Innovation through Imagination — Envisioning the Future of Technology-Supported Care

Part 2 of a three-part series discussing the importance of imagination.

I’ve been thinking a lot about imagination lately and how essential it is for stimulating innovative approaches to complex problems. We need innovation in health information technology (health IT) now more than ever with what we’ve been through — a global pandemic, rising calls for eliminating racial biases that contribute to health disparities, wildfires, and other perils. Imagination (the ability to envision what one has never seen, experienced, or heard about) helps transfer the recognition of the power and importance of medical informatics into real innovations that can improve the care of patients and reduce clinician burden.

Enormous patient needs for rapid diagnosis and treatment of unfamiliar and unpredictable diseases increasingly tax an overburdened health care system. Biomedical informatics professionals need to rise to the challenge of systems redesign, new architectures that account for distributed data structures, and the almost insatiable need for information in the moment — decision support under immense urgency and uncertainty. I believe that these new challenges require new ways of action.

In a previous blog post, I encouraged nurses to develop the skill of imagination because it

… stimulates innovation through the experience of a mental what-if, unconstrained by the realities of physics or finance. Imagination is a talent that can be learned and refined over time, benefiting from the reinforcement of envisioning that which might be, and using that vision as a test case for that which can be. 

Imagination expands the human repertoire of planning skills, moving beyond reflexive action and problem solving. Reflexive thought may lead to speedy solutions, and effective problem solving may contribute creative solutions that are responsive to identified constraints. I believe we need to meet tomorrow’s challenges now with solutions that will work into the future – a future that is likely to continue to be characterized by uncertainty and urgency. The future calls for creativity to stimulate innovation through imagination. Imagination may hold the key to devising biomedical informatics solutions that are rigorous enough to be relied upon in life-threatening situations, and robust enough to accommodate team approaches to unpredictable needs for innovative care strategies.

Philosopher Edward Casey recognized two types of imagination: spontaneous and controlled. Both are mental activities, engaging our active consciousness. Spontaneous imagination is characterized by surprise and instantaneity, like the playful stories of children or mental woolgathering while sitting in a beautiful garden. Controlled imagination is a purposeful strategy in which you focus on a specific idea or concept, and use mental powers of reasoning and forethought to anticipate future scenarios. While both types of imagination are important for effective design for biomedical informatics innovation, I am encouraging my colleagues to pay particular attention to growing their capacity for spontaneous imagination.

How does one grow the capacity for spontaneous imagination?

Contrary to the fast-paced, ‘get-it-done’ mindset that has characterized much of past years health IT efforts, a measured, slower pace is needed to create the right conditions for spontaneous imagination to emerge. This means intentionally setting aside time, short or long (without distractions or commitments) and placing yourself in a pleasant environment. It’s not necessary to come to this moment with a specific knotty problem or challenge to think through. In fact, such thoughts are likely to hamper the generation of spontaneous ideas. Spontaneous thoughts that may see far removed from your daily pursuits hold great value in training your mind to attend to new ideas and new fascinations. Avoid appraisals and self-criticism – there are many ways to train our mind to be attentive and aware, and setting aside time, perhaps 2-3 times a week, to just let your mind wander is a great start.

Why am I encouraging what sounds like new-age mantras during a time when we need solutions FAST? I am convinced by the research that cultivating open-ended periods of imagination complements already well-honed mental skills of planning and design. Opening your mind to better connect with what feels creative and interesting increases confidence in judgments about what is relevant in a situation. There is some evidence that spontaneous imagination evokes mental processes similar to meditation and results in improved problem solving and creative solution generation. Noted economist, Daniel Kahneman, advocates that decision makers balance the human tendency to think fast with deliberately thinking slowly to make better decisions. Developing the skill of spontaneous imagination is one way to improve one’s ability to think slow.

Fueling innovation through imagination will improve your ability to recognize nuances and triggers in situations, avoiding the pitfalls of reflexive thinking and expanding the design space. Imagination helps the innovator consider “what if . . .” rather than “how to”— defining the future state before designing the pathway to get there and illuminating consequences not previously recognized. Cultivating imagination increases one’s ability to tolerate uncertainty, resisting the impulse towards premature closure, and settling for adequate but potentially less-than-optimal solutions.

NLM does many things to help cultivate imagination-fueled innovation. We provide access to inspirational literature, and through effective use of the features of the My NCBI tool, you can customize your experience based on previous search interests and receive alerts when related articles appear in the biomedical literature. We fund research to discover new ways to help clinicians envision patients’ response to therapeutics. This includes the work of Antonina Mitrofanova, who is developing and sharing, through a web portal, a bioinformatics analytics system that identifies therapeutic resistance and predicts patients at risk of treatment failure. We promote open access to scientific data through our vast genomic and molecular databases, including our Sequence Read Archive, now freely available through commercial cloud services. And, through our Network of the National Library of Medicine, we work to connect communities around the country to research opportunities and trusted health information.

Imagination-fueled innovation will accelerate the design and deployment of biomedical informatics solutions to the challenges of responding to patient needs under increasingly unpredictable and demanding situations, from pandemics to natural disasters. Let’s partner with you to cultivate imagination and be the innovator only you can be!

Author: Patti Brennan

Director, US National Library of Medicine

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