Day 1: Designing Health: Integrating Service Design, Technology, and Strategy to Transform Patient and Clinician Experiences

— Thank you so much for having me today

• Super-excited to share insights in healthcare and integrating service design, technology and strategy to transform patient and clinical experiences

— Here’s and overview of what a typical week looks like for me in healthcare

• I’m often in-session doing service design blueprints
• Or I’m in the the field testing the technology-patient role

— And on the weekend I’m taking time to take care of myself, and if you have someone to help you go through it all the way, that’s a big help too

— For those who are starting work in healthcare, I’ll give lay of the land, and what is going on in healthcare as industry with a rapid transformation in clinical workspace

• Ways to optimize workflows and automate admin tasks they have to spend time with patient

— Service expectations have changed, resulting new ways to design in healthcare

— Let’s have a brief statement on why it’s hard to design for health. Three main things:

• Priority of service to make sure patient is stable and safety is number one priority— if a person’s organs are not functioning, we can’t address patient problems
• Any change we make to experience, due to complexity of structure, can mean difference between life and death, with timing being everything
• Design itself is not business as usual— We are often raising hands, but perceived by those in charge as people who are introducing high risks to the business
  • Any change we make can have severe consequences for the patient

— So three types of strategy, which I’ll discuss, and provide an example of. They are:

• Top-Down Strategy
• Sideways Strategy
• Across Strategy
• Start with providing the service engine of healthcare, and how service designer fits into a bigger role

— So, how does it work?

— Here are the components to break down for the healthcare service engine

• Top layer: Health system infrastructure, where you are inserted in, all facilities, policies, equipment, and tech available that system is providing for specific area or region
  • Leadership teams also provide operational change, technological change and clinical change— in addition to business strategists with tech or clinical operational teams. All part of same infrastructure
• Middle Layer: The service encounter
  • All touch-points in healthcare come down to this interaction between patient provider and patient, and patient-clinician interaction that can either save lives, or improve their health outcomes
  • Encounter crucial to service experience
  • Many layer of complexity to interaction— i.e. can the patient talk? Can clinical staff members help in setting up operations, appointments or service encounter and for specific moments?
• External Forces Layer: Things that might play role after encounter like healthcare laws, billing, etc.

— Service engine elements combine into service encounter that make or break healthcare experience and combine to a specific moment in time

— First strategy is top-down

• Top-down health system decisions, and way for how service encounter might look like

 

— Sideways strategy is a cross-disciplinary collaboration with corporate employees driving execution

• New policies, tools, clinical workflows, etc.

 

— Across Strategy: Middle Management and frontline work across all layers that make experience

 

— Designing for health multi-dimensional. And this is not easy

• But having idea of inspiration and top-down, across, sideways, and leveraging approach can provide transformational experiences

 

— First case study covering these strategies deals with designing an in-take process and helping figure out how org shaped pipeline of new requests or technology in way

 

— Standard workflow for this process, big picture discussions, evidence of need, before committing to digital solution

• But how to do this in large org of 88,000 employees?

— I borrowed things from the service design playbook with a twist

• 101 check-ins to build rapport with stakeholders across the org— focusing on execution, and having small work-sessions to understand stakeholders have different agendas and validate an approach
  • Process map story or situation, and wireframes can help people interact with specific thing across org

— Success involved telling a story and validating it, as opposed to process map, which can do well

• Engage with people and build rapport to make sure everything put together in way meaningful to org

 

— Example of secret sauce of project

• Participate in key meetings, even though they are not led by design team, and listen to leaders

— Be there and have space to ask question, and showing progress over perfection, helps you buy into process and understand best time to bring people together

• That way you can integrate workflow in overall company pipeline

— For sideways strategy, I’ll focus on how to build inter-disciplinary allies

— Asked to design internal framework and tool based on technical vocabulary and main source of truth

• Goal to design internal facing tool that would augment a nurse outreach program for patients, and automating admin tasks without losing human connection

— Example of framework build and structure created for conversations to get digital requirements for tool

• For people who have used CRM [Customer Resource Management] systems, we’ll reference problems, goals, and tasks framework
  • Borrowed from CRM methodology as IT and developers were familiar with that and brought up to patient or navigation need, and what would be the task for how it would work

— Example: Problem of patient needing chemo, so what would be their navigation goals

• Goals: Check in with patient through treatment
• Tasks: What’s needed to achieve goal, and solve for problems, i.e. create an auto-reminder for patient

 

— Example of what it looked in workshop and used framework and problems, goals, and tasks to be validated and what programs should have for digital tool

 

— Last example related to prototype strategy , focused on all levels of org to simulation sessions, and anyone who went through training in org

— Reimagine key moments in emergency visit, and make people like person they were interacting with while reducing clinical burden

• Making sure what was produced was replicable across regions
  • As well as set-up local team for pilot

— How was this done?

• Actual simulation sessions, based on what key moments were and validating with key stakeholders appropriated participant groups per moments, and creating flexible schedule to participate in sessions
• Flexible space
• Wrote scripts, and standardized patients trained to portray patient situations

— Also created training protocols for pilot and illustrating how to make or break experience

 

— Not only ingredients, but designer recording a session and for each moment, inviting clinician and prompt with goal and all creative freedom for specific moment

• Each session recorded, and videos informed training protocols from the Learning and Development department

— Work has been published in Springer as an academic work

— Will leave with some reflections, and take them with yourself and team and how to apply each strategy

• For top-down: How can you shape org pipeline?
  • Any shape or form that employee from team can be present
• For sideways:
  • How do you create ID for framework for solutioning, or something in company and shared space
• For across:
  • Did you invite others to prototype service interactions, without being in live environment, but real interaction that might happen in real world

 

 

— Thanks, and props to Patrick O’Connor for illustration, and Rosenfeld Media for conference, and wish you great rest of conference

Questions

1. What are ways to select tactics from three-dimensions of change?
   1. Depends on how request comes to team and higher leadership level and sensitivity of things and get it down
      1. Leveraged org resources to do it for top-down strategy
   2. Sideways strategy is still going on, to initiate and create a foundation
   3. An across strategy, came top-down and given budget to play with and innovation budget for creative freedom
   4. Still are unknowns on how things are today.
   5. Need to know environment and how request and resources given to you and making best of it
      1. Reading situation and making choices as needed
2. What are conditions you look for that let you lean towards one strategy over another?
   1. In healthcare, can’t interact in live environment, so can’t test things there and have remix of that
      1. Clinicians and nurses from pilot team and started small. Lot of sensitivity and it is hard to bring customer into making — so analogous scenarios in other industries
3. Some ways you offset bias that simulating with standardized patients creates?
   1. We have to keep testing, and rely on multiple rounds, and L&D team designed training in pilot and had creative freedom to change protocols to way they thought it was best
4. Mentioned attending other key meetings, that you don’t directly facilitate. What are you doing in lean-back mode for these meetings? When do you intervene if you feel off-track?
   1. Taking notes of the meeting, even with AI tools, helps you summarize next steps and gap in conversation, helps you get window for steps in conversation
      1. Helps get your voice heard, as people see you are paying attention
   2. Puts designer in role of business partner— by how they ask through clarification
   3. Translation between notes and action items, will give window to promote work and what you should do for the organization
      1. Don’t have to leave meeting to ask clarifying questions and playback things as other people need that clarification
5. What patterns are you seeing and success for multiple projects, and state of state for work?
   1. Ever evolving and keep self in check, as work is experimental
      1. Since experimental process, we need to know if business has appetite for experiments and in right vertical to cause good trouble
   2. Also, when patterns seen is people want to help and make things better
      1. Need to put self in their shoes and what people want and need and what they ahve done before
      2. Design is not blank slate, but bringing together what else wasn’t done and respecting legacy of what was done before
         1. There is a lot of hard work by a lot of people who tried to solve for things you are solving for
         2. You are one piece of puzzle to make things better