Empathy for the Content - WIAD DC
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In health domains, content design requires much more attention than typical in experience design. In both consumer and professional worlds, better usability does not drive engagement as much as ...

In health domains, content design requires much more attention than typical in experience design. In both consumer and professional worlds, better usability does not drive engagement as much as content accessibility, findability, and context relevance. Increasingly, designing information to meet these contexts and needs requires navigating the levels of language that reach the health seeker.
As clinicians, family members and caregivers are themselves involved in the health seeking journey, our design approaches must also recognize their contexts and needs for problem solving. The answer is not multiple apps for multiple users – we have already overwhelmed attention with the number of distinct app or URL resources. Smarter information structures, purpose layers, meaning summaries, and written voice are critical to health communication.

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Empathy for the Content - WIAD DC Presentation Transcript

  • 1. World Information Architecture Day Washington DC,     Feb 15, 2014 Empathy for the Content Designing for Touchpoints of Care Peter Jones     Redesign Network OCAD University, Toronto Copyright © 2014, Peter Jones
  • 2. DESIGN FOR CARE in context • How can design make a real difference in healthcare practice? • By caring.  Information care providers. • Care is not a single value or practice.  Every discipline performs it differently. • How should designerly care be provided? • IS THERE A “STANDARD OF CARE” FOR DESIGN? Copyright © 2014, Peter Jones
  • 3. Enabling understanding is Care. “Man finds . . . his place by finding appropriate others that  need his care and that he needs to care for. Through caring &  being cared for man experiences himself as part of nature;  we are closest to a person or an idea when we help it grow.”  Milton Mayeroff, On Caring Can information design help people grow & feel cared for? Copyright © 2014, Peter Jones
  • 4. Care-Centered Design 1. Health‐Seeking Experience. Touchpoints of Care. 2. Patient‐Centered Care. Information as a Care Service. 3. Clinical Workflow.  Adaptive Content for Performing Care. Copyright © 2014, Peter Jones
  • 5. Health Seekers • None of us self‐identify as patients. • Use an empathic design approach. • We all seek health, as a sensemaking process. • The design aim is to fulfill care. Cannot design health. • Design better value for people seeking health. Copyright © 2014, Peter Jones
  • 6. Where do you Care for Content? Copyright © 2014, Peter Jones
  • 7. Touchpoints of Care in Health-Seeking Copyright © 2014, Peter Jones
  • 8. Patient Information Needs (Motivators & Triggers to action) 1. 2. 3. 4. Understand what is wrong.  Gain a realistic idea of prognosis.  Make the most of consultations.  Understand processes & likely outcomes of tests  & treatments. 5. Assist in self‐care.  6. Learn about available services & sources of help. 7. Provide reassurance & help to cope.  8. Help others understand.  9. Legitimize seeking help.  10. Learn how to prevent further illness.  11. Identify further information & self‐help groups. 12. Identify the best health‐care providers. Copyright © 2014, Peter Jones Coulter, A., Entwistle, V., & Gilbert, D. (1999). Sharing decisions with patients:  Is the information good enough? British Medical Journal, 318, 318–322.
  • 9. Information Touchpoints of Care 5. Assist in self‐care.  6. Learn about services &  sources of help. 1. To better understand father’s condition 7. Provide reassurance &  2. Identify risks in treatment & care help to cope.  3. Learn how to care for her Dad at home 4. Prepare to discuss with clinicians Copyright © 2014, Peter Jones 7. Provide reassurance & help  to cope.  8. Help others understand.  9. Legitimize seeking help  10. Learn how to prevent  further illness.  11. Identify further information  & self‐help groups. 12. Identify the best health‐ care providers.
  • 10. Health seeking includes information   seeking & explores alternatives.  Knowledge acquisition for making  sense of health issues. One channel we have some access to. Copyright © 2014, Peter Jones
  • 11. Health Design Lab / Dr. Mike Evans Copyright © 2014, Peter Jones
  • 12. How do we help people “grow & feel cared for?” Differences we can’t easily measure ‐ • First, do no harm. Errors, usage, accuracy. • Understood, in your language & terms • Validated by your conditions of life & truth • Real & relevant cases • Affords action without being prescriptive • Multiple mediators Allows you to adapt to style / tempo • Match channel to message   • Facilitates sensemaking (see Dervin)  Copyright © 2014, Peter Jones
  • 13. 2. Patient-Centered Care Information as a care service. • Gap between medical evidence & its use • ePatients (in particular) advocate for access • We ought to push for patient sensemaking Person‐centered care … • • • Address patient’s perspective Understand patient within psychosocial / cultural context Involve patient in care to the extent desired • Beyond UX or empathy as we know it.  Copyright © 2014, Peter Jones
  • 14. Copyright © 2014, Peter Jones
  • 15. PCC Touchpoints – Where & How? Family &  social history • • • Copyright © 2014, Peter Jones Nutrition  Exercise  Health Beliefs • • Patient‐Clinician  Communications Medication  Management • Home &  Continuity
  • 16. PCC (not) in today’s Content Joint Commission  ‐ Universal Protocol • • • • • • • • • • • For invasive procedures (on you) Nearly 40 bullets Not one supports PCC Only one suggests “involve the  patient” A useless image! What could go wrong? What else could we do? Color code for patient / PCC? Prompt for language, meds,  understanding Ask if there are questions Check beliefs about procedure Copyright © 2014, Peter Jones
  • 17. CONTINUITY OF CARE DOCUMENT            IDEO + CHCF   Project Synapse • • • • Patients feel they are left on their  own to figure out next steps. Patients with serious health issues  work around the system to get the  best care. Episodic & disjointed care hides  valuable connections. Both patients & physicians doubt the  reliability of (reported) health data. IDEO + California HealthCare Foundation , 2012 Copyright © 2014, Peter Jones
  • 18. Value to Patient • Represent what I truly care about • Present information in a way I  can relate to • Help me cross‐check my facts • Help me close communication  loops among my care team • Set me up to have clarifying and  guiding conversations • Clearly lay out the next steps • Show my trajectory over time IDEO + California HealthCare Foundation, 2012 Copyright © 2014, Peter Jones
  • 19. 3. Clinical Workflow Many Points of Care. • • Points where care delivered ‐ differs by specialty & level of training Information needs differ between roles, training, service.  • • No “one stop shop” exists … No single resource (e.g. UptoDate) fulfills all information needs. Copyright © 2014, Peter Jones
  • 20. Copyright © 2014, Peter Jones
  • 21. Clinical Information Touchpoints (Canonical workflow) 1. 2. 3. 4. 5. 6. 7. 8. Inform an examination Support patient evaluation Inform a diagnosis   /  Compare diagnoses Specify screening & tests Assess & select treatments / procedures Plan patient followup   Help patient understand condition & procedures.  Educate patients (prevention, meds, maintenance) Copyright © 2014, Peter Jones
  • 22. Clinical workflow is scheduled AND complex Copyright © 2014, Peter Jones
  • 23. Point of Care Content While available for over a decade in web (& recently in mobile),  Now integrated with the patient record as EHR assistants.  Infobutton Manager in CPOE Del Fiol, et al. Infobuttons at Intermountain Healthcare: Utilization and Infrastructure AMIA Annu Symp Proc. 2006; 2006: 180–184. Copyright © 2014, Peter Jones
  • 24. Copyright © 2014, Peter Jones
  • 25. Clinical Decision Making is a much a critical time loop as Copyright © 2014, Peter Jones
  • 26. Tips on Empathy from the Air Force • In most cases doctors have less  than 3 minutes to update their  knowledge on situation • Often just 30 seconds. • In rapid situation assessment  we are dealing with fast OODA OBSERVE ACT • Information helps Orient &  Decide, may guide Act • Can content construct an  answer for < 30 second loop? Copyright © 2014, Peter Jones ORIENT DECIDE
  • 27. Then Add Complexity … • Senior physicians employ different information cognition  • They take the complex cases, requiring sensemaking. • Based on deep repertoire, experience with reasoning about  clinical problems, & pattern recognition. • Most clinical content is tested at med student level. • Medical students & junior clinicians employ a rote decision  making mode. • Enabled by prescriptive POC references  • That optimize rule‐based selection from options. Jones, P.H.  (2010). Why do senior clinicians ignore CDSS? A case for clinical sensemaking. Advances in  Healthcare Informatics Conference, AHIC 2010, Waterloo, ON.  Copyright © 2014, Peter Jones
  • 28. Information Preferences at POC • • • • HOW do clinicians need to see information? Where are they located when the critical questions arise? (Are they really all using iPads now?) Improve format design & information architecture based on: Matching content to OODA • • • • • • Orient: Long detailed titles save time! Summary, relevant to context Decide: Immediate critical steps Standard clinical workflow order best Act: Mix media types, linked to known  issues or contexts Clearly we have not mastered the writing  styles needed for 30 sec decisions! Copyright © 2014, Peter Jones
  • 29. Improving Health Design Outcomes • • Anticipate the information journey in health‐seeking Design services that help at information touchpoints. • Democratize ‐ Multiple channels: Websites, print, patient handouts, HIT, mobile apps.   Be responsive – but don’t rely on mobile apps.  (They are not TNBT @hospitals). • • • Move toward responsive service design for health‐seeking Integrated information brands (e.g., Mayo), email  responses, humanized call centers. Copyright © 2014, Peter Jones
  • 30. Caring for the rest of us? • • Care context not exclusive to Healthcare (Riane Eisler’s Real Wealth of Nations ‐ Caring Economy) • • Every issue applies to humanizing service design Services economy has not addressed shared underlying  value problems Efficiency of service has implicit aim of profit maximizing  – how might we balance values of social care? • • • As designers, expand “experience” to unit of engagement Extend empathy to shared objects of engagement Copyright © 2014, Peter Jones
  • 31. Book discount code (20%)  DFCWIAD At designforcare.com Peter Jones, Ph.D. peter@redesignnetwork.com designdialogues.com @designforcare Copyright © 2014, Peter Jones