us – and so it was that the owl, symbol of knowledge and wisdom in Ancient Greek and Roman cultures, became the unofficial mascot for our project. Every time we saw an owl over the next few weeks, we were sure to get a picture!

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The Owl

The next day, we had our first proper look at Durham, when we went on a whistle-stop tour led by Malcolm White of Brown Hat Tours. We saw firsthand the ongoing renewal and renovation of many of the former tobacco warehouses and manufacturing plants in Durham. These very solid buildings are being converted into workspaces, apartments, shopping, and recreational facilities. Malcolm also showed us several great community projects during the course of the tour – including some from organizations that we were to meet later in the assignment. That same evening, we had an early taste of the southern hospitality we were to experience so many times over the following weeks, when we were invited for a wonderful grill at the home of one of the community stakeholders.

The assignment kicked off in earnest on Monday morning, with an introductory workshop to capture initial thoughts, involving over sixty participants. This granted us our first opportunity to meet with some of the key community stakeholders in person – many of whom we were to meet again over the course of the assignment. The following fortnight involved a whirlwind of meetings with over thirty stakeholders from across the community, tours of several amazing community facilities, and two design thinking sessions. The very dedicated – and very busy – people involved in the community organizations and agencies all gave their time generously, and so we started to build a picture on what was working well, where there was room for improvement, and on how a platform could help.

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The IBM Health Corps team outside Lincoln Community Health Center, Durham

In between and after meetings and tours, we brainstormed, discussed, and came up with the scope and plans for the framework. We did this using the principles set out in a team code of conduct which we had put together in the first days of the assignment. Amongst other things, this involved using brainstorming techniques to figure out focus areas, and using a consent-based decision making process to decide on key points.

Concepts for the platform started to crystallize early, and, with help from organizations and agencies in the community, we refined them, and came up with the core strands for the platform. These involved a number of functions to help community based organizations, agencies, and health care providers to find out about each other, communicate with each other, perform cross-cutting analytics, and create holistic, community-based plans to improve health. We stuck with the avian theme in selecting internal names for the various parts of the platform – the wise Owl (analytics) was soon joined by a Finch (finder component) and a Stork (planning component)!

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The IBM Health Corps team meet with Dr. Eugene Washington, Chancellor of Duke Health .

During the latter half of the assignment, we ran the platform concepts past our community stakeholders, and made changes in response to feedback. Finally, we presented our findings and thoughts on next steps at an event in downtown Durham attended by many of the main stakeholders from the community. After our presentation, we ran a short workshop with the attendees to obtain valuable feedback and thoughts on the preferred next steps. There was a very positive response, and several good ideas on where to focus the next steps. There was even some coverage of the event by local media.

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Keynote at closing event by Gina Upchurch of Senior PharmAssist, an organization which promotes healthier living for Durham seniors. View her speech here.

The three week IBM Health Corps assignment in Durham was a wonderful opportunity and a privilege – particular highlights include meeting with so many people dedicated to improving community health, proving that the whole really is greater than the sum of the parts while working with a strong and diverse IBM Health Corps team, and, of course, getting such encouraging feedback on the platform framework and roadmap.

Eoin Carroll is a Lead Software Architect in IBM Watson Health based in Dublin, Ireland – where he works on the architecture of cloud-based products focused on addressing the needs of the Health and Human Services sectors.

 

 

IBM Studios RTP engages with Durham community on population health

By Tricia Garrett, Design Principal and Master Inventor, IBM Design – Research Triangle Park (North Carolina)

Six enthusiastic IBM Health Corps volunteers from around the world embarked on a whirlwind three-week project in Durham last month, working with Duke Health. They were here to lend their technical and health care expertise to envision an enduring population health improvement information sharing and mapping platform.

It is essential to engage a few dozen community health organizations around the shared goal of improving community health outcomes by measuring all types of health determinants over time. IBM Health Corps Program Manager Natalie Dawe and IBM Studios RTP Director Steve Kim saw an opportunity to collaborate.

Aligning community health stakeholders

Health Corps team member and designer Caroline Lu envisioned a Design Thinking workshop to understand things that were working and not working with regard to community health, inviting ideas from stakeholders. Many IBM Studios RTP designers jumped in to help plan and facilitate the workshop when this need became apparent to me.

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Brian Burnette facilitates a Design Thinking workshop for Durham community health stakeholders, along with Clay Braxton, Kristine Berry, Kevin Carr, Sean Farres, Caroline Lu, and Eric Morrow

“To get 25 stakeholders in a room and align around the challenges and opportunities… That alone was incredible,” remarked Jason Gilder, another IBM Health Corps team member. IBM Studios RTP designer Sean Farres blogged about the workshop in “Starting the Conversation.”

Natalie Dawe observed that the workshop activated leaders to “move towards true collaboration.” She was pleased to report that the Steering Committee of the Partnership for a Healthy Durham already had begun to use Design Thinking activities after the Health Corps team’s departure.

Doing our part to keep the momentum going

IBM Studios RTP designers also rallied to provide quick user interface mockups to impart stakeholders with a concrete glimpse of the possible, guided by Caroline and Natalie as the Health Corps team hurried to prepare the final presentation.

Mockups generated excitement, providing a sense of accomplishment, as well as encouraging continued momentum following the three-week engagement.

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An imagined user experience for Jade, a community health worker for patients with diabetes. Jade wants to find organizations that meet her patients’ needs, refer the patients, and understand the patient and organization follow-up.

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Designer and Health Corps team member Caroline Lu describes the role of Design Thinking to around 80 people from Duke Health and the Durham community in a final presentation at the Durham Criminal Justice Resource Center

Being a local and a Duke alum (Masters of Management in Clinical Informatics, 2012), I found it exciting to see the level of enthusiasm and engagement among community stakeholders when I attended the final presentation.

In her blog entry,“If it’s about us, but not with us, it’s not for us,” Caroline describes how her team gained a deep understanding of Durham through an iterative Design Thinking approach. Numerous co-creation activities helped the Health Corps team and participants to envision a future based on community needs.

Per Natalie Dawe, Design Thinking has been invaluable because “our mission as Health Corps is to partner with communities — not impose a solution, and we know we need to really understand the communities we serve so the recommendations we offer are feasible and sustainable.”

The IBM Studios RTP team thanks Natalie, Caroline, and the Health Corps team for the opportunity to make an impact on improving health outcomes in the community where many of us live, work, and play.

A big thanks to the aforementioned IBM Studios RTP Designers and these additional designers who supported our involvement in this project: Jacquie Goyena, Kimberly Holmes, Danielle Kingberg, Sarah Blackmon Lips, and Michael Stokes

“If it’s about us, but not with us, it’s not for us.”

Using Design Thinking to build trust, develop meaningful relationships and respond to unmet needs

By Caroline Lu, Advisory Designer, IBM Design/Watson Customer Engagement

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Selected images from our slideshow we played during our final presentation to 80 members of the Durham community.

Our first steps in Durham began with a city tour followed by a home-cooked Durham style barbeque. (This means that barbeque here is made with pork and vinegar, as opposed to the tomato based sauce in Memphis, opposed to no sauce and beef in Texas.)

Throughout our 3-week project, we embraced the principles of IBM Design Thinking and immersed ourselves in the community with many Design Thinking activities in getting to know Durham.

Our project kick-off with 60 members of the community included breaking out into 6 roundtable discussions. We continued with: 32 interviews with various members of the community ranging from community based organizations like the North Carolina Diaper Bank, Healing With CAARE, Inc., to various sectors of government, city, education, and, health, like the Durham County Department of Public Health. We also conducted interviews with people working on existing tools like United Way’s 211 and Durham Neighborhood Compass.

We boarded a mini-bus for a city tour of Durham by our friends from Brown Hat Tours. We spoke with and observed committee meetings at the Partnership for a Healthy Durham. We conducted site visits at Lincoln Community Health Center, a federally qualified health center. We also met with the East Durham Children’s Initiative and volunteered with kids in packing laundry detergent for distribution. And, we also experienced a basketball game at North Carolina Central University, the nation’s first public liberal arts college founded for African-Americans.

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Marching band playing at North Carolina Central University where the men’s basketball team, The Eagles, beat South Carolina State University 85-62

Design Thinking is a methodology about bringing people together. Design Thinking is about intent. It’s about basing any sort of outcome on human-centered needs. It’s about working together, co-creating and making sure that everybody is at the table. –And literally, we were from the start!

During our first week, we conducted a 25-person Design Thinking workshop with members of the community. Here, we were understanding things that are working and not working when it comes to addressing community and population health. We also asked the community to brainstorm “Big Ideas” that would respond to their needs.

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Members of the community voting on “Big Ideas” that they had each generated

At the end of week 2, we continued using Design Thinking with a 7-person co-creation workshop. During this stage of our project, we had concepts that we wanted to test out with this smaller group of Durham’s finest woman in health & child care management, social work & education.

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Participants co-creating a future state scenario of how a user will experience this new platform and ultimately measure collective impact for a specific health priority.

Design Thinking increases trust

At the beginning of our trip, one community member told us, “If it’s about us, but not with us, it’s not for us.”

Design Thinking helped realize that quote. It helped us work with Durham to truly understand, empathize and respond to each individual and community needs. This process helped us build trust, develop meaningful and relevant outcomes, and foster close relationships.

Design Thinking transforms ways of working

One piece of feedback after our final presentation was about how we inspired a new way of working. We activated leaders to “cut through the red tape and move towards true collaboration” through Design Thinking. We also heard that the Steering Committee at the Partnership for a Healthy Durham already used Design Thinking activities during a meeting last week!

Design Thinking as another mechanism for continuing what they have been doing

As a Designer who has followed this methodology for the past 9 years, it was encouraging and reaffirming to see this process actually work. The thing is, Design Thinking isn’t anything new. People, if given the opportunity to be at the table, will come. In Durham, people have been working together in pockets. There are hundreds of non-profits. Pilots come and go. People move from job to job and gain more and more knowledge in the new initiatives they join. There have been success stories of cross-sector, cross-organization collaboration, as seen in the Project Access. There have been unsuccessful stories to be learned from, too.

The people and community are compassionate, motivated and dedicated to a healthier Durham. They are committed to making a collective impact and fostering a culture of health. They have been doing this for years. Design Thinking has given them another point of view and mechanism to continue doing what they have been doing for years. Design Thinking helped them realize the art of what is possible.

***It would be remiss not to mention the input and support we received from the IBM RTP Design Studio on this project. Our thanks to Steve Kim, Tricia Garrett, Clay Braxton, Brian Burnette, Kristine Berry, Sean Farres (read his blog post), Eric Morrow, and Kevin Carr. From their leadership and facilitation of the design thinking workshop, to their creativity and dedication as they assisted us prepare for our final presentation, we so appreciate their willingness to help our team and the Durham community.

A French point of view: Improving population and community health in Durham

By Christine O’Sullivan, IBM Executive Architect at IBM Client Center Montpellier, Member of IBM Academy of Technology

In January 2017, I had the privilege of becoming a member of IBM Health Corps (an IBM philanthropic program) for a project in Durham, North Carolina, USA. After a very intense 3 weeks’ work, it is time now for personal reflection.

The project’s mission was to work with the Duke Center for Community and Population Health Improvement to develop a framework and plan for establishing a Population Health Improvement Mapping platform. We were to deal with organizational challenges in addition to the technical architecture design, and to encompass a myriad of organizations serving the same objective but sometimes working independently, from large organizations such as the Durham Department of Public Health and Duke University, to smaller community based organizations such as the Diaper Bank or Healing with CAARE.

The mission also focused on measuring the collective impact of different organizations and programs on population health improvement. This requires data sharing and a platform to access, aggregate, and analyze a very large number and types of data sources. We have now delivered our final recommendations to the stakeholders, providing a high-level architecture of the target platform and related required capabilities (catalog, search function, referral, analytics, and a care plan at the population level) and a roadmap to move to the next steps. Even if technology was an important element of the project, the IBM team had to deal very quickly with governance questions and paid special attention to fostering collaboration and trust between the different health and social organizations to make information sharing possible.

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Our IBM Health Corps team meeting with Gayle Harris, MPH, RN, Director for the Durham County Department of Public Health

As a Cloud architect from IBM Montpellier Client Center in France, I had to face 2 big challenges: 1) In a limited amount of time, integrate the principles and needs of the United States health systems 2) Being the only non-native English speaker in a team of 7 persons — 5 of us were from the United States, 1 from Ireland and 1 from France. (Language was especially difficult before the first morning coffee and at the end of a demanding day after holding a series of meetings, interviews, and intense work.) But I was highly motivated by this human centered project and to contribute to the objective of improving population and community health, which I believe is a universal goal.

When the IBM Health Corps Team arrived in Durham, the agenda of the first week was already booked and carefully thought out by the IBM Health Corps program manager in collaboration with the Duke Health team to offer us the opportunity to meet the key organizations. We began our engagement with an assessment of the current situation, a review of ongoing community efforts, programs and needs, meeting and listening to many different organizations’ feedback. Within the first 2 weeks, we met 60 persons during the kickoff meeting and round tables, conducted 35 interviews, held 1 design thinking workshop and 1 co-creation workshop, and participated in 3 committee meetings of the Partnership for a Healthy Durham. With this steady pace and well-chosen conversations, I felt I learned about the health systems in 3 weeks what may have taken several months!

Being immersed in this world showed us the complexity of health. Health is not just physical, it is mental and it is social. Reducing health inequities requires addressing the social determinants of health (housing, nutrition, transportation problems, etc) and identifying the root cause of the issues. Social determinants of health are defined as a priority by Durham leaders and also by the World Health Organization (WHO) regional office for Europe.

The Healthcare system is quite different in France compared to the United States. The provision of health care in France is a national responsibility. The Ministry of Social Affairs, Health is responsible for defining national strategy in addition to allocating budget expenditures among different sectors (hospitals, ambulatory care, mental health, and services for disabled residents).

My French citizen’s perspective and experience helped me to understand the challenges of a non-centralized health system in the U.S. when it comes to information sharing, governance and organization siloes. No system is perfect and in fact, both European and American systems could benefit from an understanding of the other’s strengths. Where the national health systems in Europe may help to conduct a global strategy at the population level, I must say that I truly admire the innovative approaches and the commitment by the different U.S. organizations in Durham to improve population health and tackle the root cause of possible health issue. I met extraordinary, passionate and talented people building a chain of solidarity to serve individual well-being not only for medical & clinical care but also the social determinants of health.

I’m grateful for this unique and challenging opportunity to participate to an IBM Health project and to contribute to this outstanding objective of improving population health. I’m looking forward to hearing about the project’s progress and success!