Visualizing

Our virtual human body looks and acts like an incredible video game.

Members of the Humaginarium tribe are called customers, consumers, patients, users, gamers, players, learners, and (my favorite) eyeballs. Each of the monikers emphasizes a different role. The special role performed by eyeballs is to view.

So what engages eyeballs in Humaginarium? The answer isn’t obvious. After all Humaginarium is scientific entertainment that’s not been done before at scale; has never been done for a mass market of regular folks. Members of our tribe will surely be astonished and amazed by what we show them. Will they like the show and keep coming back for more?

To increase the chances we invented an intriguing visual style in the confluence of medical and fantastical illustration. One depicts a natural, objective world of the senses. The other imagines a make-believe, subjective world of the mind.

Our medical illustration is state-of-the-art CGI of human anatomy (structure), physiology (function), and pathology (abnormality). This kind of digital visualization involves dimensional, colorful, high-resolution, high-fidelity, animated pictures. It looks sophisticated and technical, but the roots of medical illustration trace all the way back to pharaonic Egypt. It informed Classical and Renaissance science and art and continued to evolve in the centuries that followed. Modern medical illustration that leverages technology began with Spanish neuroscientist Santiago Ramón y Cajal and blossomed in American surgeon Frank Netter‘s Atlas of Human Anatomy. These artist-doctors rendered Homo sapiens in elegant and precise drawings that were (and still are) used by clinicians and educators.

New medical CGI renders Homo sapiens as discrete atoms, and complete organisms, and at every scale in between including molecular and cellular. Want to zoom a chromosome? No problem, have a look. Want to strum an auditory ossicle? Right this way, point the light. Our medical CGI prompts folks to view and manipulate every ingredient of a virtual human body without ever cutting into a real one.

This kind of visualizing is naturalistic, but is it realistic? My answer is no, because a realistic picture of anatomy, physiology, and pathology is extremely hard to parse and comprehend; and therefore not as useful. State-of-the-art medical CGI is very useful because it idealizes subject matter. The rendered biology appears true to nature, yet easy to see and experience; moreover it’s beautiful, no less than great works of art and architecture. To encounter awesome new medical illustration is to gaze in wonderment.

The beauty of medical CGI serves as a docking station for fantastical CGI. It allows actual organic matter to dovetail with absurd and ridiculous inventions; together they generate nothing short of visual magic. People have always experienced this kind of magic without thinking much about it. For example as children with a wishbone after dinner, a ringlet of hair in a locket, and a baby tooth under a pillow. In these everyday examples and in Humaginarium, the real body acts like a wardrobe that opens into Narnia.

What does our scientific Narnia look like? Well, there’s a substratum of idealized anatomy, physiology, and pathology; that’s the natural world of Homo sapiens. Pure figments of our imagination populate that world: things like gardens with unmarked paths, caves with cryptic messages etched on the walls, opalescent pools that ripple when they speak, supernatural humanoids and beasts, horrifying monsters, criminals intent on gambling momentary gratification for a lifetime of pain, immanent spirits, enchanting songs. Our fantastical CGI is overlaid on the natural kind and littered with tangible clues like those that Jules Verne created for his adventurers.

Much of the spectacle in Humaginarium throbs with attitude and nervous energy. Members of our tribe don’t stroll through an art gallery but work hard to find their ways through a maze of chronic illness, in an enchained world that yearns to be free. That’s why our virtual human body looks and acts like an incredible video game. It doesn’t invite eyeballs to observe and learn. Instead it challenges them to survive and prosper despite the odds. That is why they like the show and keep coming back for more

Learning

The most desperate problems emerging from chronic illness have a surname: Vulnerability.

Humaginarium is entertainment for consumers who have, risk, or wonder about chronic illness. Participation is voluntary. Nobody is forced or cajoled to join. Like a carnival barker, the only promise we make is fun. It’s important to say this because unlike presenters of classic health education, Humaginarium must offer art that regular folks like and want for its own sake, whether or not it solves their problems.

Thanks to art, Humaginarium probably has more in common with medicine than bland health education does. Truly? Well yes, because medicine historically is a mixture of art and science, with art doing the lion’s share of the job until the mid 20th century. Even today in the technical vanguard of biomedicine, art is a critical component of what matters to most people: healing and wellness. When medical arts are eclipsed by instrumentation and data, health care can begin to seem manipulative and futile, if not ridiculous, to the folks it serves.

Humaginarium likewise is a mixture of art and science. Though we don’t boast about solving problems, that’s actually why we exist. Real-life problems; often unacknowledged, misunderstood, denied, hidden, scorned, or ignored by the kinds of folks who buy video games for escapist fantasy rather than useful information. As they enjoy the experiences we prepare for them, their health issues are pulled through an aesthetic ringer I call catharsis. That’s pretty much the same ringer that doctors and shamans have used for millennia and still use today.

In my view all the most desperate problems caused by chronic illness have a surname: Vulnerability. By that I mean weak defenses against illness and the clueless pursuit of wellness. Vulnerable consumers don’t make themselves better; they let things get worse. They don’t relish the esoteric complexity of the body; they’re obsessed with appearances. They don’t ask hard questions they can’t begin to answer; they delegate that to experts who know everything. Experience eventually shows how little medical experts actually know and how risky and inefficient such delegation can be.

As a problem solver, Humaginarium is not paternalistic. It doesn’t tell consumers what to think or do beyond one simple command: win the game. That’s their mandate. Thing is, they have to figure out how to win. On their own. They can share ideas and experience with peers, but they can’t delegate.

Instead players build their own knowledge and make their own choices in their own self-interest; and health literacy emerges. This learning style is called constructionism. You’ll find it in healthcare simulations for medical students and physicians, but you won’t find it in health education for patients who need it just as much. Why? That doesn’t matter. It’s about to change.

Consumers initially come to Humaginarium not for information or simulation or education of any kind, but to be amused. To enjoy a virtual experience of the human body in its battle with unfair, unfeeling, out-of-control destiny. As in all their favorite video games, players must develop new competencies to win. But this time their gains deliver more than make-believe victories.

Capabilities learned in Humaginarium are wholly transferable. A fight for health in our fantasy prepares people for a similar fight in real life where, maybe for the first time, they’ll deeply understand and strive to control existential threats like diabetes, cancer, or heart disease. We want them to bring better defenses against illness and longings for wellness to the battle. Ones that fit their own circumstances more or less perfectly.

When that happens, Humaginarium may perform like a magical healing art of the 21st Century.

Unit

The unit isn’t complicated; it’s just unprecedented and seems hard.

We’re starting to research and build a commercialization model. The job is described in a link on our new website. Select the Resources menu in the upper right corner of any page, then pick Commercialization. A 24-step method opens in a new window. It’s a little challenging to execute, so your suggestions will be very welcome indeed.

The job is supported by an experiential learning cohort at the Northern Illinois University College of Business. Humaginarium is blessed to have these smart, ambitious and personable consultants at its side.

The first hurdle we face is our unit. For those who haven’t plumbed the depths of financial analysis, a unit is an average instance of what we make and sell. We define a unit in order to estimate its economic value over time at scale. A logical, evidence-based estimate is a prerequisite for engaging investors in 2019.

So what is our unit? It’s a “bundle” of products and services that fulfills a singular purpose for consumers. That purpose is also known as our brand promise and value proposition. Our unit has four integrated components:

  • Platform
  • Game
  • Diagnostic
  • Community

Our platform tempts customers with trailers and mini-games. It frames chronic illness as the non-intuitive subject of entertainment. It offers a menu of full-scale games that are now available or coming soon. It highlights post-game components of diagnostic and community. The call to action is an invitation to create a free account. Only account owners have access to other functional components of the unit.

A game is an immersive, interactive science fiction fantasy. On desktop or mobile screens, players contest with morbidity encroaching on the human body and spirit. They search out this enemy in order to interrogate, contain, or destroy it. Meantime the enemy sets traps to foil or vanquish players. Game mechanics are mediated by a dynamic, high-fidelity simulation of human physiology. This is real biology projected into fantasy. Players have to outsmart an ingenious enemy, the product of eons of evolution, in order to win. The emphasis on cognitive skills makes this experience a puzzling strategy adventure.

Customers keep playing a game until they achieve a satisfactory goal; or switch to a different game; or choose to leave the magic ring of fantasy and cross into real life. Just outside the ring is a diagnostic that processes personal data relevant to a disease faced in the game. The diagnostic identifies risk factors. It lets customers mitigate personal risks with lifestyle and medicinal choices. It also models purported outcomes of their choices until they’re ready to cement them in resolutions. Modeling is therapeutic in that it helps customers make informed choices in light of their own self-interest.

After a diagnostic customers can join a safe social network (moderated and closed) where they assemble or join communities of interest centered on chronic illness, or game play, or objective health science; or anything else they deem useful or meaningful. Like Quora, the purpose of community is peer-to-peer learning. What’s learned in a game is applied in a diagnostic and reinforced in a community. Community is a controlled environment for meaningful self-disclosure.

All customer experience of a unit is elective. Customers may use some components and ignore others though full value comes from using all of them.

Having said all of this I now wonder, is the unit too complicated? Using the methodology in our outline, I try to answer the question with analogies. Is our unit as complicated as the computer on my desk or phone in my pocket? No, far less complicated than that. Is it as complicated as surgery or marriage? Not even close. Is it as complicated as a building by Frank Lloyd Wright, a combine by Robert Rauschenberg, or a concerto by Philip Glass? Of course not. Is it as complicated as the novels of JRR Tolkien or video games of Sid Meier? Give me a break.

The unit isn’t complicated; it’s just unprecedented and therefore seems hard. The method we use to model commercialization may demonstrate that our components are really not unprecedented, but the bundling is.

Scientific entertainment. Variation on The Wave, by William-Adolphe Bouguereau

Resolution

Every neuron plays a role in destiny, and individuals who get that will keep their resolutions.

Humaginarium modulates playing and learning so transparently that consumers don’t know or care which experience they’re having in the moment. They care only about winning and they know when they reach the pinnacle. What happens next?

That’s a choice. Some consumers play again at higher levels of difficulty and challenge, or with different people. Others change course for a completely separate challenge and experience. Still others exit the entertainment and make use of what they learned in real life. How does that happen?

It starts with self-assessment of health and lifestyle risks typical of illness battled in a just-played game. By completing an intelligent questionnaire, individuals enable our back end system to identify vulnerabilities and threats in their environment, medical history, and genetic phenotype. The assessment produces a kind of living quest map with critical branches.

The next step is to design a choice architecture based on a personal quest map. The architecture computes formative and summative impacts of choices on an adjustable timeline. Shorter and longer term outcomes are modeled by altering choices. It’s plain to see that no quest map produces immortality and freedom from pain, but at the same time regular folks can discover far more control over symptoms and outcomes than they ever thought possible.

The penultimate step is to make a resolution. Fiddling with choice architecture heightens self-awareness and the sense of personal responsibility for illness and wellness. Resolution cements hard and easy choices into a promise, like the New Year’s resolution we make and break year after year. What’s different about this?

The fantasy novelist Ursula K. Le Guin has an answer. She writes that “need alone is not enough to set power free: there must be knowledge.” In other words, one’s need to lead a longer, healthier life is inconsequential unless it is based on understanding, the deeper the better. In matters of illness and wellness, that’s understanding of one’s body. Not just what it looks like and how it feels, but how it works and grows; how it avoids and overcomes adversity; how it decays and fails. Precisely the things that are observed and learned while playing for hours and hours in Humaginarium.

Knowledge rather than yearning positions resolution for success. Along with knowledge comes sentiment such as courage, resilience, curiosity, conation. Every neuron plays a role in one’s destiny, and individuals who understand that are more likely to keep a resolution.

The logic here is tight yet incomplete. It still leaves people vulnerable to a threat that dates back to Ancient Greece and is more common than ever in a depressed and depressing world. It’s the Sisyphean Condition.

People who confront and master a chronic illness in Humaginarium are not cured. People who self-assess, design a choice architecture, and make a brave resolution continue to struggle, rolling their own immense boulder to the top of a hill where it inevitably rolls down another side. Does that make them futile? No. Foolish? I don’t think so because now they understand their struggle; they know where their controls are; and in the spirit of Albert Camus, they have captured meaning and purpose in a world that can seem, to people with a chronic illness, utterly cruel and indifferent.

The final step after resolution is community building. Individuals who have played, learned, assessed, designed, and resolved are still pretty much on their own. We can’t leave them there and expect the best outcomes. Instead we invite them to join self-assembling communities of interest on our social network where personal decision-making continues with those who care deeply about each other. Which is just about everybody who has or treats a chronic illness.

Website

A new website for investors, sponsors, advisors, business partners, and employees.

One of my 16 milestones for 2019 is an overhaul of the Humaginarium website. This will be version 3 since getting the startup off the ground. Versions 1 and 2 retailed abstractions like vision and mission; stuff that feels good but doesn’t yield much traction. Version 3 has a higher calling. It’s about products and services. What we make and sell. What consumers buy and use.

Version 3 is streamlined. It tells a simple story in big scrolling pages that answer a few basic questions:

  • What is a “Humaginarium”?
  • How does it work?
  • Who’s it for?
  • What does it cost?

A Humaginarium in this context is not an idea but a thing. I’m focused now on how our pioneering product will be made; the experience it will create; why thousands or millions of consumers may love their Humaginarium and a few may decide to pay for it; and how much value a Humaginarium is likely to have for those who build or use or share it. We’re rigging a simple version 3 story along these lines in our online shop window and will invite passersby to come in for a closer look.

A few who are intrigued may enter; when they do version 3 will be ready for them. It offers nine substantial and practical resources for potential investors, sponsors, advisors, business partners, and employees. The resources are:

  • Business Model
  • Commercialization
  • Marketing
  • Finance
  • Fundraising
  • Elevator Pitch
  • Links
  • Paper Prototype
  • Evidence

My web design challenge – familiar to every startup doing innovative things – is to describe product and market in concrete terms without saying too much or too little. Saying too much too soon may eventually force the company to abandon choices that don’t hold up over time; to stop work that isn’t well thought out and shouldn’t be continued for technical or financial reasons. The agile term for that is “pivot,” but it feels a bit like “drift.” Fine for others, but I prefer to think carefully before acting, do what I said I would do, and stay the course come hell or high water. Hence my 16 milestones and the version 3 website.

Saying too little is also a problem but for different reasons. It betrays a lack of courage, one of the qualities we’re set to kindle in consumers with a chronic illness. And saying too little lacks excitement. I believe a startup that isn’t risking a moonshot is just another small business. So I have to say enough to ignite passion without making stuff up that I suspect isn’t true. That puts the challenge somewhere between Mark Zuckerberg (fabulist) and Elon Musk (dreamer) on the path of Steve Jobs (Zenist).

I’m designing the raw materials of humginarium.com version 3 and liking how it’s coming along. Technical wizard Dave Walker will take my bricks and mortar and craft a shop with a crystal clear window facing the world. We can’t wait to hang the OPEN sign.

Money

The mechanism for empowerment is not rocket science. It’s health science.

The annual spend on health care is well over three trillion dollars in the United States; far more than in any other country. How much is three trillion? Three thousand billion. 20% of gross domestic product. Every year. Merriam-Webster defines trillion as “an indeterminately large number.” It’s imponderable. And the spend on health care is increasing.

But precisely who spends all that money? Is it the United States? Not exactly. Regular folks known as taxpayers and adult consumers actually foot the bill. The US government merely regulates the market.

Normally when regular folks decide to spend even a little money, it’s for something they want. To solve a problem or satisfy a need. Is that why Americans spend so much on health care? You’d think so, but I wonder. The United States ranks eleventh of industrialized nations on aggregated measures of quality, efficacy, accessibility, efficiency, value, and equity of health care. We stand out only for extravagant cost. Does that sound like solving problems or satisfying needs?

The answer depends on who? As in, whose problems are solved and whose needs are satisfied. There are mainly four kinds of who in health care: providers, suppliers, payers, and patients. Three solve their problems and satisfy their needs by absorbing hefty shares of that trillion dollar spend. One doesn’t. Guess which one doesn’t.

The answer is patients. Patients, aka taxpayers, aka consumers, aka regular folks don’t charge for their health care. They pay for it. Actually they pay out the wazoo for treatment that on the whole is relatively poor. Why? Possibly because in care settings regular folks are helpless, ignorant, vulnerable, afraid, and malleable. People who fit that description are easy to control. They pay the money not to solve problems and satisfy needs, but because they don’t have much of a choice. Most don’t even know how to choose. Everything is so complicated! They can’t manage their spend though they underwrite the entire industry. Geez is right!

Enter Humaginarium. Why? To lower the cost of health care? No. To increase the quality, efficacy, and value of health care. No, no, and no again. To empower folks who maybe can do those things? Yes, indeed yes.

The mechanism for empowerment is not rocket science. It’s health science, a branch of knowledge that helps folks understand and make good choices, thus becoming good stewards of their bodies and not just bill payers. You will not find a provider, a supplier, or a payer in the health care industry who empowers patients with that knowledge, because it’s not their job. That’s not what they’re paid for.

Then whose job is it? Regular folks, of course. And an unprecedented, astonishing new program of job training for them is called Humaginarium. It’s in the pipeline! So consumers, now hear this:

  • You can understand things like physiology and pathology.
  • You can enjoy learning how your body deals with chronic illness.
  • You can make good medical and lifestyle choices.
  • You can be brave, curious, well-informed, and strong.

That’s your job. Humaginarium is like the eagles. Don’t look down. We’re coming to help.

Scientific entertainment. Variation on Daphnis et Chloé, by Louise Marie-Jeanne Hersent-Mauduit

Contests

Corporate stakeholders like shiny new toys.

Soon after I joined the MATTER Healthcare Incubator in October, three partner organizations announced contests. None were a good fit for Humaginarium but I entered them anyway. Why? To learn more about the needs of corporate stakeholders; stretch my universal value proposition to the limit; practice my nascent pitch; and assess the competition. It was fun actually and I gained a few insights.

The partner organizations were Novo Nordisk (supplier), Advocate Aurora (provider), and Blue Cross Blue Shield (payer). Each called for innovations that serve a special interest:

  • The supplier wants to improve the treatment of diabetes
  • The provider wants to improve the quality of primary care
  • The payer wants to improve health equity in the community

Each contest attracted about 70 submissions from around the United States. I was surprised by the number and distribution because the prize in each contest was just a small amount of money. More than money though, the partners promised to commit human resources to the winners in order to advance their ideas to the next level.

As far as I can tell, I’m the only contestant who proposed a solution involving health education and literacy. Among the finalists, all of the others pitched technology that collects or generates data from patients. The data theoretically get used by clinicians to increase the speed and certainty of treatment.

The bleeding edge of these innovations is data analytics. “In God we trust, all others bring data.” Some contestants also preached the gospel of artificial intelligence. They coupled data analytics with expert systems in order to make their apps perform medical diagnosis and recommend treatments. Some contestants further broadened their scope by aggregating third-party technology into their architecture. So for example, after a patient enters a description of symptoms, the app crunches a universe of medical records and research to suggest a diagnosis and course of treatment. Assuming that you, as the patient, are sufficiently alarmed by that point because the signs point to cancer (like what often happens on WebMD), the app schedules an appointment with your doctor and calls a Lyft to get you there. You lose no time before experiencing the full curative force of our marvelous health care system. Providers capture more revenue from you, who would otherwise be oblivious to your condition; and they spend less time treating you because a lot of your health care has magically become self-serve.

I think all of the final pitches fit under a rubric of “connected health,” though there’s still a lot of variation. This overall pattern reinforced my perception that connected health is “hot” and shouldn’t be ignored in the design of Humaginarium. AI is likewise hot, but that makes me a little nervous because the science of AI is many years away from making life or death decisions about health, at least when it comes to mine. It’s a safer bet for pizza delivery. There’s a slight chance that data analytics and artificial intelligence in health care are digital lingo for “smoke and mirrors.” I doubt it, but it’s possible.

Anyway my takeaways from all three contests are:

  • Corporate stakeholders like shiny new toys
  • The top innovations solve provider problems, not patient problems
  • They want to automate health care to the extent possible
  • That pairs nicely with increasing capacity and efficiency
  • Patients themselves are objects rather than subjects of innovation
  • Self-care is a euphemism for medication adherence

Most of the finalists were pretty far along on their journey, with fully developed products, teams, pilots, partners, and customers. Thus their innovations were low risk because they were seeking support for execution rather than ideation. They have traction.

I was delighted to be the only contestant promoting health literacy, delivering health education that empowers regular folks to think like a consumer and not just behave like a patient. This brought to mind the Jungian gallery of archetypes. My brand archetype of sage is uncontested at least in these contests. The question remains though, can a sage attract investments and make boatloads of money? We shall see.