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Integrating Design Using the Native Language of Healthcare

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Talk at the Health Design Conference at Rice University April 2018

Published in: Design
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Integrating Design Using the Native Language of Healthcare

  1. 1. Integrating Design Using the Native Language of Healthcare Joyce Lee, MD, MPH Robert Kelch Professor of Pediatrics http://www.doctorasdesigner.com/ Twitter: @joyclee @joyclee
  2. 2. Unitio Lenovo (Grant Funding) DISCLOSURES @joyclee
  3. 3. Pediatrician/Diabetes Specialist Health Services/Clinical Research Clinical Translational Research Participatory Design/Maker Movement BACKGROUND @joyclee
  4. 4. @joyclee
  5. 5. This is not my reality @joyclee
  6. 6. xxxxxxx-diabetes-fax@med.umich.edu @joyclee
  7. 7. Don’t fix the problem, make the USER Do a workaround @joyclee
  8. 8. Don’t Change the Default, Send an email Reminder Hide Admin Docs Email: “The EHR made ”Hide Admin Docs” the default which hides lots of documents. If you are unable to find something that was imaged, first look to see if the “Hide Admin Docs” box is checked and uncheck the box if it is”” @joyclee
  9. 9. ”Do not follow these instructions-it will create the most work possible” Give instructions that go against the user’s best interest @joyclee
  10. 10. MD=“Medical Designer” @joyclee
  11. 11. Engaged Learning for Students from UMSI/Art & Design Design Thinking Workshops for Medical Students @joyclee
  12. 12. Design/Maker Workshops Apps Design by Teens Participatory Design/ Maker Workshops @joyclee
  13. 13. MakeResearch: Mastering Adolescents’ Knowledge and Engagement in Research @joyclee
  14. 14. umsickapp.info Diabetemoji.com @joyclee
  15. 15. How Might We Achieve GreaterAdoption of Design in Healthcare? @joyclee
  16. 16. Design in Tech 2015, John Maeda @joyclee
  17. 17. How Do We Measure ROI in Healthcare? @joyclee
  18. 18. @joyclee
  19. 19. “Patients, caregivers, clinicians and researchers work together to choose care based on best evidence; together they drive discovery as natural outgrowth of patient care; and ensure innovation, quality, safety and value, all in real-time.” -C3N Project A Learning Health Care System @joyclee
  20. 20. Design Quality Improvement
  21. 21. Quality Improvement Measure and improve the ROI Science of Improvement
  22. 22. Push boundaries, surprise, and delight Design Thinking Quality Improvement Measure and improve the ROI
  23. 23. Aim: To decrease the % of the population with HbA1c ≥ 9% and increase the % of the population with ≥ 0.5% HbA1c interval improvement Preference driven treatment and effective self- management Enhanced registry population management & Pre-visit planning Peer/community support Education/training to support technology use and patient viewing and problem solving with blood glucose data between visits Interventions/toolkits for addressing barriers to adherence Efficient use of technology and data to support care Access to care and regular follow-up Screening for depression Psychosocial Support Shared decision making Partnership between engaged patients and the care team Effective use of EHR by diabetes team for population management Care Process Measures • % of pts testing ≥4 times/day or using CGM (6/7 days/week) • % of pts giving 3 or more short- acting boluses/day • % of pts reviewing data between visits • % pts setting, documenting, and reviewing goals • % completed pre-visit planning • % with ≥ 4 visits per year • % of pts with annual CDE/RD/SW visit • % of pts on case mgmt pathway • % pts screened for depression Developing a Clear Measurable Aim and a Theory of Change @joyclee
  24. 24. Assembling a Team QI Director Associate Director Visual Designer Patient/Family Advisor Data Analyst Research Associate Project Manager Marketing Specialist Physicians Diabetes Educators Social Work/Psychology Admins/Office Manager Patient Advisory Board @joyclee
  25. 25. Implementing Interventions to Support Evidence-based Care Depression Screening Patient Portal Enrollment High-Risk Follow-up Shared Decisionmaking for Blood Glucose Monitoring @joyclee
  26. 26. Studying the Science of Patient Engagement Website and Newsletter Surveys @joyclee
  27. 27. Creation and Maintenance of a Data Registry @joyclee
  28. 28. Caldwell P, Mother Jones @joyclee
  29. 29. Unstructured Data Missing Patient-reported Data Underutilized Data Design (Too many clicks!!)
  30. 30. @joyclee
  31. 31. Unstructured Data Missing Patient-reported Data Underutilized Data Design (Too many clicks!!) Flowsheets/Smartforms Patient Portal Questionnaires Reporting for Population Management Clinical Interface Redesign @joyclee
  32. 32. Improving the Patient Experience @joyclee
  33. 33. @joyclee
  34. 34. “I’m reaching my last year at Stanford and I’ve run into an issue: I can understand why physicians should have design thinking as a tool. But when I think about the schooling and training to be a doctor I can’t help but imagine my creativity being crushed by endless memorizing and “this is exactly how you do this” kind of thinking. I gave up medicine for design, and I want to know if I even needed to make that choice.” @joyclee
  35. 35. I think in my institution since they don’t know what design is, I am better off being a doctor who practices design as designers wouldn’t even be able to set their foot in the door (they would never know to hire one!), I can be a “peer” or “one of them” that can hopefully help convince them of the ROI. But that’s inside a healthcare delivery system.” @joyclee
  36. 36. “I do think that there is a lot about medical school that is a pain; but it does gain you credentials, a deeper understanding of the “mindset” of medicine, and continuous exposure to users. Being immersed in that is very instructive from an ethnographic point of view. I only have clinic a few times a month. I savor those times because I always learn new things.” @joyclee
  37. 37. “One last thing, I do think systems design is important for design and in particular learning health systems. When you are trying to move outcomes and move multiple levers like policies, recalcitrant medical professionals, patients, it does sometimes help to have the clinical perspective and authority to guide the design and development of clinical medicine as well as patient experience.” @joyclee
  38. 38. DESIGN IS A MINDSET Don’t accept the status quo DESIGN IS A MULTILAYER PROCESS DESIGN WITH PATIENTS AND CAREGIVERS @joyclee
  39. 39. www.doctorasdesigner.com Medium: https://medium.com/@joyclee Twitter: @joyclee joyclee@med.umich.edu Ashley Garrity, Emily Hirschfeld, Valeria Gavrila, Michelle Wichorek, Lilia Verchichina, Dorene Markel, Amy Ohmer, Jacob Dwyer, Ram Menon, Pediatric Diabetes Team ACKNOWLEDGMENTS @joyclee

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