Interview with Peter Jones, Part I

Peter Jones's new book, Design for Care: Innovating Healthcare Experience, is on sale now! Use discount code RMBLOG for 20% off the original price in our store.

We sat down with Peter to ask him a few questions about healthcare and the design process. Here's what he had to say:


peter-jones.jpgRosenfeld Media: What's the book about in a nutshell?

Peter Jones: Design for Care is the book I would have wanted when starting in this area almost 10 years ago. It deals with the complex intersection between healthcare and the services of design. The book leans heavily toward what designers need to know about healthcare, which is the harder to learn stuff than design method. So I focus on three major design approaches. I deal with information use but not so much informatics, which has its own deep literature. My approach to service design is a "care systems" approach, which is needed in clinical practice design. And I focus on system design of care organizations and processes (healthcare institutions are called that for a reason, they are very structured).

I designed it as a guidebook for design professionals to navigate across the conflicting and confusing perspectives, methods, and current issues in healthcare services. While it's not truly comprehensive—health is a huge field—it covers more ground than any prior book. The other audience is healthcare professionals. They have to learn about the practices, tools, and validity of design and design research before they will fully sponsor and work with us as members of the care team. So I've sacrificed emerging technology and more risky design practices to focus more on fundamental cases to which I had direct access. There's a lot of creativity in the design research methods, where I've selected some unique but highly validated tools for sharing with these audiences.

Are you advocating a design process for healthcare, or is there a different meaning to care?

PJ: The book is not a single design process, it's a series of frames that fit each of the sectors I chose. Each frame has an application, a bit of theory and a central case study I selected three broad sectors—consumer, clinical practice, and institutional - and these have their own slices that follow a patient's journey through the system.

Technology, as many believe, does not "drive" healthcare practice. At the very heart of things, "care" drives healthcare, and that's the ultimate focus of design work. Making sure care happens, to serve patients, families, communities and the caregivers. Healthcare is a human system all the way through, full of the heroics and messiness of taking care of people. In my view, the humanity of practice explains why the field seems so far behind. Doctors, nurses, staff, everyone on the front lines are working directly with and on patients and their stakeholders. Technology can always be worked around, mediated, fixed over time. Nobody ever held up care because an EMR wasn't working right. So the "user demand" for design excellence is not a big driver, yet. Better usability, information workflow, and service flow will save lives—but it's not an immediate save. Care delivery comes first.

RM: Where is the "Care" in Design for Care?


PJ: I found that every one of my stories and chapters had a different take on the meaning of care in its context. In a technical sense, it means the delivery of clinical services by professionals treating a patient's health concerns. In a social sense, care is the meaning of human concern for another's well being. In the design sense, I see our purpose essentially in helping caregivers innovate. Helping care happen, designing for the experience of the one being cared for. To me that not only includes what we call patient experience, it means whole families and communities and circles of care. And to a great extent that means making the work of caregiving and care practice more humane, safe and engaging. Clinicians to a great job of care while coping with constant workarounds. Rather than just fixing the sources of problems (such as wait times), the big design contribution will be to lead innovation for new integrations of technology and workflow practices.

With the strong practices of empathic design now, I think design practice has a stake in this practice. But to earn our rights, design must practice in the field, practitioners should be dedicated to healthcare as other care professionals are. Otherwise we'll just be hired guns creating efficiencies.

Our society and institutors are very ambivalent about actual caring. We give lip service to "being caring" but its not a strong North American value. Consider that most caregivers—family members—are not socially valued, are never paid. Yes, doctors are among the highest paid professionals, but it's due to risk and technical proficiency, not care. The real clinical carers are nurses, and they have always fought for equality. There's been a turn in social philosophy recently that should help make a case for designing as care professionals. Riane Eisler writes about the caring economy in the Real Wealth of Nations, and advocates a paradigm shift toward a "caring economics" that treasures the real value of human relationships, communities and national well-being. In the book I cite Milton Mayeroff whose view is both simple and profound, where care is a strongly local, felt understanding that actively seeks to help another person grow. I believe designers can fulfill that role with others in "care delivery" and health services. We can help others to grow and if not always help the healing process, we can design better artifacts, systems and places that provide care safely, attentively, and universally. We need to be working with clinical teams and "caring providers," but yes, designers can help bring the inherent care values in healthcare to the center, making them understood, within our services and clinics.

RM: Thanks, Peter!

Stay tuned for Part II of Peter's interview next week! Pick up a copy of his new book, Design for Care: Innovating Healthcare Experience, and use discount code RMBLOG for 20% off!

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