This presentation was a part of the "Design for Change" track at the October 29, 2015 Partners Center for Connected Health Symposium. The presentation discusses how Empathy can be our guide as we seek to improve health experiences.
Amy CuevaFounder, Chief Experience Officer, and Health Principal at Mad*Pow
11. “Insist upon pretense and you’ll have
it. Insist upon mediocrity and it is
yours. Insist upon beauty and you will
ﬁnd it. Insist upon learning and you
will learn. Insist upon living with great
passion and you will see differently.”
13. WHAT IS GOOD FOR THE
PEOPLE WE SERVE IS
ULTIMATELY GOOD FOR
14. “There is nothing soft about it.
Empathy is a hard skill that should
be required from the board-room
to the shop ﬂoor.”
HBR: Belinda Parmar
IS NOT AN OXYMORON
15. THE VALUE
OF DESIGNDesign-Driven Companies Outperform S&P by 228%
Over Ten Years - The ‘DMI Design Value Index' Posted
By Michael Westcott, Monday, March 10, 2014
Updated: Monday, March 10, 2014
Friends & Family
Web MD, YouTube,
Walk in Clinic
THE HEALTH ECOSYSTEM
19. THE HEALTH ECOSYSTEM
Friends & Family
Web MD, YouTube,
Walk in Clinic
WE CAN GATHER TOGETHER
AROUND SHARED OBJECTIVES &
DESIGN AN ECOSYSTEM OF CARE.
29. in ethnographic studies so they can
experience customers ﬁrst hand and
feel empathy for them. A research
report alone won’t do it.
IMMERSE KEY STAKEHOLDERS
30. "You have to have a good theory. Every time
we take an action it is predicated upon a
theory. It is in understanding the people we
serve in the present that we construct a
theory about the future.”
CONSTRUCT A THEORY
32. Sara Wachter-Boetcher
“Everybody Hurts: Content for Kindness”
…if we’re able to consider users at their
worst, and if we’re able to make experiences
feel good for people at their most vulnerable,
most difﬁcult moments, then we can make
them work for everybody."
DESIGN FOR PEOPLE AT THEIR WORST
BLOGGERS RECEPTION BROKER
HOME CARE &
ENVIRONMENTS PROCESSES ARTIFACTS
TION & MAINT.)
ADMIN KITS GLI E
ENVIRONMENTS PROCESSES ARTIFACTS
ENVIRONMENTS PROCESSES ARTIFACTS
touch point in
39. is a byproduct of how we
are organized internally
to deliver it.
41. HBR: Belinda Parmar
"Empathy can be measured, and your
business’s empathy quotient can be assessed,
allowing CEOs to pinpoint their companies’
strengths and weaknesses, and see how they
rank alongside their competitors."
EVALUATE AND MEASURE
Hi Everyone, I am Amy Cueva, one of the founders and Chief Experience Officer of Mad*Pow, an experience design agency here in New England.
I am also chair of HxRefactored, a conference we founded 6 years ago dedicated to exploring how human-centered design and technology can improve health experiences. The next one is right here in Boston at the Westin Waterfront April 5th-6th 2016.
At Mad*Pow I oversee our health practice where we work with organizations across the health spectrum from non-profits to government to insurers to hospitals to health tech and pharma companies. We are working with them to improve the quality of interaction they have with the people they serve, both inside and outside of their organizations. The experience we have bringing human centered design to such diverse organizations across the ecosystem gives us a unique perspective into gaps, unmet needs, and opportunities that exist.
I’m here with you today to share how empathy inspired design can guide us in our mission to envision better health experiences – and make the changes necessary to bring those experiences to life.
The world hates change…
The topic for this portion of the agenda is change. We know that change is difficult – yet absolutely necessary.
We see the oftentimes painful state of affairs in health in terms of how people experience the system - we feel it.
We know there are so many problems to solve. But we also feel the hope associated with the notion that there must be a better way.
We desire change. We know change is needed.
I believe design provides us with….
We are all designers in this system and we can drive the change that is needed.
This series of talks will present ways that empathy inspired design, behavior change design, and organizational design can empower and guide positive change.
I will be discussing empathy inspired design in my talk here today, advocating for the inclusion of the people who will be affected by the solutions we create in the process of creating them. That is the backbone of human-centered design
Designing for motivation and behavior change can empower individuals to improve their health and achieve greater vibrancy. Dustin DiTommaso, the head of our behavior change practice at Mad*Pow will be diving deep into key considerations for effective and lasting behavior change.
Organizational design can help us foster cultures of creativity, collaboration, customer centricity, and innovation - making it more possible to bring phenomenal experiences to market. Adam Connor, the head of our organizational design practice will be sharing his insights with you on this topic.
And then there is just pure fun which can bring truths to light through a different style of interaction. We are inserting a bit of gameplay into this section and we do hope you will let your inner child play with us as we explore these concepts with you.
Empathy will inspire our direction as people, help our organizations achieve better results, and also help us to deliver positive human impact.
We’ll explore each of these areas and then I will share some tips for integrating empathy inspired design into our organizations.
How many of you have been seriously affected by a health situation, either your own or through a loved one?
Of course – it is part of the human experience, right?
The wounded healer concept occurred to me when I was coming to grips with the adversity I’ve experienced in my own life, facing the addiction of a loved one, the diagnosis of one of my children with an auto-immune disease, going through a divorce, and coping with my own anxiety and depression.
All of these experiences shaped my perspective.
Being open with my patient story through joining Regina Holiday’s walking gallery, giving a soul baring presentation at the XX in Health retreat, and hearing the patient stories of so many in the industry through conferences like this opened my eyes and firmed this notion.
So, I did some research and found that Carl Jung actually coined this term, he said
“A good half...”
And we know hurt. We know what it is like to experience pain, confusion, fear, and anxiety. And that gives us a greater capacity to understand, to empathize, to feel the pain, confusion, fear, and anxiety of another.
That empathy, that emotion, that awakening, has created a burning desire within us to heal the system - to make things better… so that people won’t have to experience what we experienced… and perhaps through healing the system we will experience healing ourselves.
Our experiences form our individual passion, help us find our purpose, and they fuel our drive. And we need that drive to persevere and do the hard work necessary to make change in health.
Because people will tell us we are wrong. We have to be prepared for that.
You may have heard the saying… “He who hears not the music thinks the dancer is mad”.
If you are a lone voice, then it is even more important for you to be heard and to keep fighting.
We can embrace our unique perspective and with the courage of our conviction seek out those who share it.
We need to get comfortable being uncomfortable because change is difficult, especially when you are the one driving it forward.
But we will continue to do what we do because we must. There is no other response.
You will walk because you must. Because there is no other response. Because you have been given so much and love impels you to go.
We have not only been inspired to make change by the adversity we’ve experienced in our own lives, but the adversity that the industry faces as a whole.
We certainly have our fair share of adversity in health. Medical expenses are still the number one reason for bankruptcy in the country. We spend the most of any nation in the world and are 17th in the world in terms of outcomes. There are so many complexities to contend with, various institutions with competing perspectives, new legislation and FDA regulations to understand, HIPPA, lots of institutional residue, and few easy or clear solutions.
But I believe the adversity that we have experienced personally and professionally has made us stronger, and makes us even more driven and better equipped to rise to the challenges we face such that we truly improve the experience of health.
Transition to Business:
Empathy helps us find our direction as individuals. It can also help our organizations find their direction.
…What is good for the people we serve is ultimately good for the business.
Empathy driven design will lead our organizations to become more human focused and and deliver bottom line results.
In the Harvard Business Review article: “Corporate Empathy is not an Oxymoron” Belinda Parmar says ”There is nothing soft about it...
And this empathy will inspire how we design our products, services, partnerships, and organizations.
Corporations are not only waking up to the value of empathy, they are also waking up to the value of design.
Explain the Design Value Index.
And this is not the only illustration of the value of design, the Design ROI Research Project conducted in Finland found an overwhelming correlation between competitiveness and a focus on design.
Another method of proving the value of design is to explore the inverse: What is the potential cost of not investing in design? Jonathan Shariat, author of the soon to be released book “Tragic Design” was inspired to write the book and make change after being devastated by the story of a little girl with cancer who died because the nurses treating her were unable to clearly view the treatment regimen in the EMR.
There is ROI associated with a focus on design and potentially disastrous outcomes associated with a lack of focus on design.
We will continue to see customer and design centric companies serve their people better and win in the marketplace.
Customer focus and design can definitely help.
With this one simple site redesign we were able to drive clear business results and save users a great deal of frustration.
But it is not all about site redesigns…
As organizations mature in terms of their understanding of design, they move from “hitting it with a pretty stick” (visual design,interface design), to valuing design as an essential discipline and critical success factor (user experience design), to fostering an empathy-driven culture where the customer is the focus and that thinking is woven into business practice (experience strategy, service design, design thinking, design training).
And we need to make the customer, the patient, the person, the focus of our efforts, because right now they are left to navigate a very disconnected ecosystem on their own.
The health system functions but does not get as close to whole health as we would hope possible considering our human capacity to care, connect, and innovate.
We can move beyond the transactional.
We can build trust with those we serve.
We can be there when they need us most.
We can begin to become their partner throughout their health journey, tracing their path through the ecosystem, identifying unmet needs and organizations who have shared objectives.
We know that siloes exist both inside and outside of our health organizations but I believe that new forms of collaboration will help us to break down walls and will lead to unprecedented innovation and unimaginable results.
New partnerships and shared services will help us start to break down walls and address the pain points and unmet needs present in the current health ecosystem.
“We can gather…
It was in that spirit of collaboration around shared objectives that we partnered with the CDC, JSI, and Non-Profit AIDS service organizations as well as HIV patients themselves to understand what truly leads to medication non-adherence in HIV and design an application that aligns with intrinsic motivation, involves social support and makes the connection between adherence and improved lab results.
This app went live in the app store just last week.
This Cindy Gallop quote pretty much sums it up, “Shared values + shared action = shared profit (financial & social)”.
Customer focus and empathy inspired design is not idealism, it is good business - and a practice that can also deliver positive impact at the societal level.
Transition to society:
It is an experience economy. Organizations in other industries have realized this.
In financial services for example, it is not about just selling products and services or enabling customers to complete self service transactions easily, it is about the relationship the people have with the organization and the perceived benefits of that relationship that count.
Imagine the potential here – if a large national bank helped it’s customers save 5% more. That would be of benefit to that bank, and of course to those individuals, but it would also have tremendous impact on society as a whole.
When society wins, the business wins.
Better health, emotional wellbeing, financial wellbeing, sustainability, and education.
Consumers are more and more aware of the impact corporations make on society every day and it is informing the decisions they make around who to do business with.
Impact focused organizations will align with the passions of their customer base and will thereby be differentiated in the marketplace.
This stance requires taking the long view. An understanding of long term impact and not just short term returns.
I believe purpose will lead to profit. And I am not alone…
Roy Spence, explains in his book “It’s not what you sell, but what you stand for” that great companies have an authentic sense of purpose — “a definitive statement about the difference they’re trying to make in the world.” — and a workplace with the “energy and vitality” to bring that purpose to life
This is big – you may want to grab onto this concept
Beyond marketing and advertising – weave it in – gain competitive advantage
Profit not enough – move boundaries
Insurance & Pharma
Profit without taking advantage – consideration for impact and ethics
… As organizations... I can’t even tell you how excited I am about this! You will see this happening more and more in the next few years. But I am telling you about it now! We go into planning meetings wanting to come up with new ideas. This may be a concept that you want to grab hold of and run with.
And it goes beyond the marketing message or the advertising campaign, purpose driven companies will build momentum and traction around their purpose by weaving it into all business functions and gain competitive advantage as a result.
It isn’t enough to make a profit anymore. This calls us to move beyond the standard boundaries that have defined our organizations in the past.
We see these boundaries begin to shift as insurers aim to help their members get healthier and not just be their “adjudication partner” and as pharma companies explore digital “therapies” in addition to drugs.
Profit can be delivered with consideration for customer needs and motivations AND without taking advantage of the them. A decided understanding of how the decisions an organization makes will impact society, for unintended consequences, and associated ethics will be required.
We have been considering how ethics should guide the work we do at Mad*Pow and that lead two of our fantastic designers, Sam Dempsey and Ciara Taylor to create the Hippocratic oath for designers. The Oath was collaboratively written by designers throughout the industry.
You will be hearing more about ethical considerations for the behavior change interventions we are designing during Dustin’s talk.
We’ve talked about the importance of empathy in guiding our work.
Now I’d like to share some methods that we have seen help organizations effectively integrate empathy and desing thinking into business practice….
We can become students of the problem, inclusive in our approach.
In getting outside the four walls of our typical environment and getting face time with the people we serve we can come to a deeper understanding of what will drive real meaning and value in the context of their lives - what will truly motivate, engage, inform, guide, and comfort.
Humans are complicated. The richness of detail in the story provides us with both information and inspiration.
We can encourage stakeholders at our organizations to get involved in ethnographic studies, participatory and collaborative design methods, and validation activities like usability, usefulness, desirability and efficacy testing.
Humana recently paired c-suite executives with an ethnographer and they spent 1 day per month with a medicare member in their home. They also spoke with that same member once per week on the phone for a half hour.
They came to understand the struggles of their members and develop empathy for them. They then understood in their hearts, not just in their minds, how much work needed to be done to fix things and funded an 80 person consumer experience team to drive experience innovation as a result.
Companies that do this on an ongoing basis will receive the rich information that will guide experiential improvements for years to come.
Clayton Christenson discusses the importance of theories in guiding disruptive innovation and points out that “it is understanding the people we serve in the present that we construct a theory about the future.
Ethnographic research, where we talk with and observe real people in their “native habitat” helps us to develop a rich understanding of current problems and unmet needs such that we can create solid theories that will guide our efforts moving forward.
In addition, it activates our empathy and provides needed inspiration for our creativity.
For example, If we want folks managing chronic conditions to not use the ER as their primary care office, have we been in the ER and spoken with people there or are we making assumptions around why they are there and how the situation might be improved?
Through research we come to understand emotion…
…”Emotion will show us where we need to focus, where we are doing well, and where we need to improve.”
The emotions of the people we serve matter. They affect the trajectory of their path forward.
Emotion matters. Not just the emotion of the people we serve, but our emotion as well…
We need to allow ourselves to feel. Emotion moves us beyond cognitive knowing to visceral knowing - that gut feeling we get inspires our curiosity, powers our imagination, enhances our wisdom, leads to us to take action, and motivates us to persevere.
Sara tells us in her talk “Everybody Hurts: Content for Kindness” that we need to design for people at their worst.
We can consider the full range of emotions and situations people will bring to their experiences via personas.
In walking in the shoes of the people we serve we can explore how to make things better for them.
Personas can contain not just demographic information, but also behavioral, psychographic, and emotional information.
They can guide our teams in making decisions about the experience.
Personas can help, but personas alone are not enough.
We can also look at the interplay of emotion with their health journey to understand what is affecting them and how.
We can look for spikes in emotion as they are indicative of an at risk individual or an unmet need.
Then, we can envision an improved journey where frustrations are remedied and the design is eliciting the emotions that were intended across every touch-point in the ecosystem.
Sensing devices will help us understand the connection between emotion and health as well as bubble up opportunities for intervention.
Medical decisions can catch people by surprise. Lack of knowledge can lead to lack of confidence and increased anxiety. With an understanding of how emotion can affect the decision making process we partnered with the Informed Medical Decisions Foundation to design an evidence based decision support tool that helps pregnant women get the information they need to make the best decision for them.
We can formulate a “hierarchy of needs” based on research insights to focus our experiential efforts and measure our performance. For example -
Trustworthy - I got the information and utility I needed at every touchpoint I needed it.
Easy - This company, product or service is easy to do business with.
Kind - I felt like they were considering my needs and that I was treated well.
Meaningful – Was meaningful to my life – I achieved a greater outcome or received an unanticipated benefit.
Very Cool - Wow, that was actually very cool.
Many in our industry suffer from shiny object syndrome, where we oftentimes want to jump to very cool without having delivered trust, ease, kindness, and meaning.
One important consideration that that can drive better outcomes is to design to improve the in person interactions that occur “beyond the screen”.
We can consider how to involve clinician and family education and communication in the design of the solution such that good patient/doctor conversations are facilitated and the family is engaged in supporting the patient.
We can audit the ecosystem of interaction – examining each touchpoint from the perspective of each persona and their hierarchy of needs starting at the bottom and working towards the top.
We can audit present experiences and future state theories against the organization’s purpose beyond profit as well.
“The experience is a byproduct of how we are organized internally to deliver it.”
If we are a mess on the inside, the resulting experience will be a mess as well.
It isn’t enough to imagine an amazing experience. We also need to bring that experience to market.
Adam will be discussing how to create a more empathic, creative, and collaborative culture in his talk.
In order to deliver exceptional experiences, we will need to help our organizations transform themselves into being empathy driven and customer focused in all they do.
We will continue to investigate models for communicating the benefits of empathy inspired design to executives and decision makers, immersing them in the process, and providing them with essential training, methods, and tools to aid their efforts.
We recently conducted a week long training session at a large health system for 60+ individuals in human centered design, design thinking, and collaborative process, to give them the tools necessary to work better together. We also trained them to be trainers so they could extend the learning gradually to the rest of the organization.
And training does help! Telefonica Germany was able to see a 6% improvement in customer satisfaction within 6 months of implementing an enterprise level empathy training program.
In the HBR Article I mentioned earlier “Corporate Empathy is not an Oxymoron”, Belinda points out that empathy can be measured, but also that “Serious people will regularly dismiss empathy for the more concrete and defensible virtues of rational analysis.”
I would argue that rational analysis does not supply the richness of inspiration that empathy and human centered design does - inspiration that will fuel both experiential and disruptive innovation.
But don’t stop with measuring your organization’s empathy, Consider how to measure performance on the customer hierarchy of needs and the organization’s purpose.
Create incentive programs and bonus structures that stem from these measures. Many companies have found that when incentive programs aligned with customer focused measurements, rapid improvement were achieved in short order.
One company that we work has assembled an inter-disciplinary team that evaluates whether business decisions will have a positive, negative, or neutral impact to the customer experience. If the anticipated impact is negative, there is an escalation path available to remedy the situation.
Decision making frameworks can help, but avoid creating a culture where numbers strip the humanity out of the decision making process.
In closing, I believe that empathy will inspire our direction, fuel business innovation, and deliver positive human impact - helping us to improve the experience of health.
I want to thank you so much for exploring the power of empathy inspired design with me here today. Thank you!