The patient of the past is not the patient of the future. Mayo Clinic is currently engaged with the Center for Innovation in a multi-year initiative to redesign their outpatient practice, a necessary step for any large healthcare provider who hopes to be relevant and financially aligned with the future. The organizational and operational design of the current clinic has been influenced by the patient of the past and their medical needs. From our exploration, we hypothesize that today’s patient is significantly different from the patient of the past and new care models should better support the needs, goals, motivations, and emotions of these new patients. Additionally, we believe that the patient of today will continue to change, allowing us to consider a new paradigm of flexible, evolving care models that continue to adapt to the changing needs of patients. The goal of this presentation will be to share how the current patient and patient of the future differs from the patient of the past and tie these findings to the on-going design explorations being conducted at Mayo Clinic. Meredith DeZutter is a Senior Service Designer at the Mayo Clinic Center for Innovation. Her work focuses on designing new healthcare services, products, and experiences across the clinic by understanding the intersection and connections between existing systems with disruptive landscape drivers. In addition to her work at Mayo Clinic, Meredith has over 15 years of global consulting experience in identifying and developing innovative design solutions for both products and systems. Meredith has led design research and strategy efforts for project teams for organizations such as Kent Hospital, Becton Dickinson, Herman Miller for Healthcare, and Thoratec Corporation, among others. Additionally, she has delivered lectures and papers on new ideas and methodologies in design research and strategy to corporations, professional societies, and exhibitions. Meredith has a BFA in Industrial Design from Carnegie Mellon University. Prior to working at Mayo Clinic, she was the Director of Research at Ximedica as well as the Director of Design Strategy at Insight, both design consultancies focused on healthcare service design and medical products.

1. HEALTHCARE EXPERIENCE DESIGN CONFERENCE 2012
Aligning New Care Models
with the Patient of the Future
Meredith DeZutter Center for Innovation at Mayo Clinic

2. THE CENTER FOR INNOVATION- PLATFORMS
The work at the Center for
Innovation focuses on paradigm
shifts in healthcare; we use
PRACTICE
human-centered, participatory REDESIGN
research and design
methodologies
CARE AT A COMMUNITY
DISTANCE HEALTH
© 2012 MFMER

3. MISSION AND CORE VALUES
“The needs of the patient come first”
PRACTICE
REDESIGN
CARE AT A COMMUNITY
DISTANCE HEALTH
© 2012 MFMER

4. DEFINING THE PATIENT
The health continuum highlights the patient perspective
© 2012 MFMER

5. FORECASTING FRAMEWORK: STEEP [M]
The STEEP [M] methodology is used in
forecasting work to understand the
forces that surround people to
understand trends and drivers
Social
Medical Technology
Political Economic
Environ.
© 2012 MFMER

6. PATIENT OF THE PAST: 1930’s
Looking into the past, what external forces influenced the
patient of the 1930’s…
© 2012 MFMER

7. PATIENT OF THE PAST: 1930’s
Looking into the past, what external forces influenced the
patient of the 1930’s…
SOCIAL & ENVIRONMENTAL
ECONOMIC & POLITICAL
Lifespan 62 • SS Act, New Deal for
Great Depression economic recovery
• Authoritarian
•
Unemployment
regimens in Europe
•
Radio / some TV
• 1939 WWII
•
•
TECHNOLOGY MEDICAL
• New materials; • Some vaccinations
nylon, synthetic Tuberculosis, measles,
rubber polio
• New machinery; • No antibiotics
helicopter, jet • X-Ray
engine • Physician solo expert
© 2012 MFMER

8. PATIENT OF THE PAST - IMPLICATIONS
What trends can we discern about the patient of the 1930’s based
on this quick review?
- A time of uncertainty; people allowed
institutions / government to control their lives
- Large institutions / government worked to
standardize, one large system for all
- Information lacking; many did not play an
active role in making health and other personal
decisions
- Limited options for products and services
- Experiences created and distributed by others
© 2012 MFMER

9. FORECASTING RESEARCH: TREND CARDS
Approximately 200 trends identified
© 2012 MFMER

10. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: One person delivering
diagnosis
 Crowdsourcing diagnosis on the NYT Well Blog
of complex medical cases
 All welcome to respond not just physicians
 Also seen in the Slate posting “How Facebook
Saved My Son’s Life”
© 2012 MFMER

11. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: Care, support, and
information can only come from health care
institutions and physicians
 Social networking site
 Members share conditions and treatments
over time
 Data collected can be powerful in the future
© 2012 MFMER

12. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: Large institutions have
monopolies / control over people
 Microloans or credit that people can provide to
others; disruptive innovation in finance and
healthcare
 Often empower people who may not receive
loans from banks
 2009 estimated 74 million recipients
© 2012 MFMER

13. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: Health is only a medical
condition; social and economic conditions are not
related
 Nonprofit embedded in hospitals in 6 cities
 Connects low-income patients with basic
resources (food, housing, or other resources)
to be healthy
© 2012 MFMER

14. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: Access to systems have
fixed locations
 Delivery of computing as a service or utility
rather then product
 New system implications for EMR and other
key healthcare systems such as ordering and
billing
© 2012 MFMER

15. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: One person delivering
diagnosis
 Super computer as a diagnostic tool to
complement care team
 IBM currently working with WellPoint to
diagnose and provide treatment options
 At Memorial Sloan-Kettering Cancer Center,
Watson will be used as a decision support
tool for clinicians
© 2012 MFMER

16. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: The ability to monitor your
body at home and make decisions about health
without consulting a physician
 Wear at night to gather data on sleep patterns
to improve sleep quality
 Provides alarm clock that measures brain
activity to wake user at optimal time
© 2012 MFMER

17. FORECASTING RESEARCH: TREND CARDS
Orthodoxy challenged: Physically seeing patients
is the best and only way to provide diagnosis
 Data is power – date mining allows us to
discover new patterns from large data sets
 Appropriate for predictive modeling and
preventing acute conditions
 Will challenge what information we capture in
the future
© 2012 MFMER

18. PATIENT OF THE PRESENT & FUTURE
How are these forces shaping the patient of today and the future?
© 2012 MFMER

19. PATIENT OF THE PRESENT & FUTURE
How are these forces shaping the patient of today and the future?
SOCIAL
• Aver. Lifespan 78; aging population
• Social media, communities
connecting people and services
• User-created content
• On-demand entertainment,
services, and media
© 2012 MFMER

20. PATIENT OF THE PRESENT & FUTURE
How are these forces shaping the patient of today and the future?
SOCIAL
• Aver. Lifespan 78; aging population
• Social media, communities
connecting people and services
• User-created content
• On-demand entertainment,
services, and media
ECONOMIC
• Global economy in recession
• The rise of China and India
• SS and gov’t healthcare
unsustainable
© 2012 MFMER

21. PATIENT OF THE PRESENT & FUTURE
How are these forces shaping the patient of today and the future?
SOCIAL
• Aver. Lifespan 78; aging population
• Social media, communities
connecting people and services
• User-created content
• On-demand entertainment,
services, and media
ECONOMIC
• Global economy in recession
• The rise of China and India
• SS and gov’t healthcare
unsustainable
ENVIR. & POLITICAL
• The “Occupy” movement
• Arab Spring
• Patient Protection and Affordable
Care Act [2010]
• ACO’s
© 2012 MFMER

22. PATIENT OF THE PRESENT & FUTURE
How are these forces shaping the patient of today and the future?
SOCIAL TECHNOLOGICAL
• Aver. Lifespan 78; aging population • Cloud computing
• Social media, communities • Computer assisted decision-
connecting people and services making (Watson)
• User-created content • Portable diagnostics
• On-demand entertainment, • Nanotechnology
services, and media • Ubiquitous sensors
ECONOMIC
• Global economy in recession
• The rise of China and India
• SS and gov’t healthcare
unsustainable
ENVIR. & POLITICAL
• The “Occupy” movement
• Arab Spring
• Patient Protection and Affordable
Care Act [2010]
• ACO’s
© 2012 MFMER

23. PATIENT OF THE PRESENT & FUTURE
How are these forces shaping the patient of today and the future?
SOCIAL TECHNOLOGICAL
• Aver. Lifespan 78; aging population • Cloud computing
• Social media, communities • Computer assisted decision-
connecting people and services making (Watson)
• User-created content • Portable diagnostics
• On-demand entertainment, • Nanotechnology
services, and media • Ubiquitous sensors
ECONOMIC
• Global economy in recession
• The rise of China and India MEDICAL
• SS and gov’t healthcare Chronic disease
unsustainable Individualized medicine
•
Regenerative medicine
ENVIR. & POLITICAL
•
Rise of retail clinics
• The “Occupy” movement
•
• Arab Spring
•
• Patient Protection and Affordable
Care Act [2010]
• ACO’s
© 2012 MFMER

24. PATIENT COMPARISIONS
How does the patient of the past align with the patient of the future?
TRENDS: PATIENT OF
TRENDS: PATIENT OF PAST
PRESENT & FUTURE
Institutions / government control; Questioning / rejecting large intuitions
worked to standardize, one system and authority
 
for all Unaccepting of standardization
Non-questioning of authority Ability to access information

Lack of health information Multiple options for products and
 
Limited options for products and services
 
services Create own experiences and choose

Experiences and information created when and where they occur

and distributed by others

© 2012 MFMER

25. IMPACT TO MAYO CLINIC
What do our learnings about the
patient of the today and the future
mean for health care?
© 2012 MFMER

26. Principle 1: One size does not fit all
IMPACT TO MAYO CLINIC
Different patient types have different needs
© 2012 MFMER

27. Principle 1: One size does not fit all
IMPACT TO MAYO CLINIC
Medical need is the foundation but not enough
© 2012 MFMER

28. Principle 1: One size does not fit all
IMPACT TO MAYO CLINIC
Individualized medicine will change processes
© 2012 MFMER

29. Principle 2: Power to the people
IMPACT TO MAYO CLINIC
Providing care for people that aligns around their need and
empowers them to make decisions
1) Many not aligned with the needs of the patients;
organizational structure represents the physician training
2) Patients a critical part of care team; given information to
make decisions
3) Appointments and interactions should be arranged and
scheduled around the patient not the availability of clinicians
or access to departments
© 2012 MFMER

30. Principle 3: It takes a village
IMPACT TO MAYO CLINIC
© 2012 MFMER

31. Principle 3: It takes a village
IMPACT TO MAYO CLINIC
© 2012 MFMER

32. Principle 4: Build connections and
IMPACT TO MAYO CLINIC
relationships, not buildings
© 2012 MFMER

33. Principle 4: Build connections and
IMPACT TO MAYO CLINIC
relationships, not buildings
© 2012 MFMER

34. We need to keep
FUTURE WORK
moving forward, at
Mayo Clinic we will:
1) Continue to understand the needs of
the patients through ethnographic
research
2) Experiment with new ideas within
the practice; clinical lab opening this
summer where we can experiment
with new ideas
© 2012 MFMER

35. LAST THOUGHT
We are all patients and should create
the system and experiences we want;
what would you like to see?
© 2012 MFMER