EPISODE TRANSCRIPT
Content may be slightly edited for clarity.
Bey
Hello and welcome to So Curious, a new podcast from the Franklin Institute.
Angelica
In this season Human 2.0, we will be talking to scientists and nonscientists about technology, innovation, and the human experience.
Angelica
We’re your hosts. I’m Angelica Pasquini.
Bey
And I am The Bul Bey. But you can just call me Bey.
Angelica
On today’s episode, we’re going to be talking with materials scientist Dr. John A. Rogers and chief innovation officer at Penn Medicine, Roy Rosin.
Angelica
Today we’re going to be talking about wearable technology. What is the most advanced thing you’ve ever created?
Bey
Oh, man. I don’t know. It might be a sandwich. The most advanced thing that I have ever created is likely a song, right? But I would love to move forward in the future and think about….I’ve brought this up before: behavioral functionalities in music, and how do you change moods? And it would be awesome, I don’t know, maybe in the future there’s like a watch or a phone that lets you know that this song will likely make you feel better. There’s playlists that are titled “upbeat,” and so on and so forth. But maybe there will be playlists in the future that has backed-up data and backed-up technology that will prove or show that there’s a high likelihood that this song will make you dance or this song will make you feel good.
Angelica
When you first think of something and then you finally get to listen to it back. What is that process like for you, basically from concept to finished creation?
Bey
Yeah, innovation and creating isn’t necessarily something I feel I ever have an entire and complete and absolute grasp on. I have a thought and an idea and a feeling that I’m trying to evoke or connect. You tinker and you work in your workshop or your laboratory or your studio — music or otherwise — and you see how close you can get to that. But in the process of doing that, you discover other things. And I think that’s what’s really cool. And that’s also a parallel between writing comedy, writing music, and also, I don’t know, writing DNA or writing tech that people can use for their health, wellness, mental health, and so on. You’re in the process, you’re never quite sure where you are, but you keep asking questions to guide you along.
Angelica
I would say for me, there’s the idea, and then there’s exactly where you think it’s going to go. And then you have these moments of hating it and then walking away, and then you kind of like have this Eureka moment. And the cool thing about technology that I think happens to people is they’re working one way, and then one day you realize, oh, no, this is it. Or oh, yes, this is it, whichever. And that happens to me a lot. I’ll have one line and then just have so much fun playing with it for a long time, and then it turns into something else.
Bey
Our first guest is Roy Rosen. Roy Rosen has been the Chief Innovation officer at Penn Medicine since 2012, where he works with leaders across the health system in order to turn ideas into measurable impact in terms of health outcomes, patient experience, and new revenue streams. After earning an MBA at Stanford, Rosen got his start at the software company Intuit, where he created an internal incubator that focuses on turning ideas into actions and changed the way Intuit handles new business creation. Rosen believes in falling in love with the problem,and that it’s not just about the technology, it’s also about the team.
Bey
Hi, Roy. Can you please introduce yourself?
Roy Rosin
Hi, my name is Roy Rosin. I’m the Chief Innovation Officer at Penn Medicine.
Bey
How are you?
Roy Rosin
I’m good, Ben. Good to see you. Thanks for having me.
Bey
Let’s get right into this. Can you talk about the first moments of you creating or innovating something?
Roy Rosin
That’s such an interesting question. I never really thought of myself as an innovator, and I went to a company that sort of encouraged creativity, this is backed at Intuit, out in Silicon Valley. And I think it was just a small enough company that everyone was encouraged to take a lot of accountability about solving problems that they saw. And so that’s really the way I think about the beginning of being innovative was more just having the freedom and independence of thought to say, hey, there’s a problem, I think I can go solve it long before we understood really what friction meant and how to reduce friction to improve products. I remember when the Internet first came around, just thinking about how what everyone was doing was just getting stock prices. And one day I was just using… I think it was probably Microsoft Word…where they have this little dropdown. You can look at your last files and pick a file that you’ve used recently…thinking to myself, why don’t you do that for stock prices? Why don’t you remember all the things you looked up in the past? Why don’t you just make it a save function at the end?
Roy Rosin
So all of a sudden you keep going back to the same site where you could get all the stuff at once instead of one at a time. The innovation wasn’t about the little things. It was about the fact that you could take an idea and you could act on it. You could try something and see if it worked or if it didn’t work. And over time, you know, those little ideas became whole products and whole businesses, which are the ones that I think I’m both most proud of and probably the ones that were material to the company.
Bey
You mentioned friction. What is that and how does that play into innovation?
Roy Rosin
I think a lot of what drew me to Penn was this study of behavioral science, of changing what people do, changing what they choose or don’t choose the decisions they make or fail to make. And the world is just full of friction. Things that get in our way, they get in the way of doing the right thing, too often. When I think about what changes behavior, whether this is in software technology, whether this is out in the world, I tend to think of it now in terms of friction, things that either get in the way or make things easier to do. People tend to do the easiest thing to do, like water flows to the lowest point. And I think the reality is when you get rid of friction, you change behavior. If you make something easier to do, more people will do it. It’s sort of that simple. In the health world, we want to have people take healthier behaviors. If you make it harder to get the unhealthy food and easier to get the healthy food, you’ll see a change. Right. Friction management is a big deal.
Angelica
I was seeing that you were talking about the difference between innovation and creativity and how sometimes those are looked at as the same thing, and that’s not right. Can you talk a little about that?
Roy Rosin
Creativity and invention are about novelty and doing something that’s new. I think about innovation a little bit differently in that innovation sort of implies you’ve captured value from those new things. So if you’ve invented something that’s new that nobody ever buys and nobody ever uses, I’m not sure you’ve actually innovated. You’ve definitely invented something. You’ve been creative to think of something that’s not been done before. But there’s this gap between creativity, invention, and value capture… And innovation has this sense that you’ve actually done something that matters and you’ve actually done it in a way that you can capture value from it.
Angelica
Sometimes you think you’re creating value and you’re not.
Roy Rosin
Yeah, well, it also means that you have to be able to measure value, because some people think of that in terms of economic value. Sometimes you might think of that as societal humanity value. So you get to define the needle you’re trying to move, but it means that the needle has moved. Innovation implies the ability to move that needle and capture value.
Bey
Why do you think it’s so important to turn ideas into impact?
Roy Rosin
What I often say is you have to turn ideas into action. Right? Because you have to do something to learn something. A lot of times you have this idea, you think it’s a great idea, and in your head it’s a wonderful idea, but then it meets the reality of the world and it doesn’t work at all. The thing that I think we, and the whole industry, and everyone trying to do good problem-solving has learned over the last decade or two is that you’ve got to test these things as quickly as possible. You build this beautiful castle in your head about the way things are going to be. You’ve got to go figure out the way things really are. You don’t know what human beings are going to do. You don’t know how they’re going to use it. You don’t know whether they want it. You don’t know any of those things. You don’t know if it’s going to work or not.
Bey
I appreciate that answer so much. I know as an artist, as a creative, I have ideas all day. I kind of get locked into, I guess, paralysis through analysis.
Angelica
Yeah.
Roy Rosin
In the early days, I remember one of the big, big failures in the earlier part of my career was this concept of Quicken Brokerage. And we had 15 million active users on Quicken, and we had built the largest consumer software business out there. Total bomb, absolute complete failure. Nobody was interested. It was not a good idea. It’s not what they wanted from us. And it was a really interesting experience to learn from that type of failure to say, wow, that’s not the way you do these things.
Bey
What’s the importance of failure in innovation and being creative?
Roy Rosin
It’s one of my favorite topics because I think in the old days, people used to say, hey, make it okay to fail, create a culture where failure is okay. And I think what most people mean when they say that is make it okay to fail fast and cheap. The evolution of innovation and innovation methodology is that you can learn more quickly and more cheaply that you’re going in the wrong direction. What’s really going on is that you have a hypothesis and assumption. You are designing an experiment using these new methods where you can do it super fast and super cheap. And actually, it feels more like you’ve invalidated a hypothesis than failure, right? Basically, yeah. You found you were wrong, and it’s okay to be wrong, but having it be okay to be wrong has a different connotation than, like, hey, “failure,” because people think “Failure, oh, my God, you lost $10 million.” So how many of us can lose $10 million in two years of our lives? So, hey, you know what? Lose two weeks of your life and lose $200. That’s the way I try to think about failure now, is think about as quickly as possible, you’re going in the wrong direction.
Bey
So, Roy, you have a genius philosophy. Would you mind walking us through the couple of philosophies that you have, explain them to us, and how you came up with them, and how they apply to your work? The first one that I love a lot is “fall in love with the problem and not the solution.”
Roy Rosin
Yeah. And most of these are philosophies that I’ve adopted or adapted. I don’t know how many I came up with myself, but Scott Cook was the founder of Intuit, and Brad Smith, who was our CEO for a long time… We used to talk about this falling up with the problem all the time, and it was just because you’d see so many cases where you had to iterate or pivot or change directions and you ultimately found a success. And so we would look at these things and say, how do you get to the winner when you’re usually starting with a loser? On my very first day of work here at Penn, a bunch of people wanted to do online scheduling for doctor’s appointments. It’s a great idea. We should do it. It’s way more convenient. But if you get down to what they were solving for, right, you know, the actual problem — the actual problem! — was: you can’t get in to see a doctor. So if we had gone up and done that kind of “Open Table” online scheduling, it would have simply been faster and easier to see that you can’t get in. That’s not the goal.
Roy Rosin
The goal is to get in, right? Not to make it easier to see you can’t get in. So if you fall in love with the problem of getting a new patient visit faster, you could do something different. And our teams here at Penn did a whole bunch of things differently. Things like load balancing, where, hey, maybe you can’t get in there, but I can get you in over here at a different part of town, or even I can redesign the way we do care and free up some spots from people who may not need them so much. So there are other ways to get people in faster, but it wasn’t going to be the “Open Table” online schedule.
Bey
Being efficient, I love that. And very quickly, can you talk about the “Five So Whats?”
Roy Rosin
Yeah, these things are really linked, right. My favorite story, and I tell the story all the time is the Hertz Rent-A-Car story. This really tells the difference between the “Five Whys,” and the “Five So Whats?” Because people know about the Five Whys, right? Get to the root cause, don’t attack the symptoms. That’s the Five Whys. So if you’re looking at renting a car back in the 1980s when I’m coming out of school, you’re in that line for hours. But you knew what the problem was. The problem with this incredibly slow line. So you define the problem as a slow line. What’s better? A faster line. So you start doing the Five Whys, right. Why is the line so slow? Why is the line so slow? But if you go the other way, instead of asking why, why, why, you ask, so what? So what? And so you say, well, what would be good about a faster line? What you’re really trying to do is shrink the time between your plane landing and when you’re on your way. As soon as you realize the metric is not the speed of the line, it’s how quickly you’re on your way.
Roy Rosin
Now you can actually invent Hertz Gold. There’s no line. And in fact, as soon as you realize it’s really how quickly you’re on your way, you could even beat Hertz Gold, right? Somebody picks you up at baggage claim, or Elon Musk sends a self-driving car, and it’s right there outside baggage claim. You don’t even go to the car rental place at all. So that’s what we try to do, is, I get real deep on what is the person you’re trying to help really solving.
Angelica
Sometimes you don’t know that you have a problem until you see the solution. That’s the cool thing about innovating, is that we can help people realize there’s always a better way.
Roy Rosin
A lot of times we get used to stuff in our environment that is friction. Back to the friction point. Right. You just work around it. And I think the more people get trained to observe what’s around them and say, hey, that’s not right. That could be better. The start of a lot of innovation is literally just noticing things.
Angelica
Absolutely. And then it sounds like surrounding yourself with people who are open to listening to your new ideas. And that’s what this whole show is about, is connecting with people 100%.
Yeah.
Angelica
And hearing their new ideas. And we’ve learned a lot.
Roy Rosin
Yeah.
Bey
Thank you so much for coming on and taking the time.
Roy Rosin
I appreciate your having ,e. I mean, I think those connections are absolutely essential. It’s an amazing thing when you get an interdisciplinary team together., who all see that problem from different angles. And that’s how you generally go from that insight to some kind of solution that works.
Angelica
Totally.
Bey
Beautiful.
Angelica
Love that. What a beautiful way to end. Thank you. Thank you for your time.
Roy Rosin
Thank you.
Bey
Okay. So that conversation definitely has my gears turning. I love the focus and the perspective of falling in love with the problem. That changed everything at that point when I was thinking about all the things that I work on in terms of music and creative collaboration.
Angelica
Yeah. It’s all perspective. I love that he was talking about that.
Bey
Yeah! How do you engage with solutions or hurdles, whatever that might look like.
Angelica
Walking away and then coming back. I think it’s great to take space.
Bey
Yeah.
Angelica
Because the dwelling on something is really where the problem gets worse.
Bey
I mean, you’re hitting right on it. Right. In the conversation, he said he didn’t do certain things with a laser-lock focus. And it’s just I don’t know… It always hits me as… I don’t know. It’s funny. I guess? Serendipitous? When you do something unintentional, without focus and it connects so deeply with people.
Angelica
It’s true. I mean, the most ironic thing is the less that you focus and worry and try too hard, the more beautiful things end up showing up.
Bey
Yeah. I guess it’s that conscious and subconscious brain dance going back and forth.
Angelica
Totally. And I think for the future, someone like this is really trailblazing and helping people sort of free themselves up to really innovate and think big, think outside the box, think in ways that actually make huge differences. And sometimes with not so much efforting, more like…working smarter, not harder.
Bey
So now that we’ve discussed how big ideas are generated, let’s talk to someone who makes big ideas reality.
Angelica
Our last guest, John A. Rogers, is a professor of materials science and engineering, biomedical engineering, and neurological surgery. His interests and research cross many diverse fields, all with the purpose of providing insights into our health and better understanding of our bodies so that we might extend the human lifespan. Among all of Roger’s incredible innovations, his development of wearable technologies called epidermal electronic systems, or EES, has the potential to transform the way we treat patients. EES are wireless, flexible, battery-free, and can be used as heart monitors, to monitor electrolytes, or even to map the brain.
Bey
Hey, John, can you introduce yourself?
John Rogers
Yeah. So maybe I’ll just start by recapping wearable technology as it exists today. And many people are familiar with the Fitbit and the Apple Watch and all sorts of related types of devices that mount on the wrist. Anyway, there are many different types of commercially available devices of that type. Those are known as “wearables,” and they’ve kind of defined the category. And I think they’re great devices. They have broad adoption. They’re useful for many types of applications. But I think where body-integrated devices — thinking about wearables more generally, not just those that kind of loosely coupled to the wrist or the finger, but by skin-integrated devices that offer medical-grade information streams continuously. So thinking about the measurements that are done in an intensive care unit, how could you reproduce that kind of monitoring function in the form of the thin, soft patch that could mount on a relevant part of the body, not just the wrist, but really kind of anywhere on the body? I think the most meaningful applications are going to be with people who really need the monitoring capabilities, that there’s a real compelling medical requirement to stay healthy. You really need to use this device. And I think a lot of that fear drops away. These are not, at least initially, designed for healthy people.
Angelica
Totally. And what really impressed me was that just an adhesive sticker, like a small sticker, what I saw on an infant’s chest and how that can actually work as a battery-free, flexible wireless device that is monitoring the infant’s heart rate. Is that correct?
John Rogers
Yeah. I mean, the vision that we have is to build an electronic monitoring system in the form factor of a kid’s temporary tattoo. That would almost be the ideal type of physical form for a device of this type. You put it on, you don’t even know it’s there, maybe even have graphics on top. It looks cool. That’s what we had in mind, and we were able to do that.
Bey
Any points or emphasis in your career that made you realize that you wanted to focus on improving experience?
John Rogers
There wasn’t a specific moment in time. I guess as my career has evolved, I’ve always been interested in new technologies and engineering. And I think devices that have an impact on human health for us represent the most compelling opportunities.
Angelica
In your head, in the beginning, did it look similar in your mind to what you ended up creating?
John Rogers
Pretty much. I think we kind of had the idea, and I actually created a slide… So I took a temporary tattoo, put it on my arm and took some pictures of it and squeezed my skin and stretched it around. And you can see how the tattoo responds in that way. And I told my students we want to build electronics that look like that. And those pictures created great visuals, to keep the students kind of focused on the end goal. And I think they got excited about it, too. It’s a very strong motivating factor. When you’re slogging it out in the lab late at night, you’re thinking about if this is successful, all these different things are going to happen.
Angelica
And how long are you in that process with people?
John Rogers
That’s a great question. I think you kind of have the vision, OK? And that doesn’t take very long. Maybe you have that idea one day. Right. But then making it into reality, that’s a really long process. We published our first simple prototype with the building blocks in this temporary tattoo format in 2011. Just to give you a sense of the time scale. You have to stick with these things. It really requires a lot of persistence. I think that’s a really important attribute if you want to do technology development is you’ve got to be patient with it. I’ve worn lots of these electronic tattoos. I’m very much a user of the technology as we’re developing it because it’s kind of a human factors issue, like…you can develop a great piece of technology, but if people don’t want to use it, it’s useless. As I mentioned before, kind of reproduce the gold standard monitoring capabilities that you find in an ICU, let’s say, in a children’s hospital here in Chicago, where we do a lot of work… But they’re very cost effective and they can be deployed into even very challenging environments. And so we have deployed, I don’t know, 10,000 to 20,000 units into Zambia, Kenya, Ghana, India, Pakistan, and Mexico.
John Rogers
And so I spent a couple of weeks myself in Zambia, where we’re using these devices to monitor maternal, fetal, and neonatal health. So we monitor women during the delivery process. We monitor their health, the health of the fetus, and then the health of the neonate immediately after birth. And seeing the kind of impact that that kind of medical monitoring can bring to the care of patients in those parts of the globe, it’s very powerful. It serves as a very strong motivating force here in the States.
Angelica
Things come up around… Potentially, as this technology progresses into society, into day-to-day use outside of a hospital, if people would have to worry about things like data collecting. What are your thoughts on that?
John Rogers
Yeah, data management is really important. So I think there are opportunities associated with data, and then there are risks associated with data, the latter having to do with data security and health security. And you have to think about encryption and HIPAA-compliant cloud storage and who’s getting access to the data. All very important questions. But the data is really enabling, in the sense that now we can think about population-scale data collection. So I think artificial intelligence, machine learning, convolutional neural networks, all these advances in data analytics are going to intersect with these advances in wearable 2.0-type devices in a very powerful way. I think there are huge opportunities in doing more with the data.
Bey
Right, right! And I appreciate you bringing that up. As we’ve been having all these conversations in these different fields of science, there’s been constant back-and-forth between the development of the technology, and then the ethics. And so, can you talk about accessibility and why it’s important to have everybody have an entry point to develop an advanced technology and medical treatment?
John Rogers
Yes, it’s a great question, and it’s really embedded directly into our thinking when we’re doing our research and coming up with designs is, what’s going to be cost-effective so that it can be made available to everyone, not just high-end hospitals, small segments of the population, but really everyone, and not just here in the US. As I mentioned before, LMICs anywhere across the globe, that’s going to be the most impactful way to do technology development. And that cost consideration has to be built into the thinking. You’re thinking about equity, you’re thinking about disparities in health outcomes. You can look at the statistics. It’s quite striking, and a lot of that is associated with the cost of how care is done today. And I think new technologies can reduce those costs across the board. We’re interested in everything, anything, that we can get out of our lab into the hands of people who could benefit from the technology, we’re all in! We have to prioritize, obviously. And I think for us, we want to focus on serious medical-type applications. But a lot of the consumer-oriented, as you’re suggesting, maybe more mundane applications, are still interesting because they can drive volume, and they can drive manufacturing flows, and cost.
John Rogers
And so if you can find dual-use, right? Not just medical but also consumer, there are benefits that flow back and forth.
Angelica
Well, thank you so much for explaining this really fascinating and specific thing that you do. And. Yeah, it’s really, really interesting.
John Rogers
Yeah. Thanks for having me.
Angelica
Well, you know what? I’m still not getting a Fitbit, but I really appreciate everything I learned today.
Angelica
Thank you so much for listening to this episode of So Curious! presented by The Franklin Institute. The Franklin Institute is a science museum located in Philadelphia. The Franklin Institute’s mission is to inspire a passion for learning about science and technology. For more information on everything about the Franklin Institute, visit fi.edu.
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