Designing Healthcare - Cumulative research approach
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A human centred design approach to designing GP clinics in Australia
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Designing Healthcare - Cumulative research approach
- 1. Designing healthcare Dina Goebel & Belinda Tobias
- 2. AGED CARE OPTICA L DENTAL MEDICAL HEALTH INSURANCE
- 3. We practice human centred design to deliver innovation.
- 4. In partnership with our clients and their customers, we conduct research to uncover opportunities.
- 5. We design with human behaviour in mind and deliver products and services that people enjoy using to achieve the outcomes they want.
- 6. WHAT Define the ideal customer experience for GP visits
- 7. WHO • Top 5 chronic conditions • Recently moved • Recently had a child
- 8. HOW 1. Metaphor Elicitation 2. High level story cards 3. Journey mapping 4. Word association A cumulative research approach
- 9. 1. Metaphor elicitation Eliciting emotive response through visual metaphor. Metaphor We are asking our brains to re-cognise what we know and apply it to something new.
- 10. Metaphors Using a sledge hammer to crack a nut
- 11. Metaphors This homework is a breeze
- 12. Metaphors I took her words to heart
- 13. Metaphors Some health related ones Battling heart disease Fighting cancer I had the life sucked out of me
- 14. Metaphors One from the research Doctors make me sick
- 15. 1. Metaphor elicitation We provided the candidate with a choice of images to choose from to create their health care story.
- 16. 1. Metaphor elicitation The use of visual imagery and metaphor allows them to more accurately introspect and explain their emotional experiences.
- 17. 2. High level story cards Story cards are used for initiating conversation in a one-on-one interview, especially around sensitive topics, and drive momentum throughout the exercise so it can be completed in a pre-specified time.
- 18. 3. Journey mapping The purpose of this exercise is to document the experiences people have when visiting a GP Clinic. This will highlight opportunities for improvement.
- 19. 4. Word association Free word association brings up the most evocative image or metaphor the participant will relate to the brand without thinking about it. Defined word association is a more conscious process. When used with intensity cards, it provides a focus for the feeling toward the brand.
- 20. Synthesis: Analysis: Detailed examination of the elements or structure of something The combination of components or elements to form a connected whole
- 21. Outputs: Design principles Customer journey map Opportunity areas Design framework
- 22. Designing healthcare Dina Goebel & Belinda Tobias
- 23. australia@tobiasandtobias.comemail | 0403 290 715phone | tobiasandtobias.com.auweb | @belinda81025423twitter |
Editor's Notes
- Thank you, my name is Dina Goebel and I am the Program Delivery Manager for Bupa Medical. Bupa is a broad based health and care company – we offer optical, dental, medical visa services, aged care, Bupa Medical and health insurance. Last year through Bupa Medical (a GP service open to all members of the general public) we began to explore opportunities in how we can co-ordinate and integrate people’s journey through the health system which spans the whole spectrum of activity from General Practice, allied health, nursing and counselling services. We have a vision to deliver not only thorough consultations but a caring and personalised experience to the general public and are working to streamline the service delivery of GP Services because driving innovation in healthcare is part of what we do. Bupa is focused on achieving and delivering exceptional customer value and business ROI faster and more reliably by using deep customer understanding to inform decisions and design. Our customer centred approach is a core enabler to achieving our purpose of becoming longer, healthier, happier lives, by being a true health and care partner who is ‘Loved by customers’. In opening our first GP clinic in Sydney last October, our customer experience design profile was developed by the team of health professionals in our Australian Bupa Medical Office. Drawing on significant professional clinical, hospital and local GP practice experience, the Medical Directors were able to articulate a list of innovative customer experience design strategies to be developed over successive clinics. This was a great starting point but the untapped potential was to complement this knowledge with understanding the experience that patients were seeking during their next GP visit. With Australia’s healthcare delivery evolving from a complex, knowledge driven ecosystem determined mainly by medical specialty, the general public may have rarely experienced customer-led design in their local GP Practice let alone having even thought about it. When was the last time someone asked you about your last GP experience? To make a difference in Bupa’s GP Services, I required ‘customer-led design’ to ensure we continued to innovate towards a caring and personalized service. Our CX Design team engaged with all core stakeholders to understand the gaps in knowledge from the customer perspective that the project had; from here we understood that the GP Clinic project was to obtain and utilise customer insight that can inform both: The development and or validation of a strong CVP, The overall patient experience delivered throughout the end to end GP clinic lifecycle. The focus of the workshops was to also share the learning’s gained, to ultimately benefit the delivery of GP services and overall patient experience. By exploring existing and new insights, we sought to understand the end to end patient experience, from initial needs, through to engagement, service delivery and exit. By capturing the key moments of delight, pain points, moments of truth and opportunities of the ideal GP patient experience, we could begin to define how to build and cement a strong GP patient relationship, creating advocacy and differentiation of the Bupa experience.
- Thanks Dina, Hi I’m Belinda from Tobias and Tobias. We are a strategic design consultancy with offices in London and Sydney. And finding out what customers really think is what we do.
- We know good design provides a competitive advantage; human centered design is a way of solving business problems, providing strategy and innovating and puts understanding people, at the heart of design
- We believe making products and services people love, achieving the outcomes they want, can help make the world a better place. In Bupa we are very fortunate to have a client who thinks the same way. Bupa have deep experience and medical expertise. Our challenge was how to support them with insight from a patients perspective. We’ve all been a patient And there is undoubtedly fabulous practitioners out there that people love, but customer service is not what you immediately associate with a GP clinic experience, at least not in a good way. So that’s what this research project is all about, to define what good looks like. What is the ideal customer experience for GP visits.
- So how do we research this, given the sensitive nature of the subject matter? We do a lot of ethnographic research to deeply understand what people really think, feel and do in relation to a particular product or service, often by going out into the field and observing and talking to people in context. Understandably, this approach would not have worked given the confidential nature of people having a health consultation, We’d needed insight into people’s GP experiences and we needed research methods to overcome not being able to observe them in context. We also understood that it was important for us to provide information fast, so that Bupa could use it as a basis, to support the design of future clinics, get the right skills in their team and implement the right processes to support their growth over the short and long term.
- So to kick off we needed to know who to talk to. Together through a stakeholder focus and scope workshop we defined our research cohort as people with a high frequency usage and who either have a chronic condition, one of the top 5 or who had recently moved or had a child. Frequency was important because we wanted to talk to people who had a lot of recent experience with GPs
- We then settled on 4 research methods, a cumulative approach, which builds over the session to a rich and detailed picture of a person’s health care journey. I conducted two-hour deep dive discovery sessions with each participant, starting with Metaphor elicitation.
- This technique is effective because Metaphors are are so tied up with our creation of meaning. We use as many as 6 metaphors a minute whilst speaking. We use them so often they are practically invisible. Because they overlay the meaning of one thing onto something not literally related, we are asking our brains to re-cognise what we know and apply it to something new. It has a scaffold effect creating a network of analogies and a rich and new meaning Common metaphors are often visual, visceral and vivid and are a short cut to complex meaning.
- Here is an example
- They create powerful memorable images in your mind. We used the image-based technique of Metaphor elicitation to tap into this.
- Using images as metaphor for peoples experiences. We provided the candidate with a choice of metaphor pairs to choose from to create their health care story. They created a collage of images that represent something to them and then they described to me why they chose them and what they mean to them. It uses the power of images to create meaning and tap into emotions that are not normally accessed in an interview situation. It helps circumvent self reporting that adheres to what people think you want to hear rather than their unconscious emotive responses. Which is what we really want.
- One example of how this worked in this research was when one participant chose an image of water. She described it as something she loves. It is health giving, she drinks it, she swims in it and it eases her pain. She felt it was something she could do for herself to help feel in control of her condition - chronic arthritis. It was natural which is very important to her and she loved everything associated with water. Another participant chose the same image of water and related to me how it represented how overwhelmed she felt with her condition and coping with her life.with Diabetes. It was all too much. Very different interpretations of the same image but both rich in their emotive content, story telling and insight -- particularly in relation to - how in-control they felt in their health journey and how important that was to them. And that was in the first 20 minutes. And really got things going It turns out people love talking about their health journeys
- So to keep it focused the next exercise was a rapid question and answer session, High Level story cards. This allowed us to put all the responses into context of a ‘from the start to now’ stepped progression in a very time effective way. The method is to give the question card to the participant to read aloud and they have one minute to answer. There were 10 question cards. So that was pretty straightforward and gave us a great sense of people’s health journeys in the greater health care eco-system and where General Practice fits into that. Sometimes this broke out into longer discussions where major pain points in the journey were identified.
- We then moved swiftly on to Journey mapping. A deep dive into the detailed recall of every stage of their most recent GP experience. This took the bulk of the two-hour sessions. This starts with triggers and the reason for the appointment and all the detail of that and the on to how did they chose the Doctor and all the considerations involved in that, then on to how the booked what happened at reception, what they thought of the waiting room the consultation, acting on the advice and beyond. and having started with metaphor elicitation the open and emotive responses continued. We captured everything from what they thought of the smell, the parking and the receptionists the walls the floors and of course the GP. It became a way for people to compare their various experiences Good and bad and remember what it was they disliked and why -- and what was loved and why. It’s hugely valuable for us in creating solutions that are detailed and actionable.
- we wrapped up with the culminating exercise word association. This was simply a ten-minute exercise in emotive response to the idea of Bupa providing GP services and then choosing intensity cards to describe their reactions. This allowed us to test the water and sense the range of reactions that ‘the offer’ might elicit on first encounter and to understand where that was coming from.
- So having accumulated a large amount of data on post it notes we then went to work to make sense of it all. We mapped common themes, did a lot of analysis and then synthesis we were able to pull out design principles and insights and turn those into areas of opportunity. These were mapped against the journey stages and delineated into actionable areas of: environment, people, processes and artefacts. Making it possible for Bupa to create an excellent customer experience informed by evidence.
- also a great contributor to its success of this project was the commitment of the Customer Experience and Insights team, Jess Heidi and Hannah to be involved in the deep dive sessions, to hear the feedback verbatim. We also had daily debriefs with stakeholders. The aim was to involve all the stakeholders as frequently and as much as possible and to transfer as much of the benefit of the research of achieving empathy for real customers as we could. This works well because when we talked about potential solutions, everyone knows where it’s coming from and has the customer in mind. So its back to Dina to talk about where we went from here Thanks Bel. The team at Tobias & Tobias were able to articulate their findings in a terrific series of engaging info graphics which replicated the customer journey. The info graphics identified key aspects which customers desired, areas for improvement and the emotive stages of the customer experience during their GP visit. I was delighted they were able to achieve not only an Australian first research, but developed a debrief process which we were able to utilize across our organization. With our internal CX team we decided to separate the findings into People, Environment, Artefacts and Processes. This was further split in short term and long term activation programs and business unit specific debrief papers were developed. Along with the Tobias & Tobias team, we then engaged the various business streams to conduct detailed debriefs. In particular: a detailed brief with our Properties team and their architects; one for the HR team including the Medical Office, recruitment and training teams; of course Marketing and Operations; and then compiled a process innovation summary which included the IS and future state components. In this way we were able to engage the entire organization to be constantly developing our General Practice services in a consistent and customer-focussed way. We now have a set of clearly defined CX design principles that can be applied to any opportunity and a clearly defined roadmap to achieve a refined CVP for the ideal future state. Critical to any programs success is customer feedback and a Voice of Customer mechanism for patients was also established in parallel to capture feedback on the experience within the existing GP clinics. This will provide metrics to assist in evaluating what is working well and what needs a focus for improvement – and to track these over time. It has been a pleasure to develop a customer focussed business from ground zero using a customer design perspective. We are now assessing our findings from this unique research to see how we can use these learning’s across our broader health services business. Thank you for allowing Bel and I to share this project with you.