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Systems Oriented Design
What is healthcare in the future? Design itself is an important power to make the healthcare system change a lot.

This project is aimed at exploring the future healthcare service in system thinking to make a holistic process and assumption of future system. Cardiovascular patients is a biggest group in the world. I hope working with this group can bring a lot of inspiration for other healthcare issue. In this project, I use strategy design, service design and interaction design method to create a hotlist service for cardiovascular patients out of the hospital. Nowadays a lot of people are suffering from longterm diseases and having high risk of cardiovascular. The food is a good way to address this problem. The meaning of the food and medicine are changing. The longterm medicine cause a mental problem at the beginning. The industry of medicine are struggling with their development, The goal of this project is to discuss the touchpoint food and medicine to address all the problems here, using system design methodology.

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  1. 1. h e a l c a r d i o SYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular Yue Zou
  2. 2. SYSTEM ORIENTED DESIGN A holistic solution for the cardiovascular h e a l c a r d i o This project submitted to the Oslo School of Architecture and Design for System Oriented Design Studio cooperated with DNV GL Yue Zou, author Linda Blaasvær, Manuela Aguirre, advisor
  3. 3. ABSTRACT What is the future healthcare in future? Design itself is a important power to make the healthcare system change a lot. This project is aimed at exploring the future healthcare service in system thinking to make a holistic process and assumption of future system. Cardiovascular patients is a biggest group in the world. I hope working with this group can bring a lot of inspiration for other healthcare issue. In this project, I use strategy design, service design and interaction design method to create a hotlist service for cardiovascular patients out of the hospital. Nowadays a lot of people are suffering from longterm diseases and having high risk of cardiovascular. The food is a good way to address this problem. The meaning of the food and medicine are changing. The longterm medicine cause a mental problem at the beginning. The industry of medicine are struggling with their development, The goal of this project is to discuss the touchpoint food and medicine to address all the problems here, using system design methodology.
  4. 4. KNOWLEDGEMENTS Thank you to my advisor Linda and Manuela for their support and guidance on this project. Thanks also for Mosse and Natalia for their tutoring of interaction design and service design. Thanks a lot for my partners, Marius, Stephen and other people from DNV GL healthcare innovation center. We had great workshops during this project.
  5. 5. CONTENTS • research 1 • leverage points 23 • prototyping 44
  6. 6. First Giga-mapping research leverage point prototype
  7. 7. research 1
  8. 8. First Co-creation Workshop 2
  9. 9. WHY CARDIOVASCULAR One in four deaths (12.9 million) was from heart disease or strike in 2010. Two in three deaths worldwide were from chronic diseases in 2010 Most cardiovascular diseases can be prevented by addressing lifestyle - related risk factors. It’s obvious that cardiovascular is the biggest groups which means most important..There are two things for me. Firstly, I hope other disease can also get some insight from my project. Secondly,it’s easily to contact the patients easily. 3
  10. 10. RESEARCH PROCESS 4
  11. 11. MY PARTNER My partner DNV GL is quite a world leading group which is famous for give certification to organizations including hospitals. I’m working with healthcare innovation in DNV GL. Safer, smarter and greener is a process for the society to transformative. Sustainability needs transformative. This three words is a good evaluation for my project. Digitalization, localization are the good strategy for the branding.The main target group is China, USA, European(Norway).The evolution part is valuable as a starting point. Holistic care is necessarily. 5
  12. 12. DNV GL healthcare innovation center has done a lot of projects. They are focusing on human centered care. These general principle of patient centered care from DNV GL can give me a lot of inspiration to imply in my project. The principle has many different levels perspectives from individual level to system level.what is safety culture? It’s a big question. I use giga-mapping to figure out the DNA of safety culture. I found three words to support the DNA-SHARED EFFICIENCY TRUST. 6
  13. 13. CO-CREATION WORKSHOP This is first workshop in DNV GL. Because healthcare is a big image and my client did not give me any limitation in direction at beginning. I think I should find a start point to work with. This co-creation workshop’s main goal is to find some general problem of the cardiovascular in professional’s perspective. 7
  14. 14. Using timeline is a good way to find different problems in a holistic perspective. I want to discovery which is more important in healthcare system between in hospital or out of hospital. Iceberg model is a good way to find a same solution to relevant problems. The process aims at find ing the basic problem. 8
  15. 15. CO-CREATION WORKSHOP We had 8 steps in the the workshop, but we just finished 2 steps in the workshop. It is still meaningful. After the workshop, I collected the problems and continued the iceberg model. This process is to find the potential problems and from specific problem to new problem. Stand on the system to form a system solution for the new general problem.I use the iceberg model to find the basic and general problem. This is a good way narrow my user research. Standard information system/ Suitable Diet/Money segment/Easy communication pipe/between doctors7Good understanding between patients and doctors/Rescue system/Bad rehabilitation quality/Family support 9
  16. 16. I interviewed with two patients deeply and a short random access interview with Ten People. One was at his home for 3 hours. Another was in a cafe near his working place for an hour. It is difficult for me to contact with patients in Norway due to the protection policy. USER RESEARCH 10
  17. 17. INTERVIEW A I design an interview based on problems from the first workshops, talking about overview,Things,Lifesty le&Drug,Relationships( community),family support and rescue. 11
  18. 18. ‘I believe my doctors.I don't need my children to support me. My children visit me a lot, but I don't think they can support me for my troubles. They just gave me some regular suggestions.’ ‘I put this fitness equipment very close to my bed. It makes me feel safe, when I do some excises.’ ‘Healthy diet and nutrients work good for my trouble. 3 year ago, I followed a healthy diet routine. The doctor told me my heart trouble was better after that routine. I gave up, because it was a burden-money and a lot of steps, and doctors gave me some new medicine.’ ‘I use computer a lot. Mobile phone is important for me, because it means communication.’ 12
  19. 19. INTERVIEW B ‘I am afraid to take medicine and it make me feel like a patient. Expect hypertension, I'm quite healthy. Sometimes I forgot to take the medicine.’ 13
  20. 20. Based on the deep interview, I choose what I am interested in to do a short random interview. Two people is a small group for user research, but it is difficult to go on deep interview many times. 9/10 people believe Norway’s healthcare system. They believe doctors more than family members.Not like China, the healthcare are not very good. The people are more relied on family 7/10 people believe good diet can treat disease and keep healthy, but it is difficult to insist on a special diet.People can not insist on it because the diet is expensive and with more steps to follow. People not address a lot on diet. 9/10 people will forget to take medicine more than 4 times per month, especially longterm medicine. The longterm medicine cause social problem when they have medicine other people always ask their situation. RANDOM ACCESS INTERVIEW 14
  21. 21. PROBLEM COMPARING MAP Use this map to discover the problems. Eg; the communications between doctors Patient A agreed: he think it is not necessary, he can be a bridge between doctors.Patient B disagree: he told me they just share information not discuss my condition 15
  22. 22. I interviewed the leader of communication from LHL.LHL is special organization, because they are not only an organization but also owner of a hospital. They call this is a perfect healthcare model. We had a 2 hour talk. Kristin told me some cases about LHL- a social innovation for lung disease all around Norway which is an activity for healing mental problem and the balance between top-down structure and bottom up structure. They have a project to develop an APP for cardiovascular patients. I only know one doctor is my doctor in Oslo kommune, Legevakten. She is always busy,but she sent me some paper materials about healthcare system in Norway. INTERVIEW WITH DOCTORS 16
  23. 23. GIGA-MAPPING HEALTHCARE SYSTEM IN NORWAY General Process Management System Economic Process After the interview, I used the insights and paper materials to giga-mapping the healthcare system in Norway. 17
  24. 24. RESEARCH MAP After finishing the research map, I put the potential problems in the whole map and see their relationships in different levels, and think some preliminary ideas. 18
  25. 25. DESIGN TREND Based on structure in School of Design, CMU Nowadays, design researcher divide the design area into three area. Based on this structure, I work out three different preliminary ideas. 19
  26. 26. Good Understanding between Patients and Doctors Good understanding between patients and doctors is potential area. Opposite opinions and some same views make this area active. It can evolve in a long journey for patients in existing system. ARE SYSTEM PATIENTS GOOD CASES using risk based approach to redesign service empower individuals organize care for needs not diseases payments on results not activity integrating care across doctors and patients long investment for system invest in climate adaptation standard develop safety cases creating cultures and midgets manage risk locally ED decision making incorporating their abilities preferences lifestyle own treatment patient engagement sustainable hospital mobile health health alliance digital appointment measuring true value knowledge sharing Patients’ Journey & Existing System moderate change Medical Case Paper Visual Communication& Interaction Design PRELIMINARY IDEA ONE 20
  27. 27. Culture Driven/ Professional Power Service Design/ Interaction Design ED CARE SYSTEM PATIENTS GOOD CASES using risk based approach to redesign service empower individuals organize care for needs not diseases payments on results not activity integrating care across doctors and patients long investment for system invest in climate adaptation standard develop safety cases creating cultures and midgets manage risk locally OCIAL NEED decision making incorporating their abilities preferences lifestyle own treatment patient engagement sustainable hospital mobile health health alliance digital appointment measuring true value knowledge sharing z TY CULTURE VALUE SAFETY BELIEFS ATTITUDES PERCEPTIONS Communications founded on mutual trust Confidence in the efficacy of preventive measures. Shared perceptions of the importance of safety z Patients’ Journey & Emerging System significant change Rehabilitation Based on Community PRELIMINARY IDEA TWO 21
  28. 28. Change Medicine Industry Deign for Radical Change There are lot of research about cardiovascular patient to map the new system based on trend study. Create new scenario to interact with people under patient centered care to promote the new system.I hope to use design method to promote the hospital or medicine industry can change their role in the system. PRELIMINARY IDEA THREE 22
  29. 29. leverage points 23
  30. 30. First Co-creation Workshop 24
  31. 31. People Resource Interactions Mechanisms of Change Direction/ Idea IDEA ONE IDEA TWO IDEA THREE preliminary idea Use PRISM to Improve Ideas 1 2 LEVERAGE POINTS3 Improve Ideas PRISM METHOD from InWithForward PROCESS 25
  32. 32. 26
  33. 33. Specialist Nurse Object/Display in hospital Patients Interaction APPiPhone iWatch Website at home Object GP collect data Visualization Information Mechanisms of Change Contributing & Reciprocating to increase meaning & purpose Good touched visualization can increasing the meaning for experience and increase purpose frothier health. Scale Daily life/Hospital The young/Middle-aged Object/Environment Interaction/Product IDEA ONE 27
  34. 34. DAILY LIFE Interaction Design Product Design IN HOSPITAL Interaction Design Product Design it is a good Kickstarter project. It is a real digital object or some object combined with iwatch or iPhone. In hospital maybe is a screen connected to customer’s app and doctor’s system. This is a holistic design involve in different scenarios. IDEA ONE 28
  35. 35. Change the structure of information flows IDEA ONE 29
  36. 36. Frida is a middle age guy. He is crazy about apple products. He has a great job in a band which means he is super busy everyday. One day he felt bad, and go to see doctor. He was diagnosed with high blood pressure. a was sad. He though he was too busy to notice his health condition, Although he had some apps for his health. One day, he found a fabulous flower. He brought it to home. That’s a magic flower. The feel bad, The flower will also be in super bad condition.That’s great visualization to make him realize his health condition. HEALTH TIME HEALTH TIME IDEA ONE 30
  37. 37. Resources DNV GL Research Resources (Standard of Health) LHL (consultant) People Cardiovascular Patients General Doctors Specialist Nurse Interactions CHECKLIST LIFESTYLE GUIDE CHECKLIST REHEBITATION GUIDE CHECKLIST NOTICE MEDICINE STORY BOOK OPERATION PROCESS his pack gift is a holistic interaction between customers and professionals. Scale Daily life-Hospital Male-Female Service-Management Mechanisms of Change Feedback to increase validation & motivation The goal is to use feedback to change and promote the experience during the process. IDEA TWO 31
  38. 38. For the design part compare form and function like app or paper is important. The movie should be cartoon which not creates new mental problem. Medicine management can applied in the gift pack system. CHECKLIST LIFESTYLE GUIDE CHECKLIST REHEBITATION GUIDE CHECKLIST NOTICE MEDICINE STORY BOOK OPERATION PROCESS APP Paper Paper Cartoon PaperDigital Explore best form/materials/techniques/ ideas for gift pack Daily Medicine IDEA TWO 32
  39. 39. The gain around driving positive feedback loops. IDEA TWO 33
  40. 40. Laura is 50 years ago. She usually go to visit GP. At that time, she got a gift pack. Yes, a gift pack for her current situation. A checklist to manage her diet and CHECKLIST LIFESTYLE GUIDE When her condition got worse and worse, she went to see her GP. The GP referred a special examination. At this time, she got a gift pack. This gift pack has some CHECKLIST NOTICE MEDICINE after the special examination, She need a surgery. Before the surgery, she got a gift pack. This gift pack have a story book to soft her emotion and a movie of the operation process. STORY BOOK OPERATION PROCESS After the surgery, she also got a gift pack. In this gift pack, there is a check list and rehebitation guide book CHECKLIST REHEBITATION GUIDE IDEA TWO 34
  41. 41. Diversity and deep understanding of food and medicine change the role of food and medicine.Food can be a treatment.Medicine is for keeping health, not for treatment.More and more medicine companies evolve in food industry. Resources DNV GL Research Resources (Standard of Health/ Patient Centered Care) Designers (consultant) IDEA THREE Mechanisms of Change Taster Experiences to shape preferences & goals Barrier Busting to manage stressors & increase future orientation This direction is aim at shaping the preferences and goals also increasing future orientation. Trend People Cardiovascular Patients General Doctors Specialist Nurse Hospital Medicine Industry DNV GL Research Group Government http://www.kenko.com/product/ item/itm_6924185772.html 35
  42. 42. Food and medicine in future not just the object. It will will be with a lot of information on itself and its package or people’s APP. Regard this, use the food and medicine as a new touchpoint between the customers and professors.This also change the role of supermarket and Pharmacy in Future.Government should involve in it. DNV GL can be a certification provider in new area Scale IDEA THREE Trend 36
  43. 43. Change the rules of system IDEA THREE 37
  44. 44. Co-design is a very interesting process based on the background of DNV GL. We can figure the form, function , techniques and ideas for different stage. It also will create other relevant design evolve in this process, product and APP and service. This is a good outcome to cause discussion of the unclear Border between the food and medicine. IDEA THREE 38
  45. 45. CO-DESIGN WORKSHOP 39
  46. 46. We use the one way to identify the patients. We ignore the identity for health for people.In the workshop we used card sorting to do co- design workshop. Touchpoint: Medicine and Food Card sorting for form/function/techniques/ idea in holistic process. Based on human centered design. SEVERAL MONTHS PREVENTION VISIT GP MAKE A TENTATIVE DIAGNOSIS RECEIVING S EXAMINATION REFERS TO AN S DEPARTMENT GP/( PUBLIC HOSPITAL) EXAMINATION OPERATION NECESSARY MEDICATION SURGERY PUBLIC HOSPITAL PRIVATE HOSPITAL REHABILITATION AT HOSPITAL SHORT TIME HELFO GP VISIT GP A B C D CO-DESIGN WORKSHOP 40
  47. 47. T�ea���n� K��� He�l�� Fish Oil Collagen Te� Ve�et���� Fi�� F��i� J�i�� Nu����nt� Nu����nt�G���i� Me�i���� f�� L�n�-���� ACEI Captopril/Enalapril//Perindopril/Benaz- epril/Iimidapril/Fosinopril/Ramipril Me�i���� f�� L�n�-���� ARB Losartan/Valsartan/Olmesartan/Telmisartan/- Candesartan/Iirbesartan Me�i���� f�� L�n�-���� B blockers Metoprolol/Bisoprolol/Atenolol/Esmo- lol/Propranolol Me�i���� f�� L�n�-���� Calcium channel blockers Nifedipine/Felodipine/Amlodipine/Dilti- azem/Verapamil Me�i���� f�� L�n�-���� Diuretics Furosemide/Hydrochlorothia- zide/Indapamide/Spironolactone Me�i���� f�� L�n�-���� Antiplatelet and anticoagulants Aspirin/Clopidogrel/Tirofiban Hydrochloride/Heparin/Warfarin Me�i���� f�� ���p���n� Coenzyme Q10 Me�i���� f�� ���p���n� Cyclic Adenosine Monophosphate Me�i���� f�� �h��-���� A blocker Prazosin/Terazosin Me�i���� f�� �h��-���� Anti-ischemic Nitroglycerine/Isosorbide Dinitrate Me�i���� f�� �h��-���� Thrombolytic Urokinase/Streptokinase/rt-PA Me�i���� f�� �h��-���� Lipid regulating Atorvastatin Calcium/Rosuvastatin Calcium Me�i���� f�� �h��-���� Anti-arrhythmic Quinidine/Propranolol/Amiodarone /Verapamil Me�i���� f�� �h��-���� Inotropic agents Digoxin/Cedilanid/Milrinone Me�i���� f�� �h��-���� Anti-shock Dopamine/Adrenaline/Atropine Treatment Keep Health NEW CLARIFICATION 41
  48. 48. IDEA FROM WORKSHOP IT’S TIME TO HAVE A IT’S TIME TO HAVE B IT’S For keeping health. For keeping health. For treatment. (even through the chronic disease people have same image with normal people) Treatment Keep Health One day package X days package After x days, people will have a examination Interaction identity Package identity IT’S IT’S IT’S Health Map good bad Visual Report 42
  49. 49. DESIGN DEFINITION A TOOL TO COMMUNICATE WITH DOCTORS REDESIGN THE IDENTITY OF MEDICINE AND DIET IN SMART NOT JUST APPEARANCE ➤ Redesign the identity for medicine and food ➤ Design a professional way for people to communicate with doctors outside of hospital. Norway has a good healthcare system. People believe the professionals than other pipes. The professional communication tools are necessary for people even through they are just at high risk of cardiovascular patients. It difficult to change the identity of medicine and food trough directly way package or appearance, but digitalization still provides some opportunities to change the identity of the medicine and food. All the things require me to regard App as a touchpoint to connect the different touch points to make a holistic service for customers. HELFO is making the patients information standard which play an important role on the App which can be easily set up in future. Design is increasingly important in healthcare system. App is also a good factor to change the whole system, 43
  50. 50. prototype 44
  51. 51. TREATMENTKEEP HEALTHYPREVENTION HOLISTIC PROCESS 45
  52. 52. MAKE APP WITH MODULAR FUNCTION 46
  53. 53. an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP THREE Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP PREVENTION USER’S JOURNEY Actually people can not have a talk about suggestion for their future healthy life. Depending on the user research, people prefer to listen to professional people suggestions. Due to this reason, creating a very professional scenario is necessary for people. This is easy way to make the people follow the suggestion for prevention. They will begin their prevention from GP., regarding the prevention process as a professional treatment. Visual report is a strategy for engaging doctors. Doctors is very busy. Making a simple and meaningful image based on data is a good way to save time for doctors. The doctors can give a feedback in a short time, also creating a positive quick feedback for patients. 47
  54. 54. KEEP HEALTHY In future, delivery medicine is a obvious trend. But people is afraid of delivery medicine. 4/5 people think they hope their doctor can make sure the medicine is correct through the delivery system. This point will create a new business model in future. Who can be in charge of the medicine to delivery.. This system should be very flexible for different customers. 48
  55. 55. testing c o l l e c t d a t a o k o kc o l l e c t d a t a b l o o d p r e s s u r e h e a r t r a t e 000mmHg / 000mmHg 000/min 130mmHg 85mmHg 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 60/min 100/min 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 10/24 2015 h e a l c a r d i o PM TREATMENT USER’S JOURNEY There are already a lot of APPs tracking the body data. For simplifying the healcardio. healcardio can get the data directly from other APPs like ihealth, during the clickable prototype test, 4/5 people felt confused and difficult to use it, if they can use healcardio to collect data directly. 49
  56. 56. Comparing the APPs on the market, most of the Apps are green. To create a uniqle brand, I choose to use single main color red with a soft style. The basic principle of the Apps is simplicity. I will follow it. h e a l c a r d i o sign in sign up An angel for your heart. Gill Sans Adobe Caslon Avenir Next Color Font Soft Sharp Multiple Color Single Color BRANDING 50
  57. 57. IDENTITY OF DESCRIPTION New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP TWO Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP THREE Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E: 1 2 3 Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention. The illustration is very necessary. 4/5 users think it is useful. 51
  58. 58. 5/5 users think they can use healcardio through doctors. They don't think they can use an APP through the APPs store directly. I asked users to make sequences based on professional. 1=not professional, 3=professional A:2 1 3/ B:1 2 3/C:2 1 3/D:2 1 3/E:1 2 3 Use color for different stages. Keeping Health and Prevention stages have the same color. Treatment is use another color to show the process should be paid more attention. The illustration is very necessary. 4/5 users think it is useful. 52
  59. 59. Two Action One Action YESorNO IDENTITY OF DESCRIPTION Two Action 53
  60. 60. Test with clickable prototype 9 54
  61. 61. IDENTITY OF DESCRIPTION accurate joyful Joyful Accurate Use professional way to address the importance on diet. People use this way to communicate with doctors and get encourage.Use the joyful interaction way to change the identity of long-term medicine and make this activity more relaxed.Checklist is the most familiar way for users. This way can provide professional and accurate interaction way.Test for accurate and joyful. This quality is low. Due to the test group are 5 people. 55
  62. 62. Salt 0.50g 0.50g 0.50g 0.50g 0.50g IDENTITY OF FOOD I sent my idea to my interviewees before through the e-mail. Surprisedly, they think this is a problem for them not just for salt and fat. Sometimes their doctors to ask them to have fix amount of food, but they don't have ability to measure them. 56
  63. 63. New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA SHOPPING ONLINE STICKERS When people prefer to believe the professions, feedback becomes important. It doesn't mean doctor should do anything for their customers. We don't have enough medical staff to provide an extremely good user experience. Thus, the way of people to take the medicine, I choose empowering the individual to make a small change for future change. People use the sticks to manage the medicine by themselves. IDENTITY OF MEDICINE 57
  64. 64. New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets at the first sign of chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating blood vessels allows blood to flow more easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* I sent a email to ask two interviewees before. Both of them think they feel the physical paper is much safer than the digitalization. They will print it by themselves if they just have digital edition. 4/5 users told that they can use the paper to check the information on app. This can set a safer scenario. SAFETY CULTURE 58
  65. 65. PROFESSIONAL COMMUNICATION 5/5 people during the test, they are happy to use healcardio to communicate with doctors especially during the treatment stage. 2/2 doctors think this is a good way to communicate with patients. The doctors doesn't want to make a link through their private APPs like imassage, eve though a lot of patients want to add them. Communication part is difficult to test in a short time. The problem here is that should doctor can know anything. I just design one image for users to communicate with others, some people doubt that they don't want show some data to the doctors. If I make this apps just for cardiovascular patients. Users (5/5) can accept the data to share (salt fat blood pressure and heart rate) Share the image with others through other SNS apps is better than creating a fountain that they can use this apps with other family members and other same people. This can make the apps more complex agains the strategy simplicity. Through other platform can also make a better integration. 59
  66. 66. FUTURE SYSTEM This is new system in future. I hope use this project to show the holistic process can not live without t system thinking. I found that it is difficult to do a holistic experience now in Norway because the institution under government is independent like helfo and public health center. There should be a innovation center in future. Obviously with DNV GL basic research on healthcare. more and more design industry will go into this system. 60
  67. 67. MAP I W O R K W I T H N E W I D E N T I T Y F O R F O O D A N D M E D I C I N E I N S Y S T E M T H I N K I N G H O L I S T I C P R O C E S S F O R T H E C A R D I O V A S C U L A R A P R O F E S S I O N A L P I P E B E T W E E N C U S T O M E R S A N D D O C T O R S . I W O R K F O R SAFETY CULTURE VALUE SAFETY BELIEFS ATTITUDES PERCEPTIONS Communications founded on mutual trust Confidence in the efficacy of preventive measures. Shared perceptions of the importance of safety PATIENT CENTERED CARE SYSTEM PATIENTS GOOD CASES using risk based approach to redesign service empower individuals organize care for needs not diseases payments on results not activity integrating care across doctors and patients long investment for system invest in climate adaptation standard develop safety cases creating cultures and midgets manage risk locally PHYSICAL/PSYCHOLOGICAL/SOCIAL NEED decision making incorporating their abilities preferences lifestyle own treatment patient engagement sustainable hospital mobile health health alliance digital appointment measuring true value knowledge sharing professional patients researchers policy makers STATEHOLDERS INFLUENCE FACTORS equality sustainability EVALUATION environment timeliness cost efficiency person centered safety debt crsis/coherent aging population/equal expanding government leading urban and rural high cost/serious pressure gap between the rich and poor MAIN MARKET conservative culture patient habits and preference sector fragmentation GENERAL PROBLEM aging population emerging disease pattern climate change rising costs inequitable access poor safety record no holistic care SPECIFIC PROBLEMS 1/10 patients harmed in hospital dementia/chronic increase ICT is slow poor coordinated effort CARDIOVASCULAR STATE/NATIONAL BUDGET CITIZENS / EMPLOYERS/PATIENTS REGIONAL HEALTH AUTHORITIES LOCAL GOVERNMENT (MUNICIPALITIES / COUNTIES) HELFO PUBLIC HOSPITALS PRIVATE SPECIALISTS PRIVATE HOSPITALS GP NURSING HOMES AND LONG-TERM CARE DENTAL CARE FOR CHILDREN AND OTHER DEFINED GROUPS NATIONAL TAXES LOCAL TAXES FINANCIAL SYSTEM maritime sustainable organisation (environmental/social/economic-longterm) FOOD&WATER/OIL&GAS/ELECTRICITY&RENEWABLE/SHIPPING SAFER SMARTER GREENER SAFE AND SUSTAINABLE FUTURE oil and gas energy business insurance software AREABRANDING MANAGE RISK BUILD TRUST HEALTHCARE INNOVATION global impact aligning split incentives managing system risks empowering stakeholders accounting for value transforming mindset an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP FOUR Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets a f chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating re easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* MANAGEMENT SYSTEM NATIONAL INSURANCE SCHEME MINISTRY OF LABOUR HOSPITALS HOSPITAL TRUSTS REGIONAL HEALTH AUTHORITIES MINISTRY OF HEALTH AND CARE SERVICES GOVERNMENT PARLIAMENT DENTAL PRIMARY CARE CARE PROVIDERS PRIMARY CARE CARE PROVIDERS PROVIDERS MUNICIPALITIES COUNTIES DIRECTORATE OF HEALTH (INCL. HELFO) BOARD OF HEALTH SUPERVISION INSTITUTE OF PUBLIC HEALTH MEDICINES AGENCY RADIATION PROTECTION AGENCY BIOTECHNOLOGY ADVISORY BOARD SYSTEM OF PATIENT INJURY COMPENSATION SAK NOKC POBO 61
  68. 68. USER RESEARCH CARDIOVASCULAR PATIENTS DIAGNOSE EMERGENCY RESCUE EMERGENCY RESCUE EMERGENCY RESCUE REGULAR INSPECTION REGULAR INSPECTION STANDARD INFORMATION SYSTEM ENOUGH DOCTOR AND NURSE MONEY SEGMENT EASY COMMUNICATION PIPE BETWEEN DOCTORS GOOD UNDERSTANDING BETWEEN PATIENTS AND DOCTORS RESCUE SYSTEM BAD REHABILITATION QUALITY FAMILY SUPPORT YES NO PERSPECTIVE PERSPECTIVEPATIENT A PATIENT B PERSPECTIVE an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP FOUR Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP New Journey for you 01/10/1015 to 01/11/1015 Dear Lily, As I said through healcardio, your situation is quite nice.Continue to take Aspirin & Metoprolol to keep health. ASPIRIN This is an element for prevent heart attacks, strokes, and chest pain. Take 1 tablet everyday at the beginning of happy days before breakfast. Scan Code Put on your Aspirin Package METOPROLOL This is an element for prevent high blood pressure and chest pain. Take 1 tablet at the morning and 1 tablet at evening before diet everyday. Scan Code Put on your Metoprolol Package Your GP THIS IS FOR PHARMACY OR SHOPPING ONLINE CODE: DFBFSDA89DDA Scan Code Nitroglycerin 01/10/1015 to 05/10/1015 Dear Lily, is Nitroglycerin is for a 5 days treatment, you should take it very carefully before next week examination. How Take 1 tablet at 7:00am&9:00pm everyday. Do NOT swallow, chew, or crush this tablet. Dissolve the tablet under the tongue or between the cheek and gum.To treat an angina attack, use nitroglycerin tablets a f chest pain. Sit quietly while the tablet is dissolving. WHAT Preventing or relieving a sudden attack of chest pain caused by heart disease. Nitroglycerin is a nitrate. It works by dilating (widening) blood vessels. Chest pain occurs when the heart needs more oxygen than it can get. Dilating re easily. This reduces the heart's workload and the amount of oxygen needed by the heart. NOTICE Do NOT use nitroglycerin tablets if: you are allergic to any ingredient in nitroglycerin tablets you have increased pressure in the head you have severe anemia Your Doctor !"#$%&'()*$"+ !"#$%&'()*$"+ ,'%%-./*00*'0 !"#$%&'()*$"+ ,%+&-* an easy way to keep you from cardiovascular disease Dear Lily, Depending on your current situation ( see your document ), I think you are at a high risk of cardiovascular disease, but don't worry about it, it is not serious, if you follow these steps. STEP ONE Suitable Exercise and a Balance Diet as possible as you can, this is not just for prevention but also a good daily life. STEP THREE Most important things for diet are salt and fat. I recommended the max daily amount of salt is 6.00g and the max daily amount of fat is 6.00g. STEP FOUR Download this lovely APP - healcaedio. This is a important bridge between us. 1. It can help you to track fat and salt. 2. You can use it to manage your body data. 3. You can use it to communicate with me, and share the data you like to share. I can give you feedback as soon as possible and make a future plan. Sign up Enter this code: 463284325324 Remember that we use healcardio together. Don't feel alone. Your GP 85-130 mmHg 60-100 /min Salt:6g Fat:66g k e e p h e a l t h blood pressure heart rate 62
  69. 69. reference 44
  70. 70. 44 Giga-mapping: Visualisation for Complexity and Systems Thinking in Design. Birger Sevaldson Dancing With Systems Donella Meadows Types of Systemic Relations Birger Sevaldson The Design Way Intentional Change in an Unpredictable World Harold G. Nelson 7 Reasons Why Our Social Services Keep Failing: An Argument for Grounded Change Dr. Sarah Schulman Design For Care Peter Jones Prototype Evaluation in Service Design A Case Study at an Emergency Ward Johan Blomkvist Radical Redesign The Australian Center for Social Innovation Healthcare 2050 DNV GL Patient Centered Care DNV GL Transitions to Sustainable Development: New Directions in the Study of Long Term Transformative Change Grin J, Rotmans J
  71. 71. reflections 44
  72. 72. 44 This is a meaningful semester to know something new. In the studio, I learnt system oriented design systematically. I know how to use the system to set up a design project from research to systematic impact step by step. I can use giga-mapping in different ways. At the beginning, using the giga-mapping to find a start point-ZIP. This is most important thing for the complex problems which is difficult to find a correct stone to carry on. After that, gaga-mapping can also be used as a tool to find the relationships between problems especially combined with iceberg model. Giga-mapping can also be used in design process which can make me figure out a holistic solution easily and know the relationships between different touch points. Giga-mapping is a great process crossing the whole design process. Cooperation with DNV GL is a super happy process. They have done a lot of project about healthcare and are a global company. In this way, I can get a big picture of healthcare system all around world, and this is a great way to understand the different culture between Norway, China and other countries after the deep user researches this semester. I’m luck to visit Mayo Clinic which provide me a deep understanding of healthcare system. I think the result of this semester is good, even through the design seems to be unclear and not very interesting. The meaningful part is that this result is from system thinking not just from a good idea. Seeing the whole system map, I think my design is effective and really can benefit people in a holistic perspective. This project is not addressing single design. I think my design can make the whole touchpoint work together for a systematic impact. It is not enough time to understand the system oriented design just for one semester. It is obvious that I need a long time to practice the system thinking. I’m not familiar with the all the context of create a positive systematic impact for my design. There are so many method to create leverage points. In a real system, there are many methods which can be used together at the same time. When I consider the system impact, I often forgot to use multiple ways to create systematic impact on my own system. Using one design which can address different methods is quite difficult.
  73. 73. 44 I’m struggling with the balance between system and design. Sometimes I will face a conflict between a good idea from creativity and a normal idea from system thinking. I don't know how to adapt them to each other and put the a good idea from creativity in system thinking. This process is quite difficult. Some good ideas are not very relevant with each other, but normal ideas can be seen as a group power. System oriented design is quite difficult to evaluate in real world for a student. It is difficult for me to say which is better. Foreigner is difficult to do user research sometimes. Native language is important for interviews. This can make the interviewees into a familiar scenario. I met another interesting problem. This happened during my random access interview with 10 people. I ask them if they think Norway has a good healthcare system. 9/10 told me they think Norway has a great healthcare system. For me, my Norwegian friends complained a lot about healthcare service in Norway, but it is difficult for me to ask something bad in Norway’s healthcare system. I guess the reason is national pride. Time management is urgent issue for me this semester. Everybody has the same deadline which gave me a lot of pressure. Everyone has different projects, in this situation I think the amount of work is different at different stages. The same deadline sometimes make me super busy and sometimes have little thing to do. I have no balance speed this semester. I used the textbook time to balance my time, but I will forgot the knowledge, if I didn't do any practice. I hope I can practice system oriented design method more to understand this complex world.
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