{"schema_version":1,"assessment_id":"eoa_inverse_innovation_exp03_opportunity320_20260801","source_experiment_id":"eoa_inverse_innovation_exp03_full320_20260801","cell_id":"negative_space_design__medicine_healthcare","archetype_slug":"negative_space_design","domain_slug":"medicine_healthcare","title":"Reversible negative-space focus view for time-critical EHR review","opportunity_summary":"The candidate proposes reversibly demoting verified secondary EHR content and protecting visual space around current critical changes, with immediate reveal-all recovery. It addresses a potentially consequential attention problem and has a safe synthetic-case test, but demand, prevalence, classification reliability, comparative benefit, and distinctiveness remain unestablished.","adopter_authorizer":"A hospital clinical-informatics authority, jointly gated by patient-safety, nursing, pharmacy, accessibility, and relevant clinical-service leadership; individual clinicians retain treatment authority.","scores":{"meaningful_impact":{"score":4,"rationale":"If present critical information is being missed or recognized slowly because of display competition, improving recognition could materially affect timely and accurate care. The candidate does not establish how frequently this mechanism causes consequential errors, so the maximum score is unsupported."},"stakeholder_pull":{"score":3,"rationale":"Clinicians, patients, and safety and informatics teams have clear stakes in timely recognition, and the problem is framed in operational terms. No interviews, requests, observed workflow evidence, purchasing interest, or adoption commitment are supplied."},"incremental_advantage":{"score":3,"rationale":"Protected absence and reversible demotion offer a testable contrast with both the dense baseline and an additive-salience rival. Whether this improves detection without degrading context comprehension or dense comparison is wholly hypothetical."},"distinctiveness_plausibility":{"score":2,"rationale":"The protected-space, labeled-hidden-state, reveal-all, and urgency-restoration bundle is articulable, but the packet explicitly leaves prior art unsearched and identifies possible overlap with focus views, progressive disclosure, hierarchy redesign, and alert management."},"technical_implementability":{"score":3,"rationale":"A disconnected prototype using synthetic cases appears technically bounded, and reversible display states are specified. Safe operational implementation depends on reliable task-specific criticality classification, responsive and assistive-display behavior, and EHR integration, none of which is demonstrated."},"adoption_authority_feasibility":{"score":3,"rationale":"The candidate identifies both the institutional authorizer and the required clinical, safety, pharmacy, nursing, and accessibility gates. That clarity helps, but the number of joint gatekeepers and the intervention's potential to conceal information make production authorization demanding."},"evidence_readiness":{"score":4,"rationale":"The packet supplies a randomized three-arm synthetic-case design, explicit outcome families, problem and intervention falsifiers, excluded actions, and halt criteria. Case adjudication, measurement thresholds, sample design, and classification rules still require specification."},"safety_net_benefit":{"score":3,"rationale":"The intervention could serve as a safety layer against overlooked present information and explicitly includes accessibility and equity objectives. It could also hide needed context or perform unevenly across accessibility subgroups, so net safety benefit is unresolved."},"scalability":{"score":3,"rationale":"A software display mechanism could in principle be reused across review surfaces, but criticality rules, workflows, governance, screen constraints, assistive technologies, and integration requirements may require substantial local adaptation."}},"score_confidence":"MODERATE","costs":{"first_evidence":{"band_2026_usd":"50K_TO_250K","scope":"Design and conduct one bounded randomized usability study comparing the dense baseline, an additive-salience rival, and a reversible negative-space prototype with representative clinicians and adjudicated synthetic cases.","confidence":"MODERATE","assumptions":["No live records, treatment decisions, or production EHR connection are used.","The band includes prototype design, clinician recruitment and compensation, synthetic-case adjudication, accessibility participation, analysis, safety review, and partner coordination.","The study is conducted at one institution or a similarly bounded research partnership."]},"initial_deployment_startup":{"band_2026_usd":"250K_TO_1M","scope":"Prepare a tightly limited, reversible, non-autonomous implementation for one institution after favorable synthetic evidence, including integration design, classification governance, security and accessibility validation, and rollback controls.","confidence":"LOW","assumptions":["The host EHR permits the required presentation-layer integration without replacing core clinical systems.","Deployment remains limited to selected review workflows and does not automate clinical decisions.","Vendor fees, interface complexity, and the amount of custom rule engineering are unknown."]},"operational_launch":{"band_2026_usd":"1M_TO_5M","scope":"Launch a production-capable intervention across multiple clinical services at one health system, including validation, change management, training, monitoring, governance, support, and staged rollout.","confidence":"LOW","assumptions":["Evidence supports deployment and institutional authorities approve it.","Service-specific content rules and safety validation are required.","The scope is one health system rather than a multi-vendor or national rollout."]},"annual_recurring":{"band_2026_usd":"250K_TO_1M","scope":"Maintain classification rules, integrations, accessibility behavior, monitoring, incident review, clinical governance, user support, retraining, and regression testing for one health system.","confidence":"LOW","assumptions":["Clinical content, workflows, and EHR releases require continuing review.","Dedicated informatics, safety, accessibility, engineering, and support effort remains necessary.","No exact vendor licensing or data-access terms are known."]}},"research_burden":"HIGH","earliest_credible_horizon":"3_TO_12_MONTHS","pipeline_gates":{"recognizable_externally_supportable_problem":{"status":"YES","reason":"The sealed candidate defines a specific, observable problem—present critical information competing with equally weighted content—and provides a direct falsifier using recognition time and miss rate across density levels."},"identifiable_adopter_or_authorizer":{"status":"YES","reason":"The hospital clinical-informatics authority and its patient-safety, nursing, pharmacy, accessibility, and clinical-service co-gates are explicitly identified."},"distinct_testable_incremental_claim":{"status":"YES","reason":"The candidate claims that reversible demotion and protected spacing can outperform both the dense baseline and additive salience without worsening context comprehension, recovery burden, or subgroup outcomes."},"bounded_next_evidence_step":{"status":"YES","reason":"A randomized study with representative clinicians, synthetic cases, three specified interface conditions, no live-care use, and explicit halt conditions is authorized."},"no_unresolved_safety_or_authority_stop":{"status":"YES","reason":"The proposed first step avoids live records and care decisions, preserves clinician authority, excludes concealment of enumerated safety-critical content, and supplies immediate rollback and concrete stopping rules. This finding applies only to the bounded study, not production deployment."},"implementation_cost_scope_and_range":{"status":"UNCERTAIN","reason":"The first study is sufficiently scoped for a broad resource band, but production cost depends on unspecified EHR architecture, vendor access, number of workflows, classification-rule complexity, sites, users, and governance requirements."}},"blocking_evidence":["Whether display competition, rather than missing data or workflow conditions, meaningfully affects recognition time or miss rate in the intended review tasks.","Whether critical and secondary content can be classified reliably without suppressing evidence needed for comparison, context, or situation awareness.","Whether the prototype outperforms both the dense baseline and additive-salience rival without increasing misses, slowing action, degrading context comprehension, or increasing reveal-all recovery.","Whether accessibility subgroups, screen sizes, responsive layouts, and assistive technologies preserve the intended benefit and avoid disproportionate harm.","Whether the proposed bundle is meaningfully distinct from existing focus views, progressive disclosure, hierarchy redesign, and alert-management approaches."],"next_evidence_step":"Predefine and independently adjudicate criticality and concealment rules, then run the authorized randomized synthetic-case study with representative clinicians comparing the dense baseline, additive-salience rival, and reversible negative-space prototype. Measure critical-item detection, recognition time, context comprehension, concealment errors, reveal-all recovery, and accessibility-subgroup outcomes; falsify advancement if the prototype lacks comparative benefit or worsens any safety outcome, and halt immediately for a concealment-attributable safety-critical miss or failed restoration.","research_questions":["Does display density independently affect recognition time or miss rate when all necessary clinical information is present and correct?","How reliably can reviewers and predefined rules distinguish safely demotable content from information required for comparison or situation awareness?","Does protected negative space add benefit beyond conventional color, icon, bolding, or ranked-salience changes?","What frequency and type of reveal-all recovery indicate that the prototype is hiding too much information?","Do effects differ by clinical role, expertise, task, accessibility need, assistive technology, screen size, or responsive layout?","Do users ever interpret deliberate blankness as no data, completed work, or absence of risk?","Which elements of the intervention bundle, if any, remain distinct after targeted prior-art research?","What integration, governance, and maintenance scope would a specific adopting institution require?"] ,"recommendation":"PARTNERED_RESEARCH","uncertainty_constraints":["Closed-book assessment provides no external evidence of problem prevalence, stakeholder demand, realized clinical impact, market size, or adoption willingness.","Prior art is explicitly unsearched, so novelty and competitive differentiation cannot be inferred.","No effectiveness, classification-reliability, usability, accessibility, or workflow evidence is supplied.","Cost bands are resource-equivalent scenarios, not quotations or point estimates, and production assumptions are especially uncertain.","A safe synthetic study does not establish safety or authorization for connection to live records or clinical use."],"closed_book_prior_art_boundary":"No conclusion is made about novelty, prevalence, market position, or existing implementations. The assessment distinguishes only the candidate's stated protected-absence and recoverability bundle from its stated additive-salience rival; external research is required to determine overlap with EHR focus modes, progressive disclosure, information-hierarchy redesign, alert management, or other prior art."}