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Except for calling the fax machine obsolete (kidding, see below), Tim Brown of IDEO gets this one exactly right.  Design thinking will be an important part of ridding waste from our health care system in the short term (that 30 percent figure we continue to hear about).  Ten years on (if I have my way, more like five…or three), it will be the strategy for value creation (sorry for the management speak, but damn we need more value) as health care delivery is forced to change its ways.

The Kaiser nursing example is but one opportunity.  It’s a very important story to share in our health care worlds.  This is where Tim’s idea of design being too important to be left to designers comes in.  Opportunities like this one, many smaller and many larger, exist everywhere in hospitals.  What we need to figure out is how to bring design thinking to the trenches of health care.  To the places where the providers and workers are busy, tired, and frustrated with limited patience for the next management fad (believe me, design thinking is dangerously close to being just that). Two limitations to consider affordability (not everyone can afford or will want to afford IDEO’s talent) and accessibility (training, training, training). A supportive administration is needed, but a handed down dictatorial philosophy will fail.

Given the intricacies of health care, this movement will have its greatest success if framed as some sort of manufacturing improvement/design thinking/something-thought-up-in-health-care-because-we-think-we’re-different-from-everyone-else-strategy trifecta approach.  That way we can show how it will improve efficiency (lean thinking, etc.), use design thinking to motivate the changers, and provide appeasement for those who need it.

Wow, this post turned into a diatribe.  Also, Tim Brown has a new book about this.  We should all start reading.

The fax machine is health care’s primary mode of communication between hospitals and physicians and (to a lesser extent) payers.  Seriously.  Stop laughing.  And read this story in The Tennessean:

Doctors’ offices in Tennessee have been accidentally sending patient information, including Social Security numbers and medical histories, to an Indiana businessman’s fax machine for the past three years.

…

Keith has tried to correct the problem with the state and doctors’ offices but to no avail. He even called the governor’s office. State officials say they have contacted the doctors’ offices and told them to be sure to use the correct fax number.

Solution.

I make it a rule never to criticize something unless I can offer a solution.

That’s Don Norman expressing my New (¾ through the) Year’s Resolution in “The Design of Everyday Things.”

Social media, simple for hospitals still waiting

Okay, social media tools seem like they’re here to stay (dripping sarcasm) and if your hospital isn’t on this list (only 367 hospitals have any kind of social media presence, that leaves a few thousand still to start), it’s really time to be there.

You don’t need a social media expert to jump in, many of them are selling snake oil anyway.  Send an email to everyone in your organization asking for assistance if you’re uncomfortable, someone will respond.  It’s really pretty easy.

There is a minimum level where health care organizations should be with social media.  Here it is:

• Have an account on the major networks in descending order of priority: Twitter, Facebook, YouTube.  The others don’t matter much.
• Pay attention to two things 1) people that are talking about you and 2) people who are talking to you, which nicely segues into the most important point…
• Encourage conversation, not dissemination.  Unless you are Mayo or the Cleveland Clinic or maybe five other hospitals in the United States, people are not going to follow/friend/fan your organization for health information.  Sure, work in the topical stuff.  You’re much better off carrying on conversations with locals, but don’t just push.

  Press releases: boring.  Job announcements: also boring (if you want to do it, separate the functions between two accounts).  Is there a place for pushed content? Yes, as long as you’re also having a conversation with the the folks who follow you about said content (no one wants to talk about your press release? that’s a clue…).  (Here’s a great example of a Twitter account that only pushes, this article says the company is using it to recruit physicians.  This will be the success rate: zero).

  Even though social media allows you to spread your brand worldwide, think logically about what you’re trying to do: engage locally.  Almost everyone in Seattle doesn’t care about your hospital in Tuscaloosa.  Health care has always been a very locally delivered service (if you’re trying to catch national notoriety for your social media work, that ship has mostly sailed unless you’re doing something really cool…).  So focus on the locals.  Have conversations with patients about your services.  Help them if they have a problem.  Highlight local events.  Hold a contest.  Build partnerships with other agencies to develop a unified approach to crisis communication.  Etc.

There it is.  If you’re ready to get all strategic on social media, start here.

Health is a game

Jane is a game designer and concussed herself while writing a book (update: that reads funny, she actually concussed herself when she hit her head on a cabinet door, fluke).  The recovery became agonizing.  So she created a real world game:

SuperBetter is a superhero-themed game that turns getting better into a multi-player adventure. It’s designed to help anyone recovering from an injury, or coping with a chronic condition, get better, sooner – with more fun, and with less pain and misery, along the way.

The game starts with five missions. You’re encouraged to do at least one mission a day, so that you’ve successfully completed them all in less than a week. Of course, you can move through them even faster if you feel up to it.

Pointer via Robin who has an intriguing thought on the paradigm shift in health (or life, which health is the largest component, imo) that could be afoot.

An EMR for scrilla 50/month.

(via Jen)

Transformative teams

Jonathan Ive, senior vice president of industrial design at Apple:

We have assembled a heavenly design team. By keeping the core team small and investing significantly in tools and process we can work with a level of collaboration that seems particularly rare. Our physical environment reflects and enables that collaborative approach. The large open studio and massive sound system support a number of communal design areas. We have little exclusively personal space. In fact, the memory of how we work will endure beyond the products of our work.

This quote has an egotistical feel, that aside however, wouldn’t it be neat if this was said about a hospital patient care team?

If this gets the 1 in 3 “dudes” who don’t “always” wash their hands after using a public restroom to do so (many of whom claim they do when polled, btw), great.  But if it only allows the continued perpetration of the graphic T movement and overpriced toiletries, then blah.

Wrong

My skepticism is high.  The new Joint Commission’s Center for Transforming Healthcare is a noble effort, but few organizations throughout history have been able to radically alter the way they do business (success story: IBM).  The Joint Commission is trying to become an organization that “helps” hospitals but is likely to carry an aura of punitiveness well into the future.

Further their hand-hygiene launch project is off to a bad start, from The New York Times:

Although still in its early stages, the hand hygiene project has already made an impact in the eight collaborating hospital systems. Average hand hygiene compliance rates have increased from less than 50 percent at baseline to 74 percent. “The goal in the future,” Dr. Chassin said, “is to be consistently above 90 percent.”

Improvement, yes.  The failure comes with an appropriate goal at onset.  Ninety percent?  That goal should be 100 percent.  Period. Period, period.

Trend? Phantom Medicine…

Two interesting tidbits:

First, Wired has an interesting bit about how placebos are flummoxing the pharma world by actually becoming effective treatments (worth the read):

Ironically, Big Pharma’s attempt to dominate the central nervous system has ended up revealing how powerful the brain really is. The placebo response doesn’t care if the catalyst for healing is a triumph of pharmacology, a compassionate therapist, or a syringe of salt water. All it requires is a reasonable expectation of getting better. That’s potent medicine.

Second, research that concludes a doctor’s compassion helps cure colds faster:

A new study shows, for the first time, that the doctor’s empathy may be an even better way to speed recovery.

People recover from the common cold faster if they believe their doctor shows greater compassion toward their illness, according to a University of Wisconsin School of Medicine and Public Health study, published in the July issue of Family Medicine.

Powerful implication: the medicine of thought alone improves patient outcoems.  Is phantom medicine a burgeoning trend?