If you want to know what’s ailing the U.S. health care system, just ask the person next to you. Chances are, she’ll have a personal horror story to share about outlandish costs, inaccessibility of care, the regulations strangle on innovation, the battery of tests that physicians order out of fear of lawsuits, and on and on. The goal of the Healthcare Experience Design Conference (HxD) held in Boston recently was less about dissecting these problems and more about how we can start solving them. In the keynote address, the U.S. Chief Technology Officer Todd Park called on designers to participate in a "self-propelled, open ecosystem of innovation." As people invested in improving health care through design, we were excited to hear it.
The conference, in its second year and organized by Mad*Pow and Claricode, brought together voices from the health care and design industries to grapple with big ideas in health care. Ranging from the eye-opening health implications of current U.S. food policy to the potential of open-source data to transform the way we experience health care, the day’s talks invited plenty of debate and spirited discussion. Common across all sessions was human-centered design’s role in improving the way health care is delivered and experienced, with a few key themes that we think merit special attention:
If we’re redesigning an outpatient experience, we need to involve everyone, from the practice manager to the receptionist, in order to understand what their roles are and, more importantly, how those roles interact to create the experience patients have when they need care.
If we’re dealing with food, we should involve not only the farmer and the concerned parent but the industrial food producer as well. Many know the statistics indicating that our food is making us sick, or are appalled by the moniker "Generation Rx." But in order to design a better future, we need to hear from all stakeholders. Bring the snack food company or the pharma giant to the table. These groups want to be included, and let’s face it, we need to acknowledge their influence, even if the ultimate goal is to move beyond it. Without taking the time to understand all points of view (even from the oft-maligned "bad guys"), we’ll never arrive at a solution with enough buy-in to become real.
Since we can’t always prevent failure, especially when trying to help people make significant changes to their behavior and health, we must accept that failure is going to happen and design for it. Setting impossible expectations on a patient, and then "shaming and blaming" when they can’t meet them, or weighing patients down with so much information that they become overwhelmed, is not sustainable. Supporting success is good but insufficient. From medical devices to long-term drug treatments, we have to design safe ways to recover from failure.
We can create controlled stops for undesirable behaviors, give people ways to start fresh, remember that human capabilities are limited, and design for evolving needs over time. The patient just diagnosed with HIV needs something different than the patient who has been living with HIV for 10 years, even if they are both on the same drug regimen. A doable solution is more effective than a perfect solution that gets abandoned because it’s too hard. When we let people fail and don’t give them a way to recover, we fail them as designers.
Of course, reducing the incidence of failure is not a bad thing, and there are effective ways to do it. We can take advantage of "motivation waves," the social scientist BJ Fogg’s term for the temporary window of opportunity in which people can actually do hard things. The big takeaway: Use motivation wisely. Be smart about where you ask people to direct their energy when motivation is high, and guide them in how to do it. Facilitate sustainable change by structuring future behavior, reducing barriers to good behavior, and taking baby steps to increase capability. Meet patients where they are, rather than where they "should" be, so they won’t give up when faced with something that’s too hard or doesn’t work.
"Data" was a buzzword at HxD, thanks to Todd Park and others who brought home the point that while there is no shortage of health data being generated, the numbers need to be better understood and distributed for anyone to benefit. Park aspires to make health care data free and easily accessible, in order to fuel innovation and unleash "awesomeness." If this is your thing, be sure to look out for his next "datapalooza" so you can get in on the fun and help rid the world of such absurdities as not being able to access your own health records.
Mitch Higashi of GE Healthcare joined a chorus of speakers in noting that the next big challenge in health care won’t be about research, technology, or economics but about making data more visual, so that people can actually use it to make complex decisions easier. Rather than poring over Excel spreadsheets, we should be able to use data visualizations to help decide where to put the next hospital to save the most lives, or how to best treat low blood sugar. Perhaps this can be best summed up with the sentiment that while information is cheap, understanding is expensive.
To reiterate a conference theme, you have to know your user—and anticipate his or her needs. Gaining a holistic and contextual understanding of the people you’re designing for will help ensure an experience that will resonate. Meredith DeZutter, from the Mayo Clinic’s Center for Innovation, pointed out that our current models of care are largely the result of the social and economic forces that shaped the attitudes of patients in the early part of the 20th century and that today’s patients live in a different world and expect very different things from their health care.
Historically, the health care debate has focused on the sickest patients and those with chronic conditions. But we shouldn’t overlook the fact that the bulk of patients seek basic medical care: an annual physical, a simple procedure, or other less dire needs. We can’t only design around the most complex cases; one size doesn’t fit all. DeZutter also discussed how increasingly, health care is about connections, not spaces and tools. Families expect to be involved in the care of their loved ones, multiple specialists may need to coordinate, and data must be shared among institutions. Relationships and networked communication are the backbone of health care in the future.
Keeping all of these themes and guidelines in mind can seem overwhelming in its own right, but the important thing to take away is that health care is changing—quickly—and the role of design in health care is becoming more visible and more powerful. The real question is what are we, as designers, going to do about it?