Investor Relations
Obtaining informed consent is a non-negotiable requirement for clinicians. You founded MEDORG Ltd. on the premise to drastically improve this inevitable interaction between patients and medical professionals. What were your concerns with the status quo, both from a medical and legal point of view which motivated you to encounter this problem?
Rémy Liechti: First and foremost the administrative workload and performance pressure on healthcare providers has constantly increased over the past decades. Especially in the field of surgery, doctors often must balance the demanding clinical routine with elective and emergency procedures, caring for in- and outpatients, and provide meticulous documentation amidst a constantly growing number of patients. Given the increasing cost pressure and personnel reductions within the healthcare system, time is of the essence.
Under these conditions, the time needed by physicians to accurately attend to patient-needs is most likely to be consumed by the administration overhead. Consequently, the doctor-patient relationship is impaired. Believe it or not: The crucial patient information process is often conducted poorly, featuring barely decipherable scribbles, sometimes even illustrated on whatever surface and with whatever writing-utensil a doctor can find, which in today’s day and age, seems inapropriate. Accomplished surgeons rarely have artistic skills and are seldomly well-trained in either empathy-based communication, or in realizing the legal significance relevance a patient’s consent constitutes for the doctor-patient relationship.
This lack of professionalism eventually results in a vicious cycle, ultimately leading to compromised trust between the patient and the treating physician, involving but legal exposure. Especially invasive treatments are inherently associated with potentially hazardous complications. In these moments, the absence of trust in the doctor-patient relationship can have devastating personal, socio-economic, and legal consequences for both the patient, the physician, and the organization the doctors are aligned with.
Jonas Fischer: I couldn’t agree more: Finding a surgeon who is not only highly qualified as a medical professional, but at the same commands outstanding artistic talent, and above-average empathy as well as commitment, when dealing with all sorts of people (some might additionally suffer from a mental condition or are intoxicated) is unbelievably rare, and practically impossible to fix for any present educational system, even on the long run.
Thus, patients are forced to trust their doctors blindly and consent to a procedure the implications an average person can barely visualize and therefore understand. This renders the patient-doctor-relationship particularly delicate from a legal perspective, because we are implicitly asking human beings to approve highly invasive and potentially precarious interventions without actually understanding the full extent of the procedure, let alone imagine it anatomically. This predicament is further exacerbated by the fact that we are talking about a highly unlevel playing field: Todays interfaces discriminate through barriers of language, age, nationality, and individual cognitive capabilities inflicting additional discrimination on the most vulnerable patients. Last but not least, the current modus operandi exposes surgeons and clinics to additional pitfalls of legal liability.
How does the MEDORG Consent Protocol remedy these multilayered deficiencies?
JF: For once, it completely eradicates the lack of artistic talent found in an overwhelming majority of medical professionals by providing standardized and state-of-the art illustrations drawn by an active clinician –– which already provides a much stronger fundament on which any doctor-patient-interaction could presently be initiated:
For instance, a comprehensive illustration on a tablet covering every relevant anatomical layer of the human hand provides a much better visual initiation of a patient’s mental-model than a 30 second scribble on the back of a medical record or another arbitrary piece of paper:
The patient is actively encouraged to ask questions, form an opinion. The doctor can then effortlessly swipe back and forth between the layers of the illustration. Our minimalistic design provides comprehensive additional simulations if requested, which greatly improves the understanding of both the medical emergency itself, and its procedure. Through shared visual interfaceing, the quality of the legal agreement informed consent is standing on becomes manifest.
Furthermore, the visual character of our consent protocol can heavily reduce barriers imposed by text-based interfacing, or medical terminology. The calm and precise vector-graphics improve inclusivity in patient education by providing an easier, visual access to particularly vulnerable patients like the elderly or, people unfamiliar with the respective language.
RL: In my opinion, there is no better moment to break this downward spiral than by improving patient education now. This is the irrepeatable instant, when patients are informed about their condition, the planned treatment or procedure, and its risks and consequences. It is at this precise moment, where the patients’ trust is either gained or lost.
Therefore, it is in the best interest of both of all the stakeholders to use an easily accessible and visually self-evident interface guiding patients towards an informed decision: Last but not least, surgeons become able to truly show the patient what the procedure will actually involve – and which layer – be it bones, joints, ligaments, tendons, arteries, nerves or skin– might be affected by this intervention: They can show patients what their current medical issue is, and how it will be fixed.
But most importantly, the consent protocol gives us the freedom to present various alternatives to the patient, therefore introducing an element of actual choice instead of quickly sketching layers on top of one-another, which they can barely process during the little time we are allowed to actively educate them.
In this day and age, I feel the healthcare community should be obligated to at least be equipped to compete with state-of-the-art interfaces used in other fields of expertise like banking or legal work. It’s a question of professional courtesy.
Do you see any limitations as to the applicability of your product? Aren’t healthcare systems around the world built very differently from one another?
RL: They are indeed, but not with regard to the requirement of informed consent. And more importantly: The human anatomy isn’t different, which I find a particularly persuasive feature of our protocol: A hand is a hand, no matter whether the fracture ought to be operated on in Zurich, Nairobi, Rhode Island, or Beijing: Humans around the globe all share the same anatomy, which will also presumably stay the same for centuries to come.
In contrast to the status quo, where patients must hope to get hold of a surgeon blessed with some basic artistic talent and great communications skills, this interface takes away a large proportion of stress factors linked with patient education under time pressure. And: The complexity of surgical procedures increases with advancing innovation.
Concurrently, the difficulty of explaining the planned procedure comprehensibly to the patient also increases. In today’s practice, informed consent forms are often filled with legal texts, and graphical sketches of the planned procedure are rare or insufficient. Because surgery involves interventions on anatomical structures of the human body, I believe that graphical illustration of the anatomical layer of interest and the individual pathologies and treatment options is the winning method. Only with a good visual image can patients have an understanding of a planned procedure.
JF: Also, one should keep in mind that conflicts resulting from insufficient, vague or flat-out lack of information are not only exposing the responsible surgeon or clinic to potentially devastating legal repercussions and liability issues, but are undermining the very essence of what characterizes a healthy and stable patient-doctor-relationship: Trust.
RL: We are confident to having designed an elegant and sustainable interface to tackle the worst downsides of current patient education routine and establish a new standard in the world of informed consent. And most of all, the fact we as doctors can finally focus on explaining medical procedures to our patients in a clear and simple design instead of being stressed and inhibited by the restraints of current communication, is a great improvement.
What about the increasing relevance of AI? Will smart technology not be able to outperform your current solution in the near future?
RL: Anything is possible. But for the foreseeable future, this is highly unlikely, since such an algorithm would have to not only match, but rather outperform a human surgeon on several levels at once: Medical excellence, professional experience, anatomical accuracy, artistic talent, and most of all, interpersonal communication skills.
While hand-surgery in particular might profit from AI-assisted systems in the future, it is my belief as a clinician that the doctor-patient-relationship is both inimitable and an important cornerstone for the success of medical treatments, during all stages of the surgery. Patients confiding in the expertise and integrity of their doctors not only confront an impending procedure with more confidence but are more likely to anticipate possible risks and downsides of a medical treatment, precisely because they were transparently informed about it beforehand. A healthy and trustworthy relationship is inevitably linked to the prevention and management of conflicts within the realm of healthcare and the legal implications associated with it. An AI can certainly improve the level of information.
As a surgeon, I believe that an informed consent software based on the principle of “by surgeons for surgeons” represents the future. There is ample literature in international medical journals clearly indicating the inadequacy of patient education in most hospitals operating in countries with top-level healthcare. It is all the more surprising to me, that there has not already been more attention to this.
How does the MEDORG Consent Protocol meet the demands of current UX/UI design?
JF: We are monitoring future requirements in UX/UI design very closely and have designed the Consent Protocol accordingly: The next generation of UX/UI Design in healthcare shows multiple clear indications as whereto the market is headed: To start with, healthcare products prioritize mobile-optimized interfaces as well as responsive designs which ensure accessibility and focus on user-friendliness.
Furthermore, inclusive design principles are becoming the standard to accommodate users and fostering equal opportunities for the latter. Since patient education aimed at informed consent is an interactive endeavor, our interface must be catering to both user-needs of the patient, and the needs and interests of the doctor.
The design has to be simultaneously accurate from a medical point of view, yet simple enough for a layperson to understand, which we achieve through respecting another principle: Minimalistic design puts an emphasis on simplicity, clarity, and ease of use. It is crucial to design interfaces which are not only easy to navigate, but also facilitate a mental model of the patient’s own anatomy.
RL: Last but not least, any flashy or exuberant design or feature would be a hinderance in the daily routine of a doctor: We need to inform patients as quickly and as simply as possible. Anything else would be missing the mark.