Incorporating Design

In a health care world of useless price and cost data (individuals pay little, what’s a charge mean anyway?), comparable quality and outcomes data (see Medicare’s futile attempt at comparison via the Hospital Compare website), similar service offerings (the general hospital is an exercise in commoditization; our system dictates that competing hospitals must offer similar services), and compromised patient satisfaction scores (hospitals game the Press Ganey system by asking for high scores), how does a hospital differentiate itself from competition?

Patient experience.  How does a hospital build patient experiences?  By making design a priority (here’s evidence on why it is important).  Robert Brunner at FastCompany:

The relatively few companies in the world that are really design-driven know the secret: That design is, in fact, everybody’s job. Rather than making design a single step in the process where requirements flow in and ideas flow out, they see design as a constant topic of discussion across all disciplines and steps in the process. It is not a vertical stripe in the horizontal process flow, but a horizontal one that extends from inception through customer service and end of life.

Granted there’s a needed educational component here.  So why not start during the summer reading season (I’m a fan of year-round reading, but if you need the extra momentum brought on by the beach, it’s upon us)?  Here are 30 important design books.  Start with “The Design of Everyday Things,” it will change your perspective.

Design and disruption

The Design Council Magazine hosted a virtual round table discussion addressing the relationships between design and business.  A quote from service design specialist William Owen:

Design is integral if your business faces disruptions … in other words, if you’re in any kind of business.

Applicable design example: hospitals!

Because MRSA and C. diff are increasingly problematic in hospitals (and hospital equipment has been said to be badly designed):

British designers have come together to give the grim and functional hospital ward a much-needed revamp, and in doing so, they have thrown out the clunky old bedside cabinets, the tired mattresses and dubious-looking commodes and replaced them with more futuristic versions.

The makeover has been prompted not by aesthetic shame, but by medical prudence.

Design! The Guardian report continues:

“There are huge issues with superbugs in hospitals, but it’s likely that if we can make the environment easier to clean, we will go a long way to improving the situation. A lot of hospital furniture has nooks and crannies that are repositories for bugs, so the challenge was to design those out,” said David Kester, head of the Design Council.

How the glorious people at the Design Council did it:

Design teams were despatched to hospitals to look over wards and talk to doctors and nurses about how curtains, bedside cabinets, commodes and other ward furniture were used. The Council then called on designers to come up with smooth, cheap and simple alternatives.

Patient Experience Rundown

This post at Matter/Anti-Matter sums up nicely the poor patient experience often on display in health care settings:

  • First problem: Lack of efficient communication.
  • Second problem: Lack of personal touch.
  • Third problem: Bad office systems and technology.
  • Fourth problem: No advice.
  • Fifth problem: No prevention.

Here’s what happened:

About four weeks ago, I went for an annual physical and had standard blood work done. I was told to call back in a week, and of course I forgot. Today I had a message that said: “Hello, this is Dr. XX’s office, please call us back at xxx-xxx-xxxx.” That was it–the person didn’t identify herself and also didn’t say what the call was for. When I dialed the number, I was expecting to be told that I owed them money. But actually, the woman on the phone had no idea why she had called me. So I sat on hold, and finally she came back with my blood test results and rattled off a bunch of acronyms and numbers. I’m happy to report the results were good (at least that’s what she said), except my cholesterol was at 201 and it should be less than 200. Then the call ended.

That was it.

Broad generalization here: we’re capable of so much better.

Design, the way of tomorrow

Scott Dadich of Wired on designing under constraint, two important thoughts in reverse order:

The idea of operating within constraints—of making more with less—is especially relevant these days. From Wall Street to Detroit to Washington, the lack of limits has proven to be a false freedom. With all the economic gloom, you might not be blamed for feeling that the boundless American frontier seems a little less expansive. But design teaches us that this is our hour of opportunity.

That’s because designers understand the power of limits. Constraint offers an unparalleled opportunity for growth and innovation.

Think of a young tree, a sapling. With water and sunshine, it can grow tall and strong. But include some careful pruning early in its development—removing low-hanging branches—and the tree will grow taller, stronger, faster. It won’t waste precious resources on growth that doesn’t serve its ultimate purpose. The same principle applies to design. Given fewer resources, you have to make better decisions.

$21,000,000,000 + Health IT – (Human-centered design) = What?

DesignWell takes a human-centered approach in questioning the utility of the $21,000,000,000 outlay for health information technology in the stimulus (err, spending for the more conservative among us) bill:

I assume that most of the stimulus money will go to large technology companies that create complex database systems and algorithms to handle the intensity of data required to make it all work. However, I hope that the stimulus package carves out money to understand how data will actually get into these health records, and more importantly, how people will actually use them.

And comments on the state of personal technology in the health care world:

In all of this we must be cognizant of the real, and very sad, state of technology in most medical settings. Sure we have amazing scanners and procedures that are miracles of science and engineering. But the state of technology that is actually usable by regular, real people (patients, under-educated nurses, and doctors are real people too!) is shoddy at best. As I mentioned, I don’t envision my doctor entering my results into an iPhone app anytime soon.

Last, the missed opportunities for mindful, captivating self-reflection:

In a waiting room, we have a captive audience that is thinking about health issues because they’re about to see a doctor, yet there is nothing to help the patients. There is nothing to help people get ready for a visit to maximize the time with the doctor. There is nothing to help review past records or streamline the process in any way. What an amazing time and place for people to interact with their EHR! But there’s nothing even close to being on the right path for that. Technology is non-existent here, so a massive EHR system would be equally useless.

IDEO Inspiration

Ideo is a (beyond) cool company that helps organizations think strategically about design.  IDEO’s Method Cards provide insight (and help) into what they do and may allow you to add design components to your next project:

Hat tip: Dan Pink

In: Design Excerpt

From The New York Times:

“What designers do really well is work within constraints, work with what they have,” said Paola Antonelli, senior curator of architecture and design at the Museum of Modern Art. “This might be the time when designers can really do their job, and do it in a humanistic spirit.”

In the lean years ahead, “there will be less design, but much better design,” Ms. Antonelli predicted.

There is a reason she and others are optimistic: however dark the economic picture, it will most likely cause designers to shift their attention from consumer products to the more pressing needs of infrastructure, housing, city planning, transit and energy.

May I politely suggest adding health care to the list?  The article goes on to say, “Designers are good at coming up with new ways of looking at complex problems…”

Complex health care is.