EP 107: Designing the Hospital at Home | Helen Ouyang
Can hospital care be delivered at home? Will the hospital of the future only consist of ERs, ORs and ICUs?
Dr. Helen Ouyang is an emergency physician, Associate Professor in Emergency Medicine at Columbia University, and contributing writer for The New York Times Magazine. She has written for The Atlantic, Harper’s, Los Angeles Times, New York, The New Yorker, The New York Times, The Washington Post, and others. Her writing has been a finalist for the National Magazine Award, anthologized in The Best American Science and Nature Writing, and funded by The Pulitzer Center. Helen has worked in 20 countries across five continents in public health and humanitarian assistance. Her publications have also appeared in many academic medical journals, including The Lancet and JAMA, and she currently serves as a reviewer for Annals of Emergency Medicine and Disaster Medicine and Public Health Preparedness. She is also a mentor-editor for The OpEd Project. Until 2015, Helen was the Associate Director of Columbia’s International Emergency Medicine Fellowship. After graduating with a bachelor of arts from Brown University, Helen went to medical school at Johns Hopkins and studied for a master’s in public health at Harvard, where she was also a Zuckerman Fellow at the Harvard Kennedy School of Government’s Center for Public Leadership. Upon completing her training at Harvard, at the Massachusetts General Hospital and Brigham & Women’s Hospital, she moved out to the Pacific Northwest before finding her way back to the East Coast.
Episode mentions and links:
Your Next Hospital Bed Might Be At Home via NY Times Magazine
Can Virtual Reality Help Ease Chronic Pain via NY Times Magazine
Restaurant Helen would take you to: Bernie’s Restaurant
Follow Helen: Twitter | LinkedIn
Episode Reflection
“You see patients in their place of power, it’s a totally different thing,” De Pirro says. “That magical difference.”
This quote from Dr. De Pirro taken from Helen Ouyang’s NY Times Magazine article that we discussed in this week’s episode really stuck with me. Helen does an AMAZING job illustrating such a vibrant picture with her writing. In the article, she follows a leader in the hospital-at-home space as she visits a number of patients. One, a 92-year-old woman getting IV antibiotics and diuretics at home, while her attentive son proudly stated that she was getting better. Another, a man who preferred to be seen by the doctor while on his porch, was getting treated for dehydration, but more importantly was able to get some solid advice about his nutrition, which the provider noted seemed to consist mostly of soda and candy. Later, we meet Rita, an 87-year-old woman who, despite having her sepsis improve in the hospital, was not thriving and whose recovery had stalled. After a significant effort to set Rita up with hospital-at-home services in her Appalachian home with her family by her side, she began to eat and get out of bed again. The beginning of Rita’s story is a story I’d wager everyone has heard before. Someone enters the hospital, but recovery is slow, despite the treatment being “successful.” Dr. Ouyang doesn’t sugarcoat things or present home care as a panacea for everything that ails our health system either. There are some real challenges and questions to be answered about how we don’t create a new way to estrange and devalue those who are most vulnerable in our society. But thinking back to the quote I pulled at the beginning, it’s pretty damn incredible to see humans being treated as whole humans within our healthcare system. I have a family member who had a prolonged hospital stay recently. Surgery complicated by infection, then delirium, then decompensation, then discharge home, with no support. A week-long stay turned into a month. Knowing my family member, and their fiery sense of independence, I can say with 100% certainty that hospital-at-home would have been the right choice for her and I hope that someday, should I be in her shoes, I’ll have the choice to heal in my place of power, my most comforting place, surrounded by my family in my own home.
Written by Rob Pugliese
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Bon Ku: Can inpatient hospital care be delivered right into your home? Will the hospitals of the future only consist of emergency rooms, operating rooms and ICU's? I'm Bon Ku the host of Design Lab, a podcast that explores the intersection of design and health.
Our guest today at Dr. Helen Ouyang. She is an emergency physician and associate professor in emergency medicine at Columbia University in New York City and a contributing writer for the New York Times Magazine.
She's also written for the Atlantic Harper's LA Times. The New Yorker, the New York Times, the Washington Post and other media outlets. Her writing has been a finalist for the national magazine award. Anthologized in the Best American Science and Nature Writing and funded by the Pulitzer Center.
Helen has also worked in 20 countries across five continents in public health and humanitarian assistance.
Helen is a graduate from Brown University. Went to medical school at Hopkins and has a master's in public health from Harvard. Where she was also a Zuckerman fellow at the Harvard Kennedy School of Government Center for Public Leadership.
She completed her training at Harvard at the Mass General Hospital and Brigham Women's Hospital.
Stop by our website at designlabpod.com. There you can find show notes from each week. Learn more about our guest, and get links to related content from each episode. There's a link there where you can subscribe to our newsletter each week. Our producer, Rob Pugliese will send you show notes and links right in your email inbox whenever a new episode drops.
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Now here's my conversation with Dr. Helen Ouyang
Helen Ouyang welcome to Design Lab. I am very excited to have you on the show.
Helen Ouyang: Thank you for having me.
Bon Ku: I read this article that you wrote that just came out in the New York Times magazine. The title is Your Next Hospital Bed Might be at Home. I love this article. And in the article you talk about how the American health system desperately needs more hospital beds, and you and I are both emergency room doctors, so we experience patients boarding in the emergency room for hours and even days waiting for a bed.
Can you talk about how dire the situation is across the US of communities not having access to inpatient hospital beds?
Helen Ouyang: Yeah. So we saw it during the pandemic, right? It was scary. I mean, the New York Times had a tracker, and people can look at their state and where they lived and how many hospital beds were empty for them. So it had always been a problem. That was always going to be a bigger problem because the baby boomer generation was getting older.
So we always knew we were gonna face this problem Eventually, then the pandemic hit and it just came much more quickly, and it was frightening.
Bon Ku: There's some stats that you have in 2020, 19 rural hospitals were closed down. That's more than any in the previous decade. And, and there's something like 30% of all rural hospitals are at risk of closing. Is that, is that true?
Helen Ouyang: Yeah, that's true. And actually the number was higher, but the federal government sort of redefined what rural hospital means. So now it's nearly 30%. But yeah, it's true and it, it's scary. And we're talking about these tiny standalone facilities. You know, it's the only place that people can get healthcare in some of these rural communities.
So if one of them closes, you know, they're really outta luck.
Bon Ku: Hmm. And what is the hospital at home movement that you write about in the article?
Helen Ouyang: So the concept of Huwa home is not new. It's been done for decades, especially in Europe and Australia and even here. Back in the nineties, Bruce left, who's a geriatrician and a professor at Johns Hopkins had piloted a program. So I was a medical student at Hopkins, so I knew Dr. Left from that. We haven't talked in decades until I was writing this article, but he did take us on a home visit.
It wasn't part of hospital at home, it was just a routine home visit that he did for one of his patients. So there we were a bunch of medical students and our short white coats, and we were just bumbling along this busy roadway during weeds. It was a hot July day. I was sweating through my white coat. I was really uncomfortable.
I really didn't understand what we were doing, taking this 20 minute walk and then we get to his patient's home and she couldn't walk. She was pretty house bound. And she was just so happy that her doctor came to see her and that she didn't have to, you know, take the medical van and go to the clinic and wait.
And that was the only home visit I have ever been on before or since. But it really stuck in my mind just entire time through all the years.
Bon Ku: Yeah, I don't think I ever been on a home visit in medical school or residency.
Helen Ouyang: Was, it was pretty unique. Even now, I think it would be unique.
Bon Ku: Yeah. But you write before the 20th century treatment at home was the norm. Is that right?
Helen Ouyang: Yeah. People didn't go to hospitals. Hospitals were bad places. You went there if you didn't have family, you didn't have friends in the community have abandoned you. Most of the treatment you would get in a hospital, you can get in your own home. and then things started to change. In France, in Germany, they started to do more high tech care.
They started to do things like autopsies and all of that moved into the hospital, and then surgeries became more high tech and sterilized and anesthesia. So you couldn't do that in people's home and medical students as well. They didn't wanna be in the classroom. They didn't want didactic lectures. They wanted to learn, so they moved on to the wards.
And then the Civil War happened, and especially in the later years, you know, the public saw large swaths of men being treated in these institutions, and for the most part, they did okay and the care was organized. So people started to have a lot more faith in the hospitals.
Bon Ku: Hmm. Is there a perception among patients that you get better care in a hospital rather than at home? That, that, if care is delivered at home that is inferior or subpar.
Helen Ouyang: I think so. I mean, you go to a hospital and pulsating with machines. There's doctors in white codes, there's lots of nurses around, there's lots of people around. Now, they might not all be attending to you, but you see all of this with your eyes and it seems like you're probably getting better care.
But I think as we've now seen more and more, there's a lot of hospital acquired infections. Patients are getting upset about being woken up at all hours. The monitor beeping and nobody comes and turns it off.
so, it's all that is coming to
Bon Ku: light
so annoying. I don't know how patients ever fall asleep in the
hospital.
Helen Ouyang: then they can't get better.
Bon Ku: And these hospitals are getting more and more expensive. They can cost up to, you write 2 billion dollars?
Helen Ouyang: Yeah. And even more in some cities. So 500 bed hospital, it can cost 2 billion dollars, to build
Bon Ku: so the hospital's like probably literally the most expensive building in a community in in most states and counties. Tell us about did you go on for when writing the article, did you go to New Mexico for this?
Helen Ouyang: Yeah, I went to New Mexico and I also went to Kentucky.
Bon Ku: And you talk about some patients getting hospital at home care can you describe that for those who have not read the article and we'll put a link to the article in the show notes.
Yeah, I went to Albuquerque and I met Dr. De Pirro and she actually was a resident under Dr. Leff as well.
Bon Ku: What
Helen Ouyang: I didn't overlap with her or anything, but she is out there and she works in one of the longest running programs in the country since 2008.
Bon Ku: Hmm.
Helen Ouyang: So Presbyterian Health Services, they have their own insurance.
They're kind of like a Kaiser, so some patients have their insurance. And for that reason, they were able to start a program and sort of maintain it over the years. So I got to ride in the car with her and follow her around as she went and took care of patients. And she really does it in this old school way.
She's one of those doctors who really knows all the details about her patient's lives. She doesn't even seem to look in the chart, and she knows everything about their family members and they know her. And she goes to her homes and cares for them. And then the nurses also come at different times throughout the day as well.
Bon Ku: Hmm. And how sick are these patients? Are, are these patients who would normally get admitted to an inpatient bed, but instead they are getting treatment in their own home?
Helen Ouyang: Yeah, the first patient I met, Manuelita Romero, she was the first patient in the article. She was in her nineties. She had terrible congestive heart failure, you know, she was very sick. But she wanted to be at home. Her son wanted her to be at home, so she was getting her an iv antibiotics and her diuresis all at home.
Bon Ku: That's someone I would automatically admit to
my hospital , like, I'm like, there's no way I'm sending a 90 year old patient home who needs diaries to send IV antibiotics. I'm like, you are getting admitted. And then, no, no one, the medical admitting team wouldn't fight me on that. They'd be like, yes, this person meets criteria for not even a observation bed, but a full inpatient bed.
That's amazing.
Helen Ouyang: Yeah, it really was amazing to see.
Bon Ku: And how much is the family doing for that patient's care?
Helen Ouyang: Well, in this case uh, Manuelita Romero, she was pretty bedbound. But her son, was amazing, and he was planning on getting her outta bed, which is something that probably wouldn't happen in the hospital because she really barely walks at all. So they probably would've just let her stay in the bed.
So he did a lot for her. But the second gentleman that was in the story, Bob Saltzman, he lived in a trailer, had three dogs. He didn't have any help at all, and he was also able to be hospitalized because he was just getting iV fluids and monitoring for his kidney function.
Bon Ku: Hmm. And there's so many questions I want. To ask about this. Are the patients happy getting care at home because I find it, you know, the patients I see in the emergency room that I know need to get admitted. There's two different subgroups. You know, one is like, I wanna get admitted to the hospital cuz I don't feel safe going home.
And another subset, which I think is a minority, would go, I don't want to get admitted to the hospital. Is there any way I could just get discharged and be treated at home.
Helen Ouyang: Yeah. So the patients I met, for the most part, they really wanted to go home. So as I pointed on the article, you know, we need to figure out how this is gonna work on a larger scale in our healthcare system across the entire country if we're going to continue doing this. Because right now, when you look at the studies, patients have the consent right to go home and their families have to consent.
So almost by default, they're a little bit self-selected. So the patients I met were thrilled to be home. Some of them had been hospitalized for a few days. They still needed a couple more days of hospitalization, but they just really wanted to get out of there. So hospital at home allowed them to go home and sort of continue getting the same.
Bon Ku: hmm. If you were to predict the future, is this going to become more commonplace, would this be the norm that hospitals only admit the sickest patients, the ones who need to go to an I C U bed or need emergency care or need an operation and the rest of care can actually happen at your home? Or is that pie in the sky?
Helen Ouyang: I think we're very far from that, but I think it's definitely moving that direction because you know from the pandemic, but even before that, patients want the things at home. I mean, people are now used to using telehealth. They don't wanna leave the home if they don't have to. So hospitals, are reaching a point where they're almost expected to at least be able to offer it.
Then you have these startups that are happening everywhere. You've probably heard of Dispatch Health, I think was started by two ER doctors. But you know, they're working with insurance companies who just bypass the hospital. I mean, hospital care is extraordinarily expensive. So if you can just keep the patient from going into the ER and you meet them at home and you find out, oh, they need IV antibiotics or IV fluids, and we don't have to have them go in at all, they're doing that and hospitals know that they're playing defense.
Bon Ku: Hmm. What are some of the barriers for preventing hospital at home from happening widespread and scaling?
Helen Ouyang: Well, there's a lot of costs upfront, so you, you have to figure out these logistics. You need x-ray companies that can come at any hour and be close enough to actually go to your patient's home. You need to figure out how you're gonna get all your medications there. How are they gonna be stored? You're gonna have to figure out if the patient gets so sick, how are they gonna get back to the hospital?
You need to figure out the criteria that a patient, when they need it, they have to go back to the hospital. And then there's all the monitoring. Are you gonna be a program that has 24/ 7 telemetry with one of those biotech patches? So all of that needs to be sorted out.
Bon Ku: And do you think health systems are gonna be doing that or it's going to come from like these startup companies private startup companies outside of health systems?
Helen Ouyang: Well, the omnibus bill that President Biden signed a one point trillion. Well now it's a law. They are putting money towards the waivers, so, people can get hospital at home until the end of 2024. So the waiver that happened during the pandemic, that's going to be extended, but also part of that they're pledging that they were going to study all of these hospital at home models and figure out who should really be treated at home and what's the best way to do it, and are there people being left behind?
Were certain people being pushed into doing it. So all of that, hopefully, will start to be sorted out by the federal government, but as you said, I think some of these startups are going to play a role as well.
Bon Ku: Yeah. How did you come up with this idea? Did a New York Times say, hey, write about hospital at home, or is this something that you were thinking about?
Helen Ouyang: No, it's something I've been thinking about for a long time. I, I hadn't. been sort of following what people were doing for a couple years, just varying minimally, maybe a couple times a year. I'll look at Medically Home's website. I found out, I actually didn't even know that Bruce Leff was doing this, so I had known a little bit about it, but when the pandemic hit and the waiver passed so CMS said for Medicare patients that you no longer have to be in the hospital 24/ 7, which was required before because they required nurses to be around 24 7 and they passed this waiver. I knew at that point that everything had changed and the hospital at home was getting this massive boosts, and it was probably going going to be in everybody's home soon.
Bon Ku: I'm just fascinated by this process of, you know, coming up with this story, pitching it, and then the process of writing about it. So you pitch this to New York Times and do they go, Hey, that's great, go for it and we'll give you like a couple months to write it up.
Helen Ouyang: I wish it was that easy. Well, we do go back and forth because they wanna make sure, I mean, it's hard, right? Because I'm pitching a story and I haven't fully reported it yet, though I do definitely do some pre reporting. So I talk to people and make sure I have access and that I would be able to visit and that there was really a story there.
And then I write it up for my immediate editor and then he'll go back and forth with other editors to figure out if it's a fit and if they wanna take the story in one direction versus another. And then over several months I report it out and write it.
Bon Ku: Hmm. And these are long pieces. How many words was that article?
Helen Ouyang: I think it was almost 6,500 words.
I think it's
on the shorter side for me.
Bon Ku: It's in the New York Times like Sunday magazine section, so it's not a small piece. Does it take you, are you writing days on end when you're not working? Your shifts in the hospital, like working on these pieces?
Helen Ouyang: I am definitely reporting for longer than I'm actually writing. But yeah, magazine stories are long and kind of why I love them so much because you can really get into it.
Bon Ku: I am curious to know, was this always part of your plan to become a physician writer when you entered into medical school, or was this something that happened later on in your training?
Helen Ouyang: No, not at all. Do you want the long story or the
Bon Ku: Oh, I want the long story
Helen Ouyang: So I always loved writing. I was always just much more humanities person I think, than a science person.
Um, I always found science and
math much harder. Yay that's why we're here.
Bon Ku: Science was actually my har... I did not do well in my science classes that actually did not like my science classes. I was a classical studies major in college.
Yeah, so I studied like ancient Greek text
Helen Ouyang: Oh my God. We need to talk more about that. That's amazing. That's why we're chatting now.
Bon Ku: Yeah.
Helen Ouyang: Yeah. No, I definitely was not a science person, but I was taking a writing class in seventh grade, and we read these stories by Richard Seltzer. I don't know if you've heard of him. He is, was he, he died a few years ago, but he was a surgeon at Yale and he wrote these beautiful stories, and one of them we read was about his work in Honduras.
He was a plastic surgeon, so he went and fixed the cleft lip of a child and the child actually died on the table while he was doing the surgery and he really felt like he owed it to her family and her mother to fix it. So he actually in the middle of the night, goes down to the morgue and finishes the surgery so that they could see her face.
And that story, I don't know, it's just stuck with me. And I was like, I want to work overseas too, and I guess I'll just have to be a doctor too. So I went into medical school really to do humanitarian work, which I did for many years. And then sort of pivoted more to writing.
Bon Ku: Where were you working when you work in a lot of countries? Did you work with nonprofit organizations in different countries doing relief work?
Helen Ouyang: Yeah, I worked with a lot of nonprofits. I also worked with the UN, And also academic institutions. So I got a pretty decent survey. I think
Bon Ku: Yeah. And how do you find time to write during the day? Because you have a busy day job working in the emergency room and being an academic physician. And did you have to go to more schooling to learn how to write, or you just have always been a writer?
Helen Ouyang: I think the best way to learn writing is with a great relationship with your editor and with each story that I write, I feel like I learned so much. I also audited a few classes at the journalism school, which was very helpful too, like just workshopping with other students there. But it's, hard. You have to make time. And I work mostly weekends now at this point. So I can have time during the week
Bon Ku: You're one of those doctors you work only weekends, clinically
Helen Ouyang: pretty much.
Bon Ku: is your family a family of writers or physicians?
Helen Ouyang: Neither. I'm the first doctor in my family and the only doctor, I guess, So, Yeah, no, I think nobody isn't either. I did not grow up reading the New Yorker. I am envious of people who read the New Yorker and talked about their families at the dinner table, cuz I did not come from a family like that.
And back then, you know, there really wasn't the internet, so you had to like, know about something to seek it out. It didn't come to you.
Bon Ku: Your family's Chinese, is that right? Yeah. Yeah. My family did not read the New Yorker at, at all. And what do they think about you your current path of being a physician and being a writer. And you've published in so many national outlets?
Helen Ouyang: I am not sure if I fully understand what I'm trying to do.
Bon Ku: that's so typical of Asian families,
Do you have advice for people listening who may be in a medical field and want to write more. Do you have any tips for them?
Helen Ouyang: That's a good question. I, think this sounds very basic, but I think just start writing
Bon Ku: Hmm.
Helen Ouyang: You don't need to take a class. I think you can just start writing from your experiences as a starting point and go from there.
Bon Ku: And there's so much material that, that we have as physicians of the human stories that we get in our jobs. I think that's why a lot of physicians write, cuz there's so much material that we have in our day jobs.
Helen Ouyang: Yeah, that's true. But I try not to write too much about my day job and my patients. I think just to have some separation.
Bon Ku: Yeah
Helen Ouyang: Also for the patient's sakes,
Bon Ku: I read another article that, that you wrote. You, you have a lot of them, but it was entitled, can Virtual Reality Help Ease Chronic Pain? And have the stat there that 50 million Americans live with chronic pain. I'm curious to know how you chose this topic and and can you describe some of the most interesting things that you found in the space of, using VR to treat chronic pain?
Helen Ouyang: Well, you know, Bon, you're, you're an emergency physician. I mean, chronic pain, we as doctors, we don't know what we're doing, right.
Bon Ku: No, and it's one of those chief complaints that is the ones dislike the most because I don't, I don't know how to treat chronic pain. I know how to treat acute pain.
Helen Ouyang: Exactly. We don't know what we're doing. First, we're giving opioids, then we're saying too many opioids. Take them away. Well, what are we giving them instead? We don't know.
So, You know, I've just always been fascinated by chronic pain for a long time. And then, all this research has come out that a lot of it takes place in the brain, but that's not how we treat it, right?
We treat the body. So I just started to look at that. So if it's takes place in the brain, or the brain plays a huge role in it, why is that not where we are going with our treatments?
So, I mean, there are some, there's deep brain stimulation that people are doing implants. So when I found the virtual reality people and that they were really targeting the brain, I was fascinated by that.
Bon Ku: Can you describe what exactly that means at distinction between acute and chronic pain? So let's like take a case of someone who maybe broke their arm and they have acute pain and it'd be appropriate to treat that with opioids. But then a year later they still have pain at the fracture site, but that's not coming from that acute injury.
Helen Ouyang: right? So. There's sorts this phenomenon of central sensitization, which is that the nervous system gets involved and they amplify these pain signals abnormally, so your body thinks something's still wrong. The alarm alarm signals are still going off, but really, you're okay. You're safe. The fracture, as you described, has healed. But the brain is still sending out these pain signals and we aren't treating them
Bon Ku: Hmm. And how effective is VR technology for chronic pain?
Helen Ouyang: Surprisingly . It seems quite effective. I am not. I don't know about you. I am not a virtual reality person. I had never really, maybe I had done it one time before. I was
reporting this
Bon Ku: I, have some experience with it. We have some VR headsets in our lab, but I have not gone through one of these modules of that, you write about some startup companies that have an intervention for chronic pain so I have not participated that myself.
Helen Ouyang: Yeah, so I, I didn't, wouldn't say I came to it as a skeptic, but I was not an enthusiast about this. And then I was just seeing these patients. Putting on the VR goggles and having these profound experiences, people crying into the headset. So it definitely was doing something. And then the studies showed how that they were pretty effective. And even three, six months after they were done with the VR module, it seemed to stick around the effects.
Bon Ku: That's amazing and it's FDA approved, right?
Helen Ouyang: Yeah, they don't really approve it. They sort of authorize it. So it's the authorized Applied VR was the first company to sort of go through for chronic pain specifically, so kind of paved away for other companies.
Bon Ku: Yeah. I am a little skeptical too of this technology, but reading your article is like, oh wow. It makes sense of why it would work. Do you think it is gonna become commonplace or another tool that. A doctor has in their toolkit to treat chronic pain?
Helen Ouyang: I mean, I hope so. I, when, so when I went to Cedar Sinai, they were trying to do in the emergency room, which I think final. Yeah. Finally they did now. But I just, the thought of our chaotic er in these VR goggles,
But you know, they're slowly doing it and I mean, I think we might get there someday. I mean, I, I think people, because of Meta and everything, maybe people have become a little bit doubtful about technology or maybe it's overhyped, but I think there is a role of using it.
Bon Ku: Oh, that's, that's amazing.
one question that I love to ask our guests is, if a listener were to come visit you, where would you take them out to eat?
Helen Ouyang: Well, I used to live in a West Village, so I would say Cafe Clooney, but now I've moved to Brooklyn, so I will give Bernie's a shout out, but that's also because it's a few blocks for me.
Bon Ku: Awesome. Awesome. Bernie's, how do you spell that?
Helen Ouyang: B E R N I E s,
Bon Ku: Cool. Cool. We'll, we'll put a link to the restaurant in our show notes for those who are visiting Brooklyn and may want to check Helen's recommendation out. Well, I, I look forward to reading more articles from you. Can you give us a tease of what might be coming up in the future, or is that like secret information?
Helen Ouyang: It's top secret information.
Bon Ku: Well, you could, you could follow Helen on Twitter. We'll put her handle. In the show notes and when her next article drops, read it. Thanks Helen for coming on the show.
Helen Ouyang: Thank you so much.
Bon Ku: Check out Helen's article in the New York Times, there's a link in the show notes. You can follow her on Twitter at D R H E L E N O U Y A N G.
And you can reach out to me on Twitter at B O N K U and on Instagram at D R B O N K U.
Design Lab is produced by Rob Pugliese, editing by Fernando Quieroz. Our theme music was created by Emmanuel Houston and the cover design by Eden Lew. See you next week.
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