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Sticks & Stones

Sticks and Stones should not break bones: introducing a new health conversation protocol that gets to the root of bone fractures earlier.

Photo of Aaron Sidorov

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What challenges or opportunities are you trying to address within the problem? (200 characters or less)

Based on our research, people are not talking about Osteoporosis early enough. Currently, it seems to be about "what" happened (eg; a fracture) instead of "how" it happened (eg; just standing there).

Sticks & Stones is a proposal for a new protocol aimed at starting the Osteoporosis conversation earlier, raising the flag after the first fracture, and passing the baton between patient, HCP, and EMT. The old saying, "Sticks and stones may break my bones..." is an iconic example of the natural human instinct to remain physically tough through adversity. However, such tiny things should not break one's bones. Ideally, our new protocol would help start, facilitate, and continue the conversation around fragile bones. Our research (5 patient interviews and 3 EMT interviews) shows that patients tend to experience their first fracture due to fragile bones before even getting a clinical diagnosis of Osteoporosis. Of the 5 patients we interviewed, 4 were diagnosed with Osteopenia and 3 had deep family history of Osteoporosis. The patients we spoke with detailed the clinical conversation void that happens after their first fracture. According to a few of those patients, the current protocol is to treat with a "fix and move on" mentality rather than as a patient who may be showing signs of Osteoporosis. Our idea with Sticks & Stones is to create in-office conversation starters, a patient iD bracelet, and a fragile bones training pamphlet and microsite. These would target the main points along the patient journey where the conversation begins, continues, and picks up again at critical junctures. 

Who is your target end user and why will they be interested? (650 characters or less)

Target end user 1: People living with fragile bones who have experienced their first fracture (may or may not yet be diagnosed with Osteoporosis). Target end user 2: HCPs who treat, scan, and hold regular annual conversations with those patients. Target end user 3: EMTs and hospital staff who engage with patients after that first fracture. Our team held 8 total interviews with 5 patients and 3 EMTs. We were floored by the consistency of the theme that no one is talking about Osteoporosis soon enough. One patient spoke about being 62 years old with a deep family history of Osteoporosis. She herself was not yet clinically diagnosed, but had Osteopenia and semi-regular DEXA scans. She described how she broke her hip "while just standing there." The EMTs treated her to fix the break. Her physician treated it as an accident. She ultimately shrugged it off and moved on. It took one more fracture to diagnose Osteoporosis. Our project aims to facilitate that fragility conversation earlier.

How is your idea scaleable? (650 characters or less)

After conducting our interviews, we reexamined the brief and realized that our idea could scale by addressing a broader population if we look outside the typical clinical subset of fractures "due to osteoporosis." The nuance here is that we found that the patients we spoke with had fractures due to older age and fragile bones, but had not yet been clinically diagnosed at the time of their first surprise fracture. Thus, we imagine piloting the main arm of this idea with a focus on women 60 years and older and their primary care physicians. The secondary component would focus more broadly on EMT training. The idea involves in-office print collateral which we would hope to have funded by a grant for the pilot program in a few key cities. The second part of the project, the medical iD bracelets, would ideally be covered by networks or industry (pharma and non-profit) sponsors on behalf of their patients who have had a first fracture. The third part is a microsite for EMT education.

What do/will you measure to know if your solution worked? (500 characters or less)

1. Posters downloaded/displayed in HCP offices 2. "Sticks & Stones" bracelets ordered for fragile bones patients 3. Relevant microsite traffic and EMT training courses adopting the training

What is the current stage of development of your idea?

  • Prototype: We have done some small tests or experiments with prospective users to continue developing the idea.

If you were to become a Top Idea, would you want to actively participate in piloting your idea?

  • I want my idea piloted, and I prefer to do my own piloting in collaboration with the health system and with assistance from the Challenge partner

Company / Organization Name, if applicable (140 characters or less)

The Bloc

Website (if applicable)

https://www.thebloc.com/

Tell us about yourself or your team (500 characters or less)

About our team: We are creative designers with a passion for health solutions. We believe that, sometimes, a conversation can be the biggest innovation, especially when patient recovery is on the line. About us: Aaron Sidorov is an award-winning Creative Director at The Bloc, an independent health creative agency. He is passionate about collaborating to build simple concepts that touch lives. Audrey Palmer is a senior at Washington University in St. Louis and a former summer apprentice with The Bloc. Audrey is a designer who believes that research and user input can help make the world healthier and simpler.

Location (50 characters)

New York City & St. Louis, United States

What is your legal / organizational structure?

  • We are individuals
  • We are a Private Sector Corporation

Innovator/Organizational Characteristics

  • Female-led organization
  • International/global organization (implementing in multiple countries)

How did you hear about the Challenge?

  • OpenIDEO announcement email
  • OpenIDEO social media
  • Direct email invitation
  • Someone in my network (word of mouth)

Why are you participating in this Challenge?

Collaboration drives change. We enjoy the open, free, and collaborative nature of the OpenIdeo briefs that focus on critically impactful work for the greater human good.

How does your idea help more people who have had a first fracture either 1) discover they have osteoporosis or 2) access/navigate care?

1) Discover: Sticks & Stones helps patients and their physicians have an open conversation about the root cause of a surprising fracture and the possibility that it may be due to Osteoporosis or at least due to fragile bones that may one day become Osteoporosis. The in-office conversation starter posters help facilitate dialogue. 2) Access/navigate care: After the initial post-fracture conversation, physicians will recommend the medical iD bracelet. This will allow patients to reclaim a voice in their treatment journey and will serve as a simple visual reminder for them, their loved ones, and any first responders who may come to their assistance for a future fracture. This helps patients navigate daily decisions in bone health and make choices for themselves while also giving the medical community a quick and easy way to know their bone health history. The EMT training microsite will help teach the next generation of first responders as they help more elderly patients with fractures.

How is your idea new in the world or how does it build on existing interventions?

The concept, Sticks & Stones, is new for Osteoporosis intervention and should serve as a broad yet simple platform that can pilot in a targeted manner and expand based on learnings from the pilot launch. There are a couple relevant health projects that I would name as inspirational references for how our idea could unfold in the real world. Some relevant inspiration outside Osteoporosis: 1. https://www.vetvance.com/ — This website is a good example of an educational portal for a healthcare audience. 2. https://www.blinktospeak.com/ — This project is a great at creating a new language, making it accessible and downloadable, and turning a complex situation into a simple modern solution.

Please upload your journey map. Be sure your journey map shows when your user is introduced to the idea and when/how they access it, and illustrates which moments in the Challenge Journey Map your journey map touches.

The patient journey has a deep void where patients end up after their first fracture. At that time, patients seem not to know what really caused their bones to fracture so easily. Doctors seem focused on helping their patient's reduce the pain and heal faster. This is the moment where our idea interjects the patient journey. For EMTs, their journey becomes cluttered with various micro-journeys very quickly. We want to educate and empower EMTs as early as their training courses with a simple URL.

Who did you test your idea with, what did you learn, and how did you evolve your concept?

We tested our theories first and foremost in an open interview series with 8 participants. We interviewed 5 patients and 3 EMTs to gather insight around the broad topic of Osteoporosis, fragile bones, and what types of communication currently exist in practice. These interviews helped reshape our idea prototypes as they rendered part of our original concept (Virtual Reality Training) useless for this initial pilot. The interviews also helped focus our attention to some quick, simple, solutions to a problem we hadn't previously uncovered: connecting the communication gap in bone health. We shared our ideas with our coach, Chris, and shared them back with 1 of the patients and 1 of the EMTs to gather some quick feedback. We were never originally planning for this idea to be so focused on the "conversation," but our interviews really proved to us that Sticks & Stones was the right theme but needed to be re-framed to start, bridge, and continue the conversation about fragile bones. Based on this research, we revised the proposal to include some pilot programs with in-office print to help facilitate the post-fracture physician-patient conversation, a medical bracelet to help bridge the conversation with the EMT and hospital without even needing to speak, and an EMT-focused training website to help educate the future generations of first responders on what to look for with elderly patient fractures.

(Optional) Share documentation of your solution prototyping and testing, such as photos.

Please upload your Business Model Canvas

Please upload your team video.

Attachments (1)

sticks&stones.pptx

Please see our attached presentation deck. This includes some of our early research interviews as audio files. More interviews would be needed in the future.

15 comments

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Photo of Susan Jackewicz
Team

Hi @Aaron Sidorov Thanks for posting your idea solution to the Challenge! The "Sticks and Stones" is a phrase/image everyone can relate to, and the mix of high tech VR for imagining scenarios and low-tech, easy support would have something for everyone. Your outreach plan to include EMT training covers a patient touchpoint few think about. I used to live in a city with over 30% of the population 65+. EMT's were trained to recognize dementia - it had a bigger impact than most would have predicted. So it's a good point to develop useful training for fractures with an awareness of such a common cause as osteoporosis. Keep developing the idea!
Best,
Susan
OpenIDEO Innovation Coach

Photo of Aaron Sidorov
Team

Thanks, @SusanJackewicz! Will certainly keep developing the idea. Would love to hear more about the EMTs with training to recognize dementia and any insight you may have from that training and the impact it had.

Photo of Susan Jackewicz
Team

Hi Aaron Sidorov 
The training you asked about was developed by Teepa Snow, an occupational therapist who went on to develop training programs for people to learn how to interact with behaviors exhibited by people with different forms of dementia. You can read about the training program with first responders I mentioned here:
https://www.jems.com/articles/2012/03/dementia-expert-gives-tips-first-respond.html

In the state of Florida, there is a legal ruling called The Baker Act - which allows first responders to have anyone committed to a psyche ward if its clear they could be a harm to themselves or to someone else. It was being used frequently to control inflammatory situations involving people with dementias - who were functioning from a place of "a sick brain". Teepa's trainings enabled first responders to check and redirect behaviors, with an impact of lessening hospital admissions using this ruling.
So I feel the lesson for your idea would be to keep drilling down to the patient's needs, to understand and be empathetic to their experience in the touchpoints with the healthcare system, and identify where and how behavior might be changed to help prevent future fractures. I hope that helps!
Best,
Susan

Photo of Aaron Sidorov
Team

Thanks @SusanJackewicz! Great suggestion to keep drilling down to the personalized specific experiences.

Photo of Chris Cochella
Team

Hey Susan Jackewicz , Thank you for the shoutout. You should know that we referenced your input several times in the refinement stage. The value of perspective comes from many angles and directions. Thank you for your input. Cheers. Chris

Photo of Susan Jackewicz
Team

Hey Chris Cochella  - re: perspective....this OpenIDEO practice of many Viewpoints from the Edges making for better ideas seems to work!! Your viewpoints, included:-)!! Cheers back at you....Susan

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