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Copyright © 2013, Peter Jones
Design for Care
Design Research for Human-
Centred Healthcare
Peter Jones
Redesign Network
OCAD University, Toronto
Copyright © 2013, Peter Jones
Publishing Innovations
• Design series, design values
• Print + PDF, Kindle, ePub
• Images free on Flickr!
• Not about “selling books”
• Book as a medium for field &
practice development
• Continuous process, not an “end”
designforcare.com Booksite (DFCFRIENDS)
caredesignnetwork.com Practice network
@designforcare
Copyright © 2013, Peter Jones
Why this book.
Copyright © 2013, Peter Jones
Where care lives.
Copyright © 2013, Peter Jones
“What if Designers were included
in the team as care professionals?”
Helping Medicine change from the
inside. A design capacity for health
practice & care organizations.
• People not patients.
• Systemic, touches every sector
• Connects across disciplines
• Cases, Methods, Experiences
Rethinking Care
1. Design as Caregiving
2. Co-Creating Care
3. Seeking Health
Rethinking Patients
4. Design for Patient Agency
5. Patient-Centered Care Service
Rethinking Care Systems
6. Innovating Points of Care
7. Designing Healthy Information Technology
8. Systemic Design in Healthcare Innovation
9. Futures in Service Innovation
designforcare.com
@designforcare
Design for Care:
Innovations in Healthcare Experience
Copyright © 2013, Peter Jones
YET DESIGN HAS MADE A HUGE DIFFERENCE.
SHIFTING FOCUS FROM PRODUCTS –
DEVICES, SOFTWARE & “THINGS” …
Copyright © 2013, Peter Jones
Information & Online Services
Copyright © 2013, Peter Jones
Devices & Medical Products
Zero diabetes armband concept
Mauro Amoroso
Timesulin insulin pen
Toshiba CT scanner
Copyright © 2013, Peter JonesPhilips Design, from Coroflot magazine
Experiences
Philips CAT “dollhouse” sim
Copyright © 2013, Peter Jones
TO SERVICES & CONTEXTS …
Copyright © 2013, Peter Jones
Yet we are fragmenting Design Thinking
in Healthcare
• User Experience / Interaction Design
• Service Design
• Evidence-Based Design
• Environmental Design
• Participatory Design
• Generative Design
• Radical Innovation
• Bridging discipline: Sociotechnical systems
Copyright © 2013, Peter Jones
Contexts of Care Design
12
SERVICE
Copyright © 2013, Peter Jones
Copyright © 2013, Peter Jones
1. People, not users nor patients.
People behave as Health Seekers.
2. Hospitals / Practices, cultural & business.
Cultural & business design sustain an
enterprise in a community / system.
3. Healthcare is a service system.
Service systems are designable.
Copyright © 2013, Peter Jones
Design Geographies
Each level has a skillset.
Complexity increases with each .0
Number of stakeholders >
Need for collaboration >
But design skills do not transfer up
Healthcare may demand all 4.
At least > 1 designer
And > 1 clinician
And > 1 manager
Copyright © 2013, Peter Jones
We are all Health Seekers
• We do not self-identify as patients
• Can we design for persons?
• We all seek health – not “optimal” or perfect -
but a homeostasis adapted to our lives.
• Health seeking journeys are both near-term recovery
& full life’s cycle. Including the “healthy death.”
• Design aim is to fulfill care experiences.
1
Copyright © 2013, Peter Jones
1 2
Two points have highest leverage – Primary care & Recovery
Copyright © 2013, Peter Jones
Health seeking includes information seeking across media.
Knowledge acquisition for making sense of health.
Make the most of starting points!
Copyright © 2013, Peter Jones
Health seeking design research
From observing
to representing
to interpreting
to co-creating
Copyright © 2013, Peter Jones
Design Documentaries by Health Design Lab hdlab.ca
1
Copyright © 2013, Peter Jones
Care as Clinical Service
• Care “designed” today for efficiency & cost.
• Patient experience is not a standard of design / care.
• Patient-centered is not a new “user-centered”
Risk of patient becoming a customer …
Service systems include care teams, IT, community
• Design research differs by care context:
Sequential, Iterative, Complex, Emergent
2
Copyright © 2013, Peter Jones
Healthcare AS a design practice
2
Copyright © 2013, Peter Jones
1.0 Care design for the health seeker in their own world
Fostering self-care & preventive awareness
2.0 Clinical encounter, exam, tests, diagnosis & treatment
3.0 Healthcare team, care planning & practice management
4.0 Care organizations, organizational strategy, business
model design & healthcare policy
HIT is not separate - connects to each sociotechnical system.
Clinical Design 1.0 – 4.0
Copyright © 2013, Peter Jones
Health-seeking in Context of Care
2
Copyright © 2013, Peter Jones
Atrial Fibrillation Care
Many health services treat chronic &
complex illness as exceptions. Patients fall
between the cracks & are shuttled around,
getting fragmented care. By not adapting to
the changing reality of the chronic
demographic, costs rise as hospitals increase
their exception cases.
Morra, et al (2010). Reconnecting the pieces to optimize care in Atrial Fibrillation in Ontario.
CD1 - CD4
1
2
3
Copyright © 2013, Peter Jones
26
Atrial Fibrillation System Redesign
The improvement of individual experience is
a product of designed healthcare. Good, but
not systemic. Service design must scale.
Redesigned as a service
system - coordinated
work practices, org
protocols, patient
communication
Copyright © 2013, Peter Jones
CD2.0 - Afib Personas & Care Tools
2
Copyright © 2013, Peter Jones
Healthcare Systems
• (To date) Big Box Healthcare is disrupted
by cost & policy, not by innovation …
• Business, cultural & tech innovation.
(The system is not just a collection of services)
• How should these social systems be
designed for total health outcomes?
3
Copyright © 2013, Peter Jones
How does a patient fall through the cracks?
3
Copyright © 2013, Peter Jones
IDEO + CHCF Project Synapse
3
Continuity of Care
• Patients feel they are left on their
own to figure out next steps.
• Patients with serious health issues
work around the system to get the
best care.
• Episodic and disjointed care hides
valuable connections.
• Both patients and physicians doubt
the reliability of (reported) health
data.
• Patients feel they are left on their
own to figure out next steps.
• Patients with serious health issues
work around the system to get the
best care.
• Episodic and disjointed care hides
valuable connections.
• Both patients and physicians doubt
the reliability of (reported) health
data.
Copyright © 2013, Peter Jones
Continuity of Care by IDEO + CHCF Project Synapse
IDEO + California HealthCare Foundation , 2012 3
Copyright © 2013, Peter JonesIDEO + California HealthCare Foundation, 2012
• Represent what I truly care
about
• Present information in a way I
can relate to
• Help me cross-check my facts
• Help me close communication
loops among my care team
• Set me up to have clarifying
and guiding conversations
• Clearly lay out the next steps
• Show my trajectory over time
Value to Patient expressed as …
Copyright © 2013, Peter Jones
Can we distribute care resources
among different points of connection?
Copyright © 2013, Peter Jones
Strategic Foresight – Specialized Care
Copyright © 2013, Peter Jones
Copyright © 2013, Peter Jones
Peter Jones, Ph.D.
@designforcare
designforcare.com
peter@redesignnetwork.com`

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Design for Care Toronto launch 7.10.13

  • 1. Copyright © 2013, Peter Jones Design for Care Design Research for Human- Centred Healthcare Peter Jones Redesign Network OCAD University, Toronto
  • 2. Copyright © 2013, Peter Jones Publishing Innovations • Design series, design values • Print + PDF, Kindle, ePub • Images free on Flickr! • Not about “selling books” • Book as a medium for field & practice development • Continuous process, not an “end” designforcare.com Booksite (DFCFRIENDS) caredesignnetwork.com Practice network @designforcare
  • 3. Copyright © 2013, Peter Jones Why this book.
  • 4. Copyright © 2013, Peter Jones Where care lives.
  • 5. Copyright © 2013, Peter Jones “What if Designers were included in the team as care professionals?” Helping Medicine change from the inside. A design capacity for health practice & care organizations. • People not patients. • Systemic, touches every sector • Connects across disciplines • Cases, Methods, Experiences Rethinking Care 1. Design as Caregiving 2. Co-Creating Care 3. Seeking Health Rethinking Patients 4. Design for Patient Agency 5. Patient-Centered Care Service Rethinking Care Systems 6. Innovating Points of Care 7. Designing Healthy Information Technology 8. Systemic Design in Healthcare Innovation 9. Futures in Service Innovation designforcare.com @designforcare Design for Care: Innovations in Healthcare Experience
  • 6. Copyright © 2013, Peter Jones YET DESIGN HAS MADE A HUGE DIFFERENCE. SHIFTING FOCUS FROM PRODUCTS – DEVICES, SOFTWARE & “THINGS” …
  • 7. Copyright © 2013, Peter Jones Information & Online Services
  • 8. Copyright © 2013, Peter Jones Devices & Medical Products Zero diabetes armband concept Mauro Amoroso Timesulin insulin pen Toshiba CT scanner
  • 9. Copyright © 2013, Peter JonesPhilips Design, from Coroflot magazine Experiences Philips CAT “dollhouse” sim
  • 10. Copyright © 2013, Peter Jones TO SERVICES & CONTEXTS …
  • 11. Copyright © 2013, Peter Jones Yet we are fragmenting Design Thinking in Healthcare • User Experience / Interaction Design • Service Design • Evidence-Based Design • Environmental Design • Participatory Design • Generative Design • Radical Innovation • Bridging discipline: Sociotechnical systems
  • 12. Copyright © 2013, Peter Jones Contexts of Care Design 12 SERVICE
  • 13. Copyright © 2013, Peter Jones
  • 14. Copyright © 2013, Peter Jones 1. People, not users nor patients. People behave as Health Seekers. 2. Hospitals / Practices, cultural & business. Cultural & business design sustain an enterprise in a community / system. 3. Healthcare is a service system. Service systems are designable.
  • 15. Copyright © 2013, Peter Jones Design Geographies Each level has a skillset. Complexity increases with each .0 Number of stakeholders > Need for collaboration > But design skills do not transfer up Healthcare may demand all 4. At least > 1 designer And > 1 clinician And > 1 manager
  • 16. Copyright © 2013, Peter Jones We are all Health Seekers • We do not self-identify as patients • Can we design for persons? • We all seek health – not “optimal” or perfect - but a homeostasis adapted to our lives. • Health seeking journeys are both near-term recovery & full life’s cycle. Including the “healthy death.” • Design aim is to fulfill care experiences. 1
  • 17. Copyright © 2013, Peter Jones 1 2 Two points have highest leverage – Primary care & Recovery
  • 18. Copyright © 2013, Peter Jones Health seeking includes information seeking across media. Knowledge acquisition for making sense of health. Make the most of starting points!
  • 19. Copyright © 2013, Peter Jones Health seeking design research From observing to representing to interpreting to co-creating
  • 20. Copyright © 2013, Peter Jones Design Documentaries by Health Design Lab hdlab.ca 1
  • 21. Copyright © 2013, Peter Jones Care as Clinical Service • Care “designed” today for efficiency & cost. • Patient experience is not a standard of design / care. • Patient-centered is not a new “user-centered” Risk of patient becoming a customer … Service systems include care teams, IT, community • Design research differs by care context: Sequential, Iterative, Complex, Emergent 2
  • 22. Copyright © 2013, Peter Jones Healthcare AS a design practice 2
  • 23. Copyright © 2013, Peter Jones 1.0 Care design for the health seeker in their own world Fostering self-care & preventive awareness 2.0 Clinical encounter, exam, tests, diagnosis & treatment 3.0 Healthcare team, care planning & practice management 4.0 Care organizations, organizational strategy, business model design & healthcare policy HIT is not separate - connects to each sociotechnical system. Clinical Design 1.0 – 4.0
  • 24. Copyright © 2013, Peter Jones Health-seeking in Context of Care 2
  • 25. Copyright © 2013, Peter Jones Atrial Fibrillation Care Many health services treat chronic & complex illness as exceptions. Patients fall between the cracks & are shuttled around, getting fragmented care. By not adapting to the changing reality of the chronic demographic, costs rise as hospitals increase their exception cases. Morra, et al (2010). Reconnecting the pieces to optimize care in Atrial Fibrillation in Ontario. CD1 - CD4 1 2 3
  • 26. Copyright © 2013, Peter Jones 26 Atrial Fibrillation System Redesign The improvement of individual experience is a product of designed healthcare. Good, but not systemic. Service design must scale. Redesigned as a service system - coordinated work practices, org protocols, patient communication
  • 27. Copyright © 2013, Peter Jones CD2.0 - Afib Personas & Care Tools 2
  • 28. Copyright © 2013, Peter Jones Healthcare Systems • (To date) Big Box Healthcare is disrupted by cost & policy, not by innovation … • Business, cultural & tech innovation. (The system is not just a collection of services) • How should these social systems be designed for total health outcomes? 3
  • 29. Copyright © 2013, Peter Jones How does a patient fall through the cracks? 3
  • 30. Copyright © 2013, Peter Jones IDEO + CHCF Project Synapse 3 Continuity of Care • Patients feel they are left on their own to figure out next steps. • Patients with serious health issues work around the system to get the best care. • Episodic and disjointed care hides valuable connections. • Both patients and physicians doubt the reliability of (reported) health data. • Patients feel they are left on their own to figure out next steps. • Patients with serious health issues work around the system to get the best care. • Episodic and disjointed care hides valuable connections. • Both patients and physicians doubt the reliability of (reported) health data.
  • 31. Copyright © 2013, Peter Jones Continuity of Care by IDEO + CHCF Project Synapse IDEO + California HealthCare Foundation , 2012 3
  • 32. Copyright © 2013, Peter JonesIDEO + California HealthCare Foundation, 2012 • Represent what I truly care about • Present information in a way I can relate to • Help me cross-check my facts • Help me close communication loops among my care team • Set me up to have clarifying and guiding conversations • Clearly lay out the next steps • Show my trajectory over time Value to Patient expressed as …
  • 33. Copyright © 2013, Peter Jones Can we distribute care resources among different points of connection?
  • 34. Copyright © 2013, Peter Jones Strategic Foresight – Specialized Care
  • 35. Copyright © 2013, Peter Jones
  • 36. Copyright © 2013, Peter Jones Peter Jones, Ph.D. @designforcare designforcare.com peter@redesignnetwork.com`