How design can save the health care delivery system

The health care delivery system needs help. And, according to the design and innovation consulting firm IDEO, design is one way to improve the system without a massive -- and costly -- overhaul.
Written by Christina Hernandez Sherwood, Contributing Writer

The health care delivery system needs help. And, according to the design and innovation consulting firm IDEO, design is one way to improve the system without a massive -- and costly -- overhaul. IDEO designers use a combination of mindset and process to engage with complex challenges, said David Webster, leader of the firm's health and wellness group. They call it "design thinking."

"Design thinking is this process we use to understand what matters to users," Webster said. "When we're talking about health care, that could be the patient or the physician or the nurse or the hospital administrator or any other user. We creatively use the insight we've gained to come up with solutions. We do that from an experienced design perspective."

I spoke with Webster last week about how design can help health care solve some of its biggest problems and about how IDEO has already transformed patient experiences at some of the country's most well-known health care providers. Here's the first of our two-part conversation.

What's the role of design in the health care delivery system?

The biggest thing that springs to mind right now is that on some fundamental level [design] can change the system and realign it around the patient's needs. The fact of the matter is the health care system really isn't aligned around the patient. It's got a lot of legacy and demarcation and a lot of reasons why it's configured around medical disciplines and organizational entities. The most significant thing design can do within that system is start to put the patient's experience at the center again. It can do it in relatively immediate and pragmatic ways without requiring the whole system to change. The system is massively complicated. The good thing about design is that it can cut through all that noise and, at a fairly rudimentary level, make it all about humans again.

All the people we encounter who work in health care want that. Health care remains an incredibly noble profession and people involved in it care profoundly about the patient and the outcomes. They're as frustrated as anyone by the system. There's an unusually receptive audience for anyone that can insert a way of configuring around the patients again. That's what we try to do.

Is the importance of design in the health care delivery system increasing?

More recently, the importance of design has grown. It's still growing. Business as usual is not an option. Innovation in the system is a necessity at this point. We've got this big convergence of factors pressuring the system. There are any number of parameters that can create a perfect storm: cost, deteriorating access, aging population, the rise of chronic disease. Each of those could disrupt the system in its own right -- and they're arriving together. The system can't flex to accommodate those stresses anymore, so innovation has to happen. Design thinking as a catalyst for innovation is therefore increasingly significant.

Design has always been there on some level. A client of ours, a physician, once said that physicians share many of the same traits that designers have: empathy, curiosity and positivity. The system has been receptive and predisposed to design. It always has. But it seems like we're at a moment where things are ramping up and it's much more significant.

The evolution of design is important. Fifteen years ago when I was starting out as a designer, design for health care was mostly about discrete objects: tools, medical equipment. We still love to do that work, but design has evolved to the level of designing experience. We're thinking about strategies and systems. Design can work much more comprehensively. It's a way of engaging with complexity in pragmatic, optimistic terms. There's a lot of opportunity to make a difference easily. You don't have to fundamentally redo the system to make a difference with design. You can just remove some of the noise and refocus on the fundamental human experience aspects and it makes a huge difference.

Let's talk about a specific example. What problem did the American Red Cross ask IDEO to solve and how did you use design to solve it?

The issue was how to motivate people to donate blood and repeat donate. We start projects by taking time to figure out what the situation looks and feels like to users. We've got people who we call 'human factors experts.' Those are social psychologists and anthropologists who are expert in a subtle way of understanding what matters to people as they go through an experience. You don't directly ask people what they want. You have a conversation with them and observe subtle cues that point to inclinations or subconscious preferences. You use those insights as a starting point for design.

We noticed an interesting thing when people were going through the blood donation experience or even encountering the idea of donating blood. The language and the way the idea was communicated was all about the high-stakes outcomes: 'You can save a person's life.' 'Their life is in your hands.' It was almost a little too high stakes and too impersonal for people to engage with. It felt a bit too much like duty. We immediately [thought about what we could] do to change the focus from this abstract notion to the much more personal notion of: 'Here's the story of an individual like you and why they choose to give blood.' We made the conversation more about the donor and celebrating them as an individual. We literally put [their stories] on the walls in places where individuals are waiting to donate or are recovering from donating. It made the experience much more personal.

We also improved the basics of the experience. The Red Cross has limited resources and has to make a high school gym a venue for giving blood. We did a lot of redesign of the equipment and the screens they use and how to configure the space. It improved the flow and made it a more pleasant, relaxing, private experience for individuals.

I read the re-design was modeled on cafes versus a clinical atmosphere.

Yes. We tried to bring in cues in terms of the way the space was laid out and used. We tried to make it more like a cafe than a clinic and to allow people to conduct themselves on those terms. The catalyst [was] individual stories and allowing people to potentially share stories when they're waiting or recovering from donating.

That's a big theme. Across the system, there's something around this idea of engaging people on their terms. It's re-tweaking and re-framing an existing experience. Consumer health is a huge topic for us at the moment -- this idea of the migration of expectations from the consumer world to the health care world. If you think of what's normal and typical of the kinds of experiences you can access as a consumer, it's very real time and on your schedule. It is ubiquitous access. You get to shape the experience much more.

If you look at the experience of engaging with health care, it's stuck in another era. Apple seamlessly blends together iconic product, intuitive interactive experience, online access. That's the new expectation. That's how people expect their experience to be and it increases the gap between the consumer experience and the health experience. A lot of what we talk about now are what are ways we can introduce more control, more empowerment and more preference into the health care experience.

Coming Thursday: The role of design in health IT, how design can drive down health care costs and more IDEO health care projects.

Photo, top: David Webster

Photos, middle and bottom: IDEO project for the American Red Cross

This post was originally published on Smartplanet.com

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