The launch of GE’s new Venue™ Ultrasound is now public
knowledge. It’s a remarkable new device
built by a team of remarkable people.
There’s plenty online and plenty more coming for those curious about the
how GE hopes to contribute to the challenge of caring for the critical
patient through the Venue platform. But this short essay is about
leaders as students. I believe that this
dynamic is at the core of what makes Venue special.
The journey began a few years ago as I was out for a
Saturday morning run. It occurred to me
at the time that for most of my time in medical ultrasound, innovation was
about another micron of image resolution and another claim of uncommonly
easy-to-use human interface. We have
focused for so long on the inputs to the care-giving process. What would happen if we were focused on the
patient encounter itself? Instead of
making a simple, fast, and precise (SFP) ultrasound system, what if we worked
toward a SFP patient encounter? After
time, this refocus on the patient encounter came to be known internally by our
team as SFP2.0.
Maybe because I was out running, shortness-of-breath
(dyspnea) came to me as a target problem and we pursued this until a care-giver
said to me, “Paul, no one dies of shortness of breath.” Of course, in absolute terms, this is an
exaggeration, but the point was made, and we set about studying… well studying
emergency and critical are medicine. We did not create a class of engineers-cum-physicians, but we dug in. Eventually we settled on medical shock as the
target for this idea of SFP2.0. As we
learned, SFP2.0 became “The Shock Toolkit.”
Our study took three forms:
First, we elevated our clinical team to the staff
level. We have a terrific Clinical
Insights team that helps to set strategy for me and the rest of our
leadership. They’re all current or
former clinicians. We added a few
outside advisers to the mix.
Interestingly, one thing that we learned is that to make a difference in
point of care ultrasound, we had to unlearn what we knew about traditional
ultrasound. That’s an interesting story
for another essay.
Next, we studied. I
bet all of the leadership team and many of the rest each read about 70
peer-reviewed papers. Some more. In the end, there were twelve papers that
formed the core of our thinking about medical shock. You can find a video discussion of those papers
here. These became our touchstone and
they are still the touchstone today.
At the same time, we became students of machine
learning. We hired a few experts, but
largely, we went to school to learn with our existing team.
Some of the key problems of shock need solutions that are more nuanced
than human-derived learning can do on its own and we found that this new world
of computer-assisted algorithm development was really an accelerator for
us. To be honest, we’re only barely
scratching the surface here.
Third, we strongly adopted the ideas described in Eric Ries’
book, The Lean Start-up… Specifically the ideas of minimally viable products
and testing leaps of faith. I’ve lost
track of how many low fidelity prototypes we tested, but I know that there were
hundreds of simulated use tests and nuanced changes in design before we got to
the current implementation. In every
case, we found that we learned more from an observational experiment than we did
from a survey question. “Let’s use this
to simulate a central line placement.”
The we would watch to see what people did observed where the prototype
made it easy or not.
It was so hard to keep the disciple of observing. We were often tempted to try to sell our
ideas. Instead we learned to let the
best ideas sell themselves, learning the art of humble acceptance of observed
behaviors as more valuable than our opinions.
We were not perfect in this, and we’re still learning to be humble
students, but we know it’s good for us when we do so.
I’m beginning to believe that the early enthusiasm for Venue
is the result of this posture of a student.
Time will tell if it endures beyond the honeymoon. But I love the idea that curiosity and
disciplined study might be keys to innovation and leadership. My sights are on where to point the team and
the platform next. For sure, we’ll
continue to invest in deepening our understanding of medical shock and making
these first tools even more robust.
Venue is a really terrific system, it’s not a perfect one, and that
leaves lots of room for next steps.
But even as we deepen our study of shock, I have my head up
looking around for where next to apply a team and a platform that has
scholarship at its core. Maybe trauma,
or the monster we call sepsis, or a hundred other ideas we’re bouncing around.
Where would you lead at team like this? Which clinical challenge sparks your enthusiasm?