Go See the Doctor: Designing for Healthcare


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In this presentation User Intelligence illustrates the immense complexity of the health care industry, making it a tough industry to design a successful product or service for.

We recognize the shift of the industry, towards a more patient centered approach in the development of new products, processes and services. However, patient centrism seems to be sought after by copying a user centered approach from other industries. User Intelligence argues that this is too much simplified, and will leave out too many stakeholders, which in the end will negatively affect the result of a design project.

The health care industry deserves an approach in which the complexity of the industry is respected and incorporated. An example of an approach adapted to the specific needs of the health care industry is illustrated by a project on the emotional well being of prostate cancer patients.

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  • The only thing I would like you to remember the moment you walk out of this room and go for your second or third cup of coffee of the day is the following:When you are about to take up a project in the health care industry I would like you to do this:
  • I would like you to do this……
  • In any case, I would like you to stop, pause, hold, in order to think about how you are going to approach this project. Yes, of course you always do that. But please do it a little longer than normally, because you are about to start a project that is completely different from the other projects you have done before in other industries. In this presentation, we would like to give you the reason why it’s so different this time. And we will also give you an example of how to cope with this.
  • Bu first a proper introduction….My name is Martje van der Linde and I am the Research Director of User Intelligence. User Intelligence is a user experience agency. We help our clients to improve the experience of their interactive products. We do this, because we believe that great experiences lead to business value.
  • User Intelligence started in 2002, and we must be doing something right, because we grew from a one man show to a company with 3 offices, in Rotterdam, Amsterdam and Helsinki and we provide services in Norway and Sweden as well. We focus on 3 industries: publishing, telecom and since about 1,5 years we are also moving into the healthcare industry. We have approached this by first attending a lot of events. To just listen and watch what others are doing and where the pain points are….We noticed two remarkable things….
  • The first remarkable thing is the difference between a conventional industry and the health care industry. In a conventional industry, let’s say telecom, products and/or services go one way, and money goes the other way. It is as simple as that. We have designed for these types of industries many times, we know how that works, and we also know how to do that in a user centred way….
  • If we look at the health care industry, it is entirely different..YES. Care services are exchanged between the patient and the caregivers; commercial parties like hospitals, medical clinics and independent caregivers. HOWEVER,Money is paid to the health insurance companies directly and to the government through taxes and they both pay for medical treatments. And this is only a simplified model of the industry…. The result of this structure is that the industry has many stakeholders, sometimes with conflicting interests. It is complex, it is fragmented, there is no central organization and health insurance companies are profit driven. Nobody has the overview or the power to truly develop and structure the industry as a whole.  
  • The second remarkable thing is that there seem to be two magic words in the health care industry: eHealth and patient-centrism. eHealth seems to be seen as the solution to all problems, but I actually want to talk about word nr 2: patient-centrism. When talking to people in the health care industry, they are all convinced that the focus should be on the patient, in order to improve perception and moreover improve results. Of course this is already a very positive starting point. However, the way in which this patient-centrism is achieved is copied from how we approach user centred design projects in conventional industries!!!NO GOOD> We are applying an old skool approach to acquire something in an industry that works entirely different!! Patient-centrism does not equal what is best for the patient!
  • But no, in a health care industry only focusing on the patient (or another important target group, like nurses, or GP’s) will not deliver the same results as we are used to. It is too much simplified and leaves out too many important stakeholders!!Design of a product can deliver good results, but in many cases a project fails in the implementation or scaling phase. E.g. financial structure is insufficiently developed.
  • So, how to cope with this?We believe it is vital to start with a different approach in the health care industry. You can do that in many ways, but the main trick is to understand the network. To understand the context, the stakeholders and their mutual relationships and take that as a starting point for design. OK. This is very abstract, so we tried to make that a little more tangible….
  • So: we put together a four step program, which we call the Network Approach:1. Involve multiple stakeholders in research 2. Map the network around the health care process one is designing for – relationships and interactions in processes and the key insights per user group3. Discover the Network insights in the network: situations with conflicts between stakeholders, aligning interests or problems between those stakeholders. 4. Discover what kind of solution can contribute to multiple stakeholders and develop these into Network Solutions.  This is still quite abstract, so we will now illustrate this 4 step plan with a project that has been executed by Joris van Kruijssen in the past few months.
  • I’m the graduate intern at UI and I’m finishing my master’s Design for Interaction at the DUT
  • I’ve put the Network Approach in practice..With my graduation project.The focus of this project was the well-being of prostate cancer patients, in particular their emotional well-being.
  • As Martje mentioned, the healthcare network is rather complex. I needed to understand this network with all its pain points and opportunities in order to design a solution that is succesfull.
  • With the insights that I gathered from the interviews and literature study I’ve mapped the stakeholders.As you may notice this is already more complex than the model Martje showed you earlier, even though it’s a still simplifiedThe patient and his partner are in the center in this model, because they interact with nearly everyone in this contextHowever this doesn’t imply patient-centrism
  • With gathered insights I’ve mapped the stakeholders.As you may notice this is already more complex than the model Martje showed you earlier, even though it’s a still simplifiedThe patient and his partner are in the center in this model, because they interact with nearly everyone in this contextHowever this doesn’t imply patient-centrism
  • With the relations of the stakeholders in mind, I’ll elaborate a bit on the most striking things that I’ve noticed; the key insights
  • The doctor simply wants healthy patients…
  • Skeptical because doubts about legislations, reimbursement. They don’t feel the urge and don’t see the effectiveness. In their eyes it might hurt the quality of care and the employment.
  • The doctor simply wants healthy patients…
  • The goal of the insurer is to supply the patient as efficiently and effectively with care, to make the patient as healthy as possible while keeping costs limited.
  • We now have seen how stakeholders relate to each other, what the key insights were.I’ve combinedthese into network insightsAnd created a solutionI’ll show you some challenges and a some of elements of the prototype in development.
  • What?reflect on his experiences, thoughts and insights create a narrative aspect around his healthcare journey get relevant experiences and insights of peers, related to his situationWhy?create more psychosocial comfort with patients and their partnersEmpathy, support the patient in communicating with his physician(s)
  • So, getting back to the main message of this presentation…First a wrap up.
  • We have seen that the health care industry is very different from other industries. More stakeholders, more complexity, contradicting interests…
  • We have also seen that the health care industry is focusing a lot one two subjects: eHealth and patient-centrismHowever, the way the industry tries to achieve that Patient-centrism is by copying a user centred approach from conventional industry. The risk of that approach is that it leaves out too many of the other important stakeholders and that it does not incorporate the complexity that is so much more challenging in the health care industry
  • We believe that the starting point of design projects should be the wish to understand the network and is insights and solutions in a holistic approach. Be aware, this means you should take into account the interests of all stakeholders, but it does NOT mean that you should end up with a lame compromise of those interests.
  • And to help you along a little bit, we provide you with a 4 step program.
  • But of course, it’s not about the method. I don’t care how you do it…. As long as you
  • Think about it and choose wisely for the approach that respects the complex context of the health care industry and is able to generate ideas that really mean something to the various stakeholders!!
  • Go See the Doctor: Designing for Healthcare

    1. 1. Go See the Doctor: Designing for Healthcare #MappingHealth @UI_com
    2. 2. The only thing…
    3. 3. think a little longer… First,
    4. 4. Martje van der Linde Research Director at User Intelligence
    5. 5. We are an international consultancy, specializing in !   Research !   Design !   Strategy Focus on publishing, telecom and health t   Netherlands Amsterdam Rotterdam Norway Oslo Sweden Stockholm Finland Helsinki t   global services
    6. 6. Many industries are straightforward #MappingHealth @martjevdlinde
    7. 7. Healthcare is much more complex… doctor patient insurer government #MappingHealth @martjevdlinde patient
    8. 8. eHealth efficient, effective, lower costs improve perception and results Patient-centrism #MappingHealth @martjevdlinde
    9. 9. Patient-centrism Can make us blind to the bigger picture #MappingHealth @martjevdlinde
    10. 10. UNDERSTAND THE NETWORK In context, stakeholders & relationships #MappingHealth @martjevdlinde The trick is to
    11. 11. Creating Meaningful Products & Services !   Involve multiple Stakeholders !   Map the network and Key Insights !   Discover Network Insights !   Turn these into Network Solutions #MappingHealth @martjevdlinde
    12. 12. Joris van Kruijssen Graduate intern at User Intelligence Delft University of Technology @vanKruijssen
    13. 13. Applying the Network Approach My graduation project ‘Designing for the emotional well-being of prostate cancer patients’
    14. 14. Understand the network #MappingHealth @martjevdlinde
    15. 15. Involve Stakeholders to Map their network and Key Insights Semi-structured interviews #MappingHealth @martjevdlinde Patient Partner InsurerNurse Physician Literature study Developer
    16. 16. Involve Stakeholders to Map their network and Key Insights #MappingHealth @martjevdlinde
    17. 17. Key insights #MappingHealth @martjevdlinde
    18. 18. Patients
    19. 19. #MappingHealth @martjevdlinde KEY INSIGHT Emotionally disrupted by the diagnosis & difficulties in making sense More empathy wanted of their physician Worried to distress their family  
    20. 20. Physicians
    21. 21. #MappingHealth @martjevdlinde KEY INSIGHT Medical approach; emotional issues are often not mentioned Physicians face increasing demand on their time Skeptical of new communication systems
    22. 22. Oncology nurses
    23. 23. #MappingHealth @martjevdlinde KEY INSIGHT Like to monitor the emotional well-being of the patient Occasional moments to assess the patient’s emotional well-being  
    24. 24. Insurers
    25. 25. Prevent the need of psychosocial support for patients #MappingHealth @martjevdlinde KEY INSIGHT
    26. 26. Network insights & solutions #MappingHealth @martjevdlinde
    27. 27. #MappingHealth @martjevdlinde Track, collect and learn from experiences, together.
    28. 28. #MappingHealth @martjevdlinde Combine Key Insights into Network Insights The Patient tries to make sense of his changed life situation The Physician has limited time for an emotional care The Insurer wants to prevent the need of psychosocial support THE CHALLENGE doctor Reduce the patient’s emotional disruption
    29. 29. #MappingHealth @martjevdlinde Turn Network Insights into Network Solutions The Patient’s self-awareness and ability to make decisions increases The Physician is dealing with a more self-aware patient The Insurer decreases risk on costs for psychosocial support A SOLUTION doctor A tool for patients to track & reflect on their experiences
    30. 30. @martjevdlinde Turn Network Insights into Network Solutions #MappingHealth
    31. 31. Turn Network Insights into Network Solutions
    32. 32. #MappingHealth @martjevdlinde Combine Key Insights into Network Insights The Patient wants more empathy & is worried to distress family The Physician doesn’t often take emotional issues into account The Nurse wants to monitor the patient’s emotional well-being THE CHALLENGE doctor Empathy of care providers, distress of family
    33. 33. #MappingHealth @martjevdlinde Combine Key Insights into Network Insights The Patient is able to comfort family and update care provider(s) The Physician is able to empathize with the patient The Nurse can get regular insight in the patient’s emotional well-being A SOLUTION doctor Support the patient to inform others about his experiences
    34. 34. Turn Network Insights into Network Solutions
    35. 35. WRAP UP #MappingHealth @martjevdlinde Concluding
    36. 36. Healthcare is complex… doctor patient insurer government   care  #MappingHealth @martjevdlinde 1
    37. 37. eHealth is only the means to an end may leave out important stakeholders Patient-centrism #MappingHealth @martjevdlinde 2
    38. 38. UNDERSTAND THE NETWORK #MappingHealth @martjevdlinde The trick is to The network insights and solutions for multiple stakeholders 3
    39. 39. #MappingHealth @martjevdlinde 4 Creating     Meaningful   Products & Services !   Involve multiple Stakeholders. !   Map the network and Key Insights. !   Discover Network Insights. !   Turn these into Network Solutions
    40. 40. IT’S NOT ABOUT THE METHOD #MappingHealth @martjevdlinde But in the end I really don’t care how you do it…. 5
    41. 41. Martje van der Linde Research Director +31 (0) 10 737-0227 vanderlinde@userintelligence.com @martjevdlinde Thank You!
    42. 42. Interested. Want to see more? Follow @UI_com on Twitter Visit our website See more of our presentations