Designing for and creating better healthcare systems and services

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This presentation based upon the book "No Straight Lines: making sense of our non-linear world" was made at the CareWare conference in healthcare innovation in Aarhus Denmark – The presentation argues that when we design around the needs of humanity, we can create better healthcare systems, which are also more resilient, sustainable, adaptable and in fact less expensive to run.

That better much better does not need to cost the earth. We need to be able to hold in play at the same time considerations about how to design for the needs of humanity, to deal with systems thinking and complexity, organisational capability, technology and even data.

www.no-straight-lines.com

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Designing for and creating better healthcare systems and services

  1. 1. SEEING, CONNECTING TO, AND,DESIGNING FOR OUR BEST POSSIBLEFUTURE IN HEALTHCAREaarhus denmark 2012
  2. 2. This presentation is based upon the bookNo Straight Lines: making sense of our non-linear world.Available as:Open Access Participatory version via this link:http://read.publification.com/b/no-straight-linesPaperback and Kindle versions:http://ht.ly/7OAod
  3. 3. alan moore | www.smlxtralarge.com | no straight lines introduction 2012 The challenge:Be realistic imagine the impossible paris 1968
  4. 4. Why? do we experience such difficulty even imaging a different sort of society?Why is it beyond us to conceive a different set of arrangements to our common advantage? tony judt | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  5. 5. Why? are we not able in the 21st Century to design more adaptive and sustainable intelligent systems for health?| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  6. 6. n o t ‘ w h at i f ’ b u t …HOW?| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  7. 7. How do we create a service tobetter manage people’s chronichealth care. Reducing; wrongdiagnosis, over prescription ofdrugs, clogging up hospitals andspecialist time? | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  8. 8. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  9. 9. It is because of specialization: the power ofmodern medicine is also the powerlessness ofprofessionalsOnly the patient has enough information toco-ordinate care across specialists | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  10. 10. Markle Foundation’s ideal PHR: | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  11. 11. Markle Foundation’s ideal PHR: 1.  Access controlled by patient | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  12. 12. Markle Foundation’s ideal PHR: 1.  Access controlled by patient 2. Lifelong records | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  13. 13. Markle Foundation’s ideal PHR: 1.  Access controlled by patient 2. Lifelong records 3. Information from all | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  14. 14. Markle Foundation’s ideal PHR: 4. Universal access 1.  Access controlled by patient 2. Lifelong records 3. Information from all | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  15. 15. Markle Foundation’s ideal PHR: 4. Universal access 1.  Access controlled by patient5. Private and secure 2. Lifelong records 3. Information from all | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  16. 16. Markle Foundation’s ideal PHR: 4. Universal access 1.  Access controlled by patient5. Private and secure 2. Lifelong records6. Transparent 3. Information from all | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  17. 17. Markle Foundation’s ideal PHR: 4. Universal access 1.  Access controlled by patient5. Private and secure 2. Lifelong records6. Transparent 3. Information from all 7. Easy exchange | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  18. 18. Who wants to build a barn in a day?
  19. 19. The economics, efficiency and effectiveness of sharing
  20. 20. 3types of sharing
  21. 21. Sharing data increases safety | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  22. 22. Sharing data increases safetyClinicians need patients to know what is happeningPatients tell other clinicians what they have learnedPatients cannot self-manage if they do not have the informationOnly small number of tests, only at diagnosis, require seeing clinician beforeseeing resultKnowledge of the safe ways to give patients their data | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  23. 23. Sharing data saves clinical timeFocus appointment time on explanations andtreatmentClinicians rarely have time to go through all the test resultsPatients often schedule follow-up to ask questions they only think of outside theroomRelatives call to ask what the patients had been toldPatient will save other clinicians’ time with theirknowledge | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  24. 24. Sharing data is a processCommit to to everything long-term, but start with testresultsTest results are structured data with crucial benefits to patient with long-termconditionsAdd on prescriptions, letters, and patient-submitted dataMedical notes require retraining of clinicians, but they already know this ishappeningIncrease sharing as generate benefits and confidence | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  25. 25. Design
  26. 26. Conduct online consultationswhich are seenby all clinicians in team
  27. 27. Detailed explanations for patient saveclinician’s time
  28. 28. Personal health plansTeach patient to teach team
  29. 29. Why is PATIENTS KNOW BESTrelevant to you?1.  Designed as a platform2.  Designed for sharing: sharing data increases safety, sharing data saves clinical time, sharing data is a process3.  Truly empowering patients4.  Designing for individual and participatory learning5.  Sustainable, highly effective to an order of magnitude of 26.  Better much better does not necessarily cost the earth | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  30. 30. The ‘WHAT’S NEXT’ for HEALTHCARE SERVICESHow do we discover our best possiblefuture for the territory of Ontario’s healthcare system – when we are faced withchallenges that are highly complex anddeeply ambiguous? How do we discoverand harness the deep knowledge thatresides in the many people that both runand use that healthcare system? | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  31. 31. Our best possible future resides in theminds and hearts of the many not the few | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  32. 32. Participatory Leadership| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  33. 33. Root question: What is happening in theworld/this organization that requires us toget together to do this work? | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  34. 34. A chaordic process: building sharedawareness, co-creating a shared vision,harvesting outcomes / perspectivesco-building an action plan,Execution | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  35. 35. “Cooperation is the foundation of humandevelopment, in that we learnhow to be together before we learn how to stand apart” erik erikson | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  36. 36. designing for cooperationFaster Alone, Further Together | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  37. 37. Why is the process of the NovaScotia story relevant to you?1.  Use of participatory leadership2.  Harnessing of collective intelligence3.  Human technologies that unlock individual knowledge into deep collective insight that translates into collective action4.  Process of connecting to an emergent best possible future by connecting into deep human wisdom5.  People embrace what they create6.  Innovation + social cohesiveness7.  A lot less expensive than McKinsey | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  38. 38. The ‘WHAT’S NEXT’ for HOSPITALSHow do we design and build ahospital which enables patientsto recover from operations atmuch greater speeds, with areduced need for drugs? | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  39. 39. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  40. 40. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  41. 41. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  42. 42. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  43. 43. Why is DOWNE HOSPITALrelevant to you?1.  Designing around the needs of humanity not the needs of utility: place, space and people2.  Design thinking / systems thinking / complexity3.  Strength of Craftsmanship | www.no-straight-lines.com | making sense of our non-linear world | 2011 |
  44. 44. Summary | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  45. 45. | www.no-straight-lines.com | making sense of our non-linear world | 2012 |“the limits of our language is the limit to our world “
  46. 46. a design challenge.I + We = why?How we make context and meaning, about the webs of relationships and how we derive value from those relationships and connections are central to human beings. And all human beings participate in co-creating the complex social networks that we live in and engage with. The social environment is a dynamic field that interacts with human consciousness changes in that environment affect us psychologically. otto scharmer | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  47. 47. Human nature is not a machine Successfully designing a medical system requires not just technical and medical knowledge it requires us to have a deep understanding of human nature. Image: http://www.flickr.com/photos/camil_t/82015664/
  48. 48. designing for human systems “Me We” | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  49. 49. System Upgrade alan moore | www.smlxtralarge.com | no straight lines introduction 2012
  50. 50. the Human- OS alan moore | www.smlxtralarge.com | no straight lines introduction 2012
  51. 51. WHAT DOES THIS HUMAN OPERATING SYSTEM WANT? ITS WANTS WHAT WE WANT…| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  52. 52. OPPORTUNITY FREEDOM EMPOWERMENT MUTUALISM DIVERSITY EFFICIENCY INDEPENDENCE BEAUTY| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  53. 53. designing for: Knowledge flows NetworksOrganisations as platforms Adaptive systems Multiple outcomes| www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  54. 54. our epic goal:strengthen the sources of health | www.no-straight-lines.com | making sense of our non-linear world | 2012 |
  55. 55. www.no-straight-lines.com @alansmlxl

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